Mr. T obviously doesn’t like this idea, and neither do we!
In most cases, non-traumatic knee pain (ie. pain that did not start from an outward injury) is caused by an imbalance between the group of muscles that affect the knee joint. This group is known as the quadriceps, which is actually composed of 4 muscles. For the purpose of knee pain, the inner and outer muscles (Vastus Medialis and Vastus Lateralis) are usually the areas that harbor this imbalance. Most of the time there will be a lack of activation in the Vastus Medialis and too much activation or tension in the Vastus Lateralis.
This imbalance causes the knee cap to be pulled unequally during knee bending activities (squats, lunges, mountain climbers, etc.) which irritates the joint capsule, tendons, and ligaments that cross the knee joint. This constant irritation and inflammation leads to thickening in the joint capsule and tendons. This thickening will manifest itself as tightness, aching and even the all too common “cracking” noises that some people hear while performing a squat or lunge motion.
So how can we fix this? The name of the game is BALANCE! We want to strengthen the inside of the knee and relax the outside of the knee. Three important activities to relax the outside of the knee are releaseing the tension in the Vastus Lasteralis and IT band through foam rolling or other soft tissue treatment (hint, hint ART works great), strengthening the glute muscles, and strengthening the vastus medialis. By strengthening the glute muscles, the structures on the outside of the thigh (Vastus Lateralis and IT Band) will not be as easily stretched during knee bending activities. Strengthening the inside of the knee (Vastus Medialis) keeps the knee cap in a central position when we bend and extend the knee joint. The combination of these activities will help to reduce the irritation on the joint capsule so you can get back to leg day at the gym!