When it comes to knee pain, most lifters will scrutinize the muscles surrounding the knee joint. This makes sense because the quadriceps and hamstrings do play a significant role in knee health. But the culprit might actually be located further from the knee. Specifically, the gluteus maximus and gluteus medius.
The gluteus maximus and the posterior muscle fibers of the gluteus medius are responsible for abducting (away from the midline) and externally rotating the hip joint. Likewise, they both aid in resisting adduction (towards the midline) and internal rotation. Weak glutes may force knee valgus (inward knee collapse), creating mechanical dysfunction and eventually pain.
These paradoxical exercises can help prevent and potentially eliminate knee pain.
There are several variations of lateral walks, like placing a band around the knees or ankles. However, researchers found that by placing the band around the forefeet, gluteal activation was higher compared to placing the band around the ankles or knees. This is because in addition to resisting adduction, your feet will have to resist inward rotation.
Start by placing a short band around your forefeet (balls of your feet) and taking a hip-width stance. Slightly bend at the knees and hinge at the hips until your torso is about 30 to 45 degrees. Begin taking side steps that are a few inches wide while keeping the feet forward and resisting knee collapse. Start with 10 steps in each direction for 2-3 sets.
There are many hip thrust variations, but I prefer the double band hip thrust. First, band resistance increases towards the end range of motion or the top of the movement. That's where the glutes activate the highest – at deep hip extension. Second, placing a short band around the knees increases maximum voluntary isometric contraction of the gluteus medius by encouraging external hip rotation (driving the knees out).
Begin seated on the floor with your back against a bench. The bottom of the shoulder blades should rest just above the bench. Most people will have to sit on a box or weight stack to reach this position on a traditional bench.
Place a long band across your hips, anchored either to a rack or pair of dumbbells. Place a short band around your knees. Extend your arms across the bench for increased stability.
Bend your knees at 90 degrees and set your feet about shoulder-width apart. Inhale deeply, exhale all the air out, and contract your abs. Execute by tucking your chin, driving through the heels, and squeezing the glutes hard at the top while simultaneously driving the knees out.
Return the hips to just above the floor, right before losing tension, and repeat. Do 2-3 sets of 10-30 reps.
- Cambridge EDJ et al. Progressive Hip Rehabilitation: The Effects of Resistance Band Placement on Gluteal Activation during Two Common Exercises. Clin Biomech (Bristol, Avon). 2012 Aug;27(7):719-24. PubMed.