When many runners consider muscle groups directly affecting knee stability, alignment and thus pain, thoughts turn to the glutes (externally rotating and abducting the hip) and quads (particularly VMO).
N.B. I do appreciate the current debate surrounding VMO – I use the term as many runners will be familiar with it. For the sake of this post, you could also read ‘inner-range quads’ in place of ‘VMO’. For more on the VMO debate, read the comments thread on this previous blog post!
It is important however that we don’t overlook the hamstrings and adductors.
Dynamic imbalances between quads:hams and adductors:abductors play an important part in influencing knee stability and patellofemoral alignment during functional movement patterns such as running.
Below are a couple of videos showing two hamstring biased variations of a simple bridging exercise, which also affects the long adductors.
We use these two variations as two of the more basic exercises in our hip strengthening knee rehab program.
FREE DOWNLOAD: Runner’s Knee Rehab Resources [PDF]
90 Degree Hamstring Bridge
Challenging the hamstrings in an mid-to-inner range position at the knee, moving solely at the hip.
30 Degree Hamstring Bridge
Challenging the hamstrings in more of an outer range position at the knee, still moving solely at the hip.
Be aware that the hamstring bridges shown above place a lot of load through the lower back. I stuffed my back doing them months ago and it’s still not better. Beware.
Thanks for the important reminder for all readers…
As with all exercises, learning and practicing good form is essential. If you’re feeling a bridge (or variation) exercise in your lower back – you need to get somebody who knows what they’re doing to take a look at your technique – ensuring you’re using the correct core and hip muscle groups to stabilise.
I couldn’t agree more on how much the hamstrings affect the knees! Last Feb, I had surgery to reattach a torn hamstring (sounds fun, huh?).
After several months of rehabilitation and pt, I finally got the clearance to start running. I thought I was being smart… I didn’t just barrel back into running. I walked 20-25 miles a week for 6 weeks, started adding in little 30 second increments of running, gradually increasing the time running.
Despite my best efforts … It’s amazing how much impact a significantly weaker hammy on one side affects other body parts. Guess what started hurting the most? Yep! My right knee! (It was my left hamstring that was injured). My right knee was very unstable… I could feel it sliding out of place, popping and ultimately had a lot of pain. It took much more serious hamstring strengthening for it to finally get more stable.
My hammy is still weak… I will be doing these exercising to continue getting stronger! If you have any other suggestions on how to strengthen it (when one is significantly weaker than the other), I would appreciate it!