Your Glutes Probably Aren’t to Blame for Sore Knees, but They Could Still be Stronger

Remember when people used to blame poor patellar tracking on a weak VMO muscle? Even though the VMO has next to zero effect on patellar tracking at all? It’s kind of the same way that people push the glute med under the bus as the lynchpin for all knee valgus issues.

It’s easy to consider the GMed as a target since it’s one of the main non-knee crossing muscles associated with reducing valgus motion in open chain movement of the knee, so sure, let’s strengthen that sucker with every variation of side lying clam, monster walk, cable abduction, and whatever you want. Most studies looking at injury recovery will show decreased peak force and timing issues with glute muscles, so it makes sense to train the hell out of them.

What this may not consider though is lower leg kinematics in similar movements and activities, especially in closed chain movements. Much of the valgus motion of the knee could be considered as connected to rate and angle of foot pronation, which can also contribute to tibial internal rotation and if the person has a really aggressive flat foot and rate of pronation, it seems to supercede any potential contribution from the glutes, and likely inhibits them in some way.

So while training glutes is still massively beneficial across the board for a lot of stuff, it may not be as valuable to knee issues like valgus collapse as training lower leg function and arch control. Since pronation and tibial internal rotation coupling has been statistically cited as a potential biomechanical factor in knee pain issues, it might be worth looking at. In many instances, training foot positioning and posture can rather immediately improve balance and directional aptitudes, which can go a long way to improving knee positioning and increasing hip muscle activity as well.

You can still train glutes until your face explodes, but without involving some level of foot and ankle strengthening, the knees may likely still drop into a valgus collapse. This may mean involving more closed chain movements for the hips versus open chain movements, with an emphasis on balance and foot/ankle control than simply loading it up and repping it out.