Got knee pain?

Today I wanted to talk about knee pain. A patient recently presented with knee pain in both legs after an increase in running. This is a common presentation of sport people who increase their training session frequency or duration, so I was confident to have a look around and find the cause/s.

Nothing in our body works in isolation, so it’s prudent to consider other joints and muscle groups when dealing with pain in a certain area.

Knee pain can be injury to the knee itself, e.g. falling onto the kneecap or a blow to the knee cap, but most commonly it is part of sequelae of another dysfunction/s.

After a bit of hunting around I noticed my patient’s gluteal muscles were weak on both sides, more so the right. I started by resetting the nervous system using Chiropractic adjustments, with a special focus on activating the abdominals and showed him through the following gluteal strengthening exercises.

Before you jump in to these exercises it is important to be assessed by your Chiropractor to determine if it is inactive gluteal muscles or whether there is another dysfunction that is causing your knee pain.

clamshell.jpg
  1. Clams

    A great strengthener isolator of the gluteus medius muscle, which is often weak in this pain profile.

    Start by lying on your side, supporting your head with a bent arm or a pillow, bending your legs and stacking your knees on top of each other. Look down at your hips and make sure that they too are stacked and not leaning backwards.

    Open your top leg by raising only your knee and concentrate on contracting your gluteal muscle. If you are unsure put your top hand on your glutes and feel the muscle squeeze.

    Aim for 15-20 raises each side, but only go as many repetitions as you can feel your glute contract. If it stops contracting you’ve reached your limit!

prone heel squeeze.png

2. Prone heel squeeze

This exercise works the glutes and low back muscles and inhibits contraction of the hamstring which can be big compensatory muscles for the gluteals. When the gluteals aren’t working your hip stability is also reduced which means you may get sorer running on uneven surfaces like the beach or a trail. Additionally the increase in frequency or intensity of running (or another sport) can exacerbate dysfunctional hip joints and lead to low back or hip pain.

Start lying on your tummy in this exercise with your chin resting on your hands. Open your knees so that they are about as wide as a yoga mat and then touch the ankles together.

Squeeze the glutes to push the knees upwards and feel for the contraction. Like the first exercise continue the repetitions until you lose the contraction. Aim for 15-20 heel squeezes.

glute bridges.png

3. Glute Bridges

Finally a glute bridge is a great all rounder and as you lower your hips to the ground you work your abdominal muscles too!. There are many variations of the glute bridge to target particular muscle groups, but the aim of this particular glute bridge is to work all of the gluteus muscles - maximus, medius and minimus.

Start by lying on your back with your knees bent so your heels are close to your glutes. Slowly raise the hips high by squeezing the glute muscles, whilst keeping the thorax (mid to upper back) and neck in a straight line. Feel again for the contraction and stop when the contraction moves into the hamstrings or low back. Slowly lower yourself down to the mat again. Aim for 15-20 repetitions.

Do 3 rounds of these exercises 3-5x per week

Enjoy, Dr Alexandra

Dr Alexandra