Common Muscle Imbalance of the Knee (Patellofemoral joint)
Identifying this common muscle imbalance is key for treatment of hip/thigh/knee pain, and also for injury prevention! Vastus lateralis (lateral quadricpes) is dominates Vastuc medialis Oblique or otherwise known as VMO.
Due to it’s flexion and abduction functions and role in pelvic stability when weight bearing on one side, the TFL is used extensively when running. This can lead to it becoming overworked/overactive, especially if other abductors and stabilisers, such as Gluteus Medius (glut med), are not working effectively.
It is common to observe this imbalance by watching someone walking, running, or single leg squat. Common observations of someone with a tight lateral quad, may be poor development of medial quad compared to lateral quad. Medial knee position common, ie) knock kneed potentially
May see the patella sitting high ad laterallymedial drift of the knee as goes into a squat positionAlso look for lack of control (wobblinessaroud knee)
Person may complain of pain in the outer aspect of the knee, or under the knee cap, or above or medial side of the patella, Person may complain of pain or gridnigsounds under the knee cap with loading such as lunges, squats and stairs.
It is important to address the overactive muscle Vastus lateralis with with rolling, trigger point release, and stretching of lateal quads and of ITB. Correcting muscle imbalances around the hip are important to help reduce the stress on the TFL. Developing strength in the other hip abductor muscles is a good place to start. Strengthening glut med in isolation to master the activation of this muscle and then integrate into functional movement and strengthening. Tight hip flexors may also result in inhibition of glut max, and consideration into retraining other muscles around the hip must be given.