Dooley Noted: 9/14/2015
This weekend, I taught NeuroKinetic Therapy (NKT) I in New York City. Our wonderful teaching team showed students the relationships between hip structures and the knee.
Now that the research has finally stopped blaming Vastus Medialis (VM) for most of knee problems, the attention has been put on Gluteus Medius (G Med).
Through its ability to properly compress the hip, G Med helps to control the valgosity of the knee. This frontal plane stability protects the medial knee structures from being hammered as the knee goes uncontrolled.
But G Med doesn’t deserve all the credit.
Gluteus Maximus (G Max) and the Tensor Fascia Lata (TFL) connect to laterally to the knee via the iliotibial band. They provide lateral control of internal knee rotation.
G Max also promotes lateral and sagittal knee stability in the propulsion phase of gait. (Think: back foot / toe off.)
G Max is the strongest muscle of the human body. It’s also one of the most functionally inhibited muscles even with its power potential.
Many of us sit on it too much throughout our day, not utilizing its potential.
Many of us hinge through the lumbar spine instead of the hip, deactivating G Max and impinging its innervation from the lumbosacral spine.
If G Med rehab is not quite alleviating knee pain, consider these relationships with Gmax inhibition for knee control:
1. Overactive TFL
2. Overactive knee internal rotators (i.e., semitendinosus, gracilis, sartorius, popliteus)
3. Overactive foot pronators
4. Deep lateral rotators being used in place of GMax
5. Talocrural and Subtalar joint issues, preventing transition from pronation into supination
6. Problems controlling the knee on landing and propelling
7. Dominant hamstrings and calves, especially in sagittal plane movement
Since GMax crosses the knee, the muscle must be included in your knee differential diagnoses.
As always, it’s your call.
– Dr. Kathy Dooley