injury · running

Moralizing body parts and physiotherapy

I’m still working away at physio. Progress is being made. My knee hurts less and that’s a very good thing.

I’m amused though at the language physiotherapists use to describe body parts. Apparently I have lazy glutes and as a result have an angry miniscus.

Here’s one of the glute strengthening exercises I’m doing.


Makes sense that if one body part isn’t doing it’s share of the work, that other body parts do too much.

But is that right? I read this week in Runners World that the glute-knee connection is more complicated than you might think. See this article on hip weakness and knee pain.

If you’ve got knee pain, you might need to strengthen your hips. That’s an increasingly common prescription these days, thanks to a bunch of research over the past decade or so linking conditions like runner’s knee (also known as patellofemoral pain, or PFP) and more recently iliotibial band syndrome to sub-par hip strength. But there’s a key question lurking behind these studies: do you develop knee pain because your hips are weak, or do your hips get weak because your knees hurt and you’re forced to alter your movement patterns?

In my case physio seems to be working, or it might be that just not running is the thing that’s helping, so I’ll keep it up. Ready for a very short, gentle run soon to try it out. Wish me luck!



6 thoughts on “Moralizing body parts and physiotherapy

  1. HI Sam– good luck with the physio! I have had knee pain intermittently for a long time; first time was connected to IT band problems, and now have garden-variety PFP. Increasing my cycling has helped, and I do that exercise you showed, plus other hip flexor and quad strengthening exercises. It really helps. Am wondering if I can give gentle running a try again– it’s nice to have it as an option.

  2. I would assume your PT would mention this, but in case they didn’t: the knee going valgus (inward) during a squat seems to be particularly common among women. I’m told that it’s a symptom of weak glutes relative to quads (and maybe hammies). I believe the valgus knee is implicated in at least some knee pain.

    My basic thought is that moving through the range of motion by squatting with good form (crease in hip below the top of the patella at the bottom of the ROM, push back with the butt rather than forward with the knee, upright torso, knees out) is a pretty good way to start developing glute strength. (If you’re able to squat with a barbell on your back, that’s even better, though it may not be within reach for everyone.) The knees-out movement pattern may take some practice, but it seems pretty helpful in reducing knee pain. And the squat, of course, is fabulous for strong glutes.

    Also, Kelly Starrett’s Becoming A Supple Leopard is a great book for athletes who want to reduce pain or become more efficient at movement, and become athletes again.

  3. Goood luck, Sam. Getting injured sucks! Amazing that you’re rolling with the punches so well!

  4. I think the answer to your question is much like the chicken vs. egg. Your body works in kinetic chains, so it’s probably a result of both. If you haven’t been working certain muscles, but overworking others you’ve probably created some serious imbalances that lead to pain and weaknesses that exacerbate that pain. I love bridge exercises and especially when you work up to bridging on a physio ball or one legged bridges on a physio ball with hamstring curls! I’m a sucker for a good painful glute exercise. I too suffered several years of knee/IT band/glute problems. Squats, bridges, and good yoga over the years have helped work it out. I’d talk to my PT about some pigeon stretches as well.

  5. I hope it went well! The amount of time I have spent doing clamshells and glute raises and laying on a table at Fowler is almost silly! Knock on wood, deep squats have helped, and the mobility issues I’ve identified through CrossFit are all information to help me try to prevent injury! Good luck!!

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