Knee Pain That’s All in Your…Hip?
Many years ago, I began an evaluation of a new patient who was complaining of sport-related knee pain. Here’s how the first few lines of questioning went:
Me: Good morning, “Mr. Smith,” what brings you to into physical therapy today?
Patient: I have pain in my left knee.
Me: Where in the knee do you feel the pain?
Patient: (He points to the outside border of his left knee.)
Me: And when do you experience this pain?
Wait for it…
Patient: When I load up my barbell with 600 lbs., place it on my shoulders, and lower into a squat. When my hips get lower than my knees, that’s when I experience a sharp pain on the outside of my knee.
Yeah, I bet you’re thinking what I was thinking back then. MAYBE YOU ARE NOT SUPPOSED TO DO THAT! Well, I did not say that because this man was a professional weight lifter and he had to do that.
So, I did what I do with all of my knee patients: I tested the strength of his outside hip muscles—even though this guy had muscles on his muscles! And what do you know? His left gluteus medius (outside hip muscle) was significantly weaker than his right. This is a common problem because the gluteus medius is not a “mirror muscle.” Athletes don’t contract it and admire its reflection, if you know what I mean.
I began his treatment by massaging/releasing the muscle spasms which were present within the muscle (from being asked to do activities that were too difficult for it). Then he and I began the process of strengthening his weakened muscle—first, in non-weight bearing (side lying) and finally in a weight bearing (standing) position.
And voila! As soon as normal texture, tone, and strength were restored to his left gluteus medius muscle, my patient no longer experienced knee pain with weight lifting—even though he fully resumed his herculean efforts!
If you have nagging knee pain, make sure that your gluteus medius* is in tip top shape because weakness in this muscle will adversely affect your knee joint mechanics and eventually land you in the place of pain.
*For gluteus medius exercise instructions and photos, search the web, or see my Overcoming Back and Neck Pain or Get Healthy for Heaven’s Sake books.