There are tons of lifters who suffer from knee problems. Knee problems don’t have to happen. I feel obliged to tell people that problems at the knee mean that you don’t have proper mechanics. You simply are squatting, deadlifting or running wrong. Now it is not the end of the world. I know that nobody wants to hear this, but you are going to have to back off the heavy weight and really assess your form and correct your imbalances in order to fix your knee problems. Otherwise they will just keep creeping up on you and ruining your life.
How Muscles Control The Knee
The knee itself only does one motion, flexion/extension. That’s it. So unless you have some genetically abnormal knee, yours is probable not going to do much more. The ironic reality is that most knee problems are not actually problems in the knee.
To word that another way, you may be experiencing pain in your knee, but it might not be the actual source of the pain. The source usually comes from the two joints that sandwich the knee, i.e. the hip and ankle.
The muscles that attach to and interact at these joints have a direct effect on the knee because of its location. A balance in strength and mobility must be maintained between all of these muscle groups. When an imbalance occurs, we get movement dysfunction and knee problems.
How Imbalances Can Lead To Knee Problems
The muscles that attach at the hip and the ankle also interact at the knee. If we have a strength imbalance at anyone of these muscles, then we put the knee at risk for injury.
Take the squat for example. If somebody squats down to the floor with their heels on the ground, then their knee will become stable and they will not experience any acute knee pain. But, if the heels come off the ground, then the knee becomes unbalanced and pain is usually the result.
Let’s take a closer look at these muscles.
Quads And Hamstrings
The quads and the hamstrings are like the biceps and triceps. One side is supposed to be stronger than the other (triceps) and one side weaker (biceps). If the reverse happens, then elbow pain is almost guaranteed.
In the thigh, the quads are supposed to be stronger than the hamstrings. Usually for most people, the opposite is usually the case. This is usually due to two things: Poor posture and sitting for too long.
When we sit for long periods of time, the hamstrings become tight and shortened. This pulls the pelvis downward. In order to compensate, the lower back has to tighten up in order to stabilize the pelvis. When a person then stands up, or performs lower body exercises, they carry these bad mechanics with them. As a result the hamstrings become overworked and become too strong for the quads. The knee then becomes unstable.
There are also problems with the quads themselves. The quads are made up of 4 muscles. One of those muscles, the Vastus Medialis Oblique (VMO) is crucial to knee stabilization. Most individuals with tight hamstrings have a difficult time activating this muscle due to the tug of war contest between the two.
The gastrocnemius, or calf muscle, also contributes to knee function. When standing, this muscle helps to unlock the knee in the first few degrees of flexion. If however, the calf muscle is tight, then lower body mechanics may become compromised.
The calf muscle originates on the two condyles of the femur, at the knee, and attaches via the achilles tendon at the base of the foot. When this muscle gets tight, the mechanics of the foot are thrown off. The foot will turn out to the side when walking. This then causes the mechanics of the knee and hip to be thrown off as well. Suddenly, a small inconvenience becomes a big problem.
You can always spot somebody with tight calves by the way they squat. If they have a hard time keeping their heels on the ground when they squat, then they have tight calves. Now compound this tight pulling on the knee when running and jumping.
Take time after every workout, when warm, to stretch your calves.
The adductors are responsible for moving the leg inward. One of the adductors, adductor brevis, helps to stabilize the knee and hip during hip flexion. If this muscle becomes under active, then the pelvis may develop a lateral tilt.
Although this may look harmless and irrelevant to knee problems, it surely is not the case. When the pelvis develops a lateral tilt, it places more pressure on one knee and less pressure on the other. If you have recurring injuries on the same knee all the time and don’t know why, you may have a laterally tilted pelvis.
The tricky thing about this movement dysfunction is that the body is really good at hiding it. During squats or jumps, your body will level out your pelvis, but it will dump the imbalance on one of your knees.
The IT Band is a long tendon that runs along the outside portion of the leg. It is responsible for stabilizing the leg and the outside of the hip particularly during unilateral exercises. The key role of the IT Band, however, is to transfer force from the ground to the glutes. So in a way the glutes are really stabilizing the outside of the leg and the IT Band is just the mechanism.
This is important. If the glutes turn off, when walking or running, then the IT Band, along with the tensor fascia latte, will try to take over the role of the glutes. The IT Band will become overworked and tight. Thus leading to the infamous IT Band Syndrome.
Anybody who has IT Band syndrome will experience a sharp pain on the outside of their knee when running or jumping. Reactivating the gluteus medius and strengthening the gluteus maximus will help to resolve the problem. In the short term, put in the work and foam roll the outside of the leg.