Weakness of the Quadriceps Muscles
It is pretty unusual to see some with knee pain and just have week quads. Weak quads usually accompany some other combination of pathologies. If you have just weak quads it is probably a lingering weakness from a previous injury which has not been completely rehabilitated.
History: Your history is remarkable in that it is pretty boring. No injuries. No pain. You just have relatively weak quads. As runners, we to 10 billion push-offs to the back and our hamstrings are always disproportionately strong compared to our quads. Quad weakness can lead to a poor knee position at heel strike and lead to knee pain.
Self-Examination: When you stand in front of the mirror you don’t see anything unusual. You may have poorly developed VMOs (the teardrop muscle on the inside of your knee just above the kneecap). When you do any strength training you just do not lift as much weight as someone with a similar build.
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When you stand in front of a mirror you may see a difference in the size of your quadriceps muscles, especially the muscle on the inside of your knee, just above the kneecap. (Some runners know this muscle as the Vastus Medialis muscle, VMO)
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If you are in the gym and you complete single leg exercise for both the Left and Right, one just does not generate ad much strength as the other
Stand with one leg of a stair and complete as many step-ups as you can. Then repeat this exercise with the other leg. If you have weakness of one quadriceps muscle, you just cannot complete as many reps on one leg. Or, you just do not have as much balance or control with one leg. VID
TREATMENT
Manage The Pain
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NSAIDS will help. Kinesiology taping to stabilize your knee until you get your strength back. LIN Over-the-counter knee sleeves usually do not help at this stage.
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Continue running but avoid aggressive speed work and hill repeats, especially downhill running.
Restore full motion
Most of the time, weak quads do not lead to any limitations in range of motion. Be sure to check the flexibility of your quads and hip flexor muscles. LIN If they are tight the sequential short-term stretching will feel great.
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Stretching does not have to be part of your warm-up or cool-down. But it HAS to be part of your training program.
Begin non-weight bearing exercises to restore strength without all the pressure on the joints
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Most exercises involve minimal movement of the knee joint to reduce pressure on the joint as it recovers
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My favorite is KISS. Keep it simple Sam (Or Samantha)
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The basic knee exercise is the static quad setting with your knee fully extended. About 10,000 per day. Okay, not that many, but you get the idea. LIN LOTS
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Other great exercises you can do at home are: Straight leg raise, Short arc quad and, Static hamstring sets
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You will not be at this level very long; we just need to increase your strength while minimizing stress on your knee and making absolutely sure you can lock your knee with control.
Correct running mechanics
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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.
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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
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If you have pain with your strength training, you can apply the kinesiology tape to your knee before you start your weight-bearing exercises.
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These are done slowly, with a short range of motion, and STOP BEFORE IT HURTS.
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Wall-slides, sit-to-stand, static lunges, lateral step-ups, etc. LIN
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If you can, complete these in front of a mirror so you can watch your knee stay in track above your foot.
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Knee extension exercises, if done correctly! Watch this video. VIDEO
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When you do not have any stupid side-to-side movement of your knees when complete your exercises correctly you can progress to more aggressive exercises like dynamic squats, Bulgarian split squats, Romanian dead lifts, etc.
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As soon as you can step down from the stair without pain or complete a deep squat without pain, you can progress to your regular strength training and running programs.
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Continue to tape your knee before your hard workouts if you have pain.