Weakness of the Hip Abductor Muscles

Weakness of the hip abductor muscles on the OPPOSITE side of your painful knee:

It is pretty common to have weakness in the knee on your strong side. Since the hip on the weak side is not holding up its part of the work, the knee on your strong side begins to hurt because it is doing all the work and getting tired.

Self Examination: This is the same exam as for weakness of the gluteus medius on your painful side. You do not see anything when you are just standing in one place. It is only when you move do you notice the weakness.

Stand in front of a mirror. If you shift your weight from one leg to the other, you will notice your hip drop when you stand on the weak leg. VID
When you perform mini squats, your weak side will dip lower to the ground because the weak gluteus medius gives away, letting it drop lower than the other side. VID
When you run on a treadmill this hip drop is even more evident. VID

TREATMENT

is exactly the same as for butt weakness on your painful knee. Since I personally hate it when a website says ‘Go to some other location.’ I have put the treatment here again.

Manage The Pain

NSAIDS will help. Kinesiology to the full length of your sore IT band will help. LIN
Kinesiology tape ‘star’ to the butt PHOTO
Continue running but avoid aggressive speed work and hill repeats, especially downhill running.

Restore full motion

A lot of patients with weakness of the gluteus medius have tight IT bands. Either the stong or weak side may be tight.
Make sure you include stretching all your muscles as part of your training program. SST VID
1. Stretching does not have to be part of your warm-up or cool-down. But it HAS to be part of your training program. LIN

Begin non-weight bearing exercises to restore strength without all the pressure on the joints

Most exercises involve minimal movement of the hip. Our knees are supposed to stay below our hips when we run so the common exercise you see in the gym, the cable leg machine is NOT what you should be doing.
My favorite is KISS. Keep it simple Sam (Or Samantha)
1. Great exercises you can do at home are: clam shells, side lying hip abduction with band around legs, side bridges with weak leg toward ground.
You will not be at this level very long; we just need to increase your strength while minimizing stress on your knee.

Correct running mechanics

Gradually return to your previous running. Start on relatively flat ground or even on a treadmill. The best part of returning to running with a treadmill is that you can actually hear your footsteps. Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move. If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running. Listen and ‘feel’ how you run. Is one leg hitting the ground harder than the other? Does one arm swing differently than the other? Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.
As soon as you can run without pain and without a limp you can return to your normal running routine.

Return to running speedwork and hills.

After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

My favorite step, get back to full running!

Have fun. Eventually you will bust something else and be back to the website to fix that.

If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do. We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.

Call for a free injury screen.

817.205.3204

Begin body weight exercises with emphasis on control versus strength and power

Apply the kinesiology tape to your knee before you start your weight-bearing exercises. LIN
The basic ITB exercise is standing hip abduction. This video shows you wearing the shoe on your weak leg. Take you strong leg to the outside just a little bit. You do not run with your feet far apart. This exercise should keep your legs in a position similar to your running position. Even though your strong leg is doing most the movement, your weak leg has to hold your entire body weight. By the time you do 25 reps, your gluteus medius (butt) will be telling you it is working. VID
- Start this exercise using both hands to hold the counter to help your balance
- As you get stronger, let go with the with the hand opposite to your standing leg
- When you get better, hold on with the hand on the same side as your shoe
  - Progress to 25 reps without any hands. Look ma, no hands.
These are done slowly, with a short range of motion, and STOP BEFORE IT HURTS.
The important part of this exercise is to keep erect body posture! Leaning to your right or left will completely change the exercise VID
- Wear one of your dad’s old ties. If it hangs to the right or left, you are not upright
If you can, complete these in front of a mirror so you can watch your knee stay in track above your foot.
As soon as you can complete 24 reps without holding onto something for balance and you can keep your posture, you can progress to your regular strength training and running programs.
Continue to tape your knee before your hard workouts