Tight Glutes Can Cause Knee Pain and Here’s Why

 

Do your knees ache when you walk, run, or climb stairs? Do you feel a dull, nagging pain behind your kneecap or on the sides of your knees? If you nodded yes, your glutes could be to blame.

Did you know your glutes play a crucial role in stabilizing your knees and absorbing impact as you move?

When they’re too tight or weak, that strain gets transferred to the knees, setting the stage for injury. Sore, creaky knees might seem like just a sign of aging, but often tight glutes are the real culprit.

How Flexible Glutes Protect Your Knees

The gluteal muscles, commonly known as the “glutes”, are some of the most important muscles in the body. They consist of the gluteus maximus, gluteus medius, and gluteus minimus. These large, powerful muscles control hip extension, abduction, external rotation, and stabilize your pelvis and spine.

When your glutes are weak or inactive, the muscles of the hips and thighs must work harder to compensate. The extra stress can lead to strain, fatigue, and eventual pain or injury. Tight, shortened glute muscles can also restrict range of motion and pull your pelvis out of optimal alignment.

In essence, healthy, strong glutes help you move properly, absorb impact, rotate, and extend your hips fully. They also help your knees, hips, and lower back not take on too much load. Keeping your glutes flexible is crucial for injury prevention, athletic performance, and comfortable movement as we age.

Although your glutes are located in the buttocks/hips region, tightness or dysfunction in these muscles can manifest as knee pain. Here’s why:

Altered Alignment and Biomechanics

When your glutes are tight, it pulls your pelvis into an anterior tilt, causing an arch in your lower back. A pelvic tilt also internally rotates and adducts the femurs (thigh bones), causing your knees to collapse inward.

This altered alignment places more stress on your knee joint and surrounding structures. It also changes the biomechanics of your lower limb – the way forces transfer through the joints during movement. With tight glutes, there is less control over hip extension and rotation, so you get more shear and rotational forces going directly through to your knee.

Over time, this uneven distribution of forces can lead to knee injuries like patellofemoral pain syndrome (PFPS), iliotibial band (ITB) syndrome, and patellar tendinopathy. PFPS often presents as dull, aching pain behind or around the kneecap when walking, running, or going up and down stairs. The cause is an imbalance in strength or flexibility that pulls the kneecap out of proper alignment.

Iliotibial band syndrome causes lateral knee pain due to inflammation of the IT band, often brought on by overuse. Patellar tendinopathy refers to irritation or degeneration of the patellar tendon below the kneecap, leading to tenderness and discomfort especially when jumping or landing from a height.

The common thread among these conditions is that imbalances or weakness in the hips and glutes forces the soft tissues around the knee joint to take on more strain. Over months to years of wear and tear, they become irritated. Ensuring proper flexibility, strength, and activation of the glutes helps take pressure off your knees. By keeping your glutes flexible, you can prevent many types of anterior, posterior, and lateral knee pain.

Muscle Imbalances

Then there’s the problem of muscle imbalances. Tight or weak glutes can also cause muscle imbalances around the hip and pelvis. The glutes normally work together with core muscles like the transverse abdominis to stabilize the pelvis.

When glute strength and flexibility decline, other muscles like the hip flexors, adductors, and lumbar spine must work harder to compensate. This can lead to overactivity or tightness in these muscles, further pulling on the pelvis and femur into abnormal positions.

These muscle imbalances redistribute forces and cause uneven loads on the knee joint during movement. It’s a key reason why strengthening glutes and stretching hip flexors is an important part of knee rehab programs.

Reduced Shock Absorption

Your glute muscles provide shock absorption for your lower extremities during weight-bearing activities like walking, running, and jumping. They control hip extension as the leg pushes off the ground, absorbing some of the impact.

When your glutes are tight or weak, there is less shock absorption occurring at the hip. This means more force travels directly down the kinetic chain to the knee joint. Doing high impact activities with reduced glute function causes excessive loading on the knee over time, resulting in injury.

Here are some of the best exercises to improve glute flexibility:

Kneeling Hip Flexor Stretch – Kneel on one knee with the other leg out in front of you, foot planted. Push your hips forward until you feel a stretch in the front of your hip and hold for 30 seconds. Repeat on the other side.

Lying Figure Stretch – Lie on your back and cross one ankle over the opposite knee. Clasp your hands behind the uncrossed knee and gently pull it toward your chest until you feel a stretch in the glutes. Hold for 30 seconds, then switch sides.

Seated Pigeon Pose – Sit upright with one leg bent in front of you and the other extended straight behind. Hinge forward at the hips, keeping your back straight, until you feel a stretch in your glutes. Hold for 30 seconds, then switch sides.

Supine Twist – Lie on your back with your knees bent and feet on the floor. Let both knees drop to one side until you feel a stretch in your glutes and outer hip. Hold for 30 seconds, then repeat on the other side.

Bridge Pose – Lying on your back, push through your heels to lift your hips up into a bridge, creating a straight line from knees to shoulders. Go as high as you can to maximize the stretch. Hold for 30 seconds.

Aim to incorporate these glute stretches into your routine 2-3 times per week for the best results. Properly warmed up and flexible glutes can help reduce knee, hip, and back pain.

Conclusion

So now you know that tight glutes can change alignment and biomechanics, cause muscle imbalances, and reduce shock absorption – all factors that can lead to knee pain and injury. Focusing on stretching, mobilizing, and strengthening the glutes is crucial for improving function around the pelvis and knees.

References:

  • Kim EK. The effect of gluteus medius strengthening on the knee joint function score and pain in meniscal surgery patients. J Phys Ther Sci. 2016 Oct;28(10):2751-2753. doi: 10.1589/jpts.28.2751. Epub 2016 Oct 28. PMID: 27821928; PMCID: PMC5088119.
  • Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010 Feb;40(2):42-51. doi: 10.2519/jospt.2010.3337. PMID: 20118526.
  • Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009 Jul;39(7):532-40. doi: 10.2519/jospt.2009.2796. PMID: 19574661.
  • Hamill, J., Moses, M., & Seay, J. (2009). Lower extremity joint stiffness in runners with low back pain. Research in sports medicine, 17(4), 260-273.

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