Forums General Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years! Re: Chronic IT band/quad TIGHTNESS and knee pain (chondromalacia patella?) for 6 years!

AvatarRyan Cloutier

I asked my physiotherapist to check for hamstring weakness. She did notice a slight weakness but she noticed that the glutes are even weaker and thats the bigger issue. She said I should focus on strengthening glutes rather than hamstrings because most of the glute exercises will also strengthen hamstrings anyways and she said I dont want to be hamstring dominant.

One of the new exercises she has me doing is the Romanian deadlift (straight leg deadlift). This is an exercise I was also told to do by my previous physiotherapist but my current physiotherapist said I wasnt ready for it until now since ive improved my posture. Focus on hip hinging and sitting back with your glutes, My lumbar spine is pretty straight when doing it. There is no “butt wink” (lumbar spine flexion), which is good form. I feel my glutes and hamstrings working. The hamstrings also get a good functional stretch. She said Im more ready to perform the movement than I was before because my posture has improved. My anterior pelvic tilt is minimal now, so proper muscle recruitment is occuring. The exercise also helps reinforce the good posture I have gotten from rolfing and helps reinforce good motor patterning during daily movements. I feel like im engaging my glutes and hamstrings more especially when I bend over.I perform the bend similarly to how I would perform the romanian deadlift and feel my glutes and hamstrings working. I have only done the exercises twice tho since beginning physio with my new physiotherapist. 
One concern I had with performing the excersise is the assymetry in my pelvic alignment. Left side being different than the right. As I perform the movement there is assymetry from left and right side because of the misaligned pelvis. The physiotherapist said my pelvic assymetry is much improved since the rolfing and the previous physio exercises and that any differences between the 2 sides is subtle. She still recommends performing the romanian deadlift. 
Perhaps you should try taking a similar approach by correcting overall posture first. Then performing physio exercises to facilitate permanent change in the new posture and good motor patterns and proper functional movements. The new posture will allow you to perform the exercises properly. The exercises will re-wire your muscles and brain to proper muscle balance and movement.