Daily Mobility Exercises by Dr. Kelly Starrett 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!



Right knee pain, IT band/quad tightness 
So after watching plenty of functional patterns (Naudi Aguilars) videos, comments, blogs etc.. I think I figured out what is wrong. I think I figured out what is causing my tight quad/IT band leading to knee pain. 
—>Weak lower right inner core/abdominals, weak transverse abdominis (TVA) on the right side
How did I figure this out: extensive research + trail and error + functional patterns (naudi aguilar)
1) Strengthening the VMO did not help
2) Strengthening VMO + Self Myofascial Release (SMR) –> did not help
3) Glute strengthening + SMR + ART + massage + osteopath –> did not help
4) Glute strengthening + deep core strengthening + SMR + Rolfing –>helped slightly
From this we can deduce that:
– VMO unlikely whats causing the problem and current literature supports this. Also, I am quad dominant. So strengthening VMO would strengthen the quads and cause even more imbalance and incorrect motor patterns.
-Tight IT band/quads and hip flexors muscles is not whats causing my problem. It is a symptom of the real cause
-Weak glutes is unlikely whats causing the problem as months of proper glute strengthening did not improve symptoms and Naudi Aguilar supports the fact the weak glute medius is probably not the cause.
However, recall that 3-D gait analysis showed: 
1) Pelvic drop on left side 
-indicating the right glute medius is weak and cant support the one leg stance.
-This is incorrect. It wasn’t the right glute medius that was weak. It was the lower right deep abdominals (TVA)
-When contracting and tightening the lower right abdominals my right pelvis dosnt shift laterally which prevents my left pelvis from dropping
-I have anterior pelvic tilt (lordosis in lumbar spine, and kyphotic cervical spine)
-Pelvis on right side: Is twisted forward and shifts laterally to the right.
Why is posture like this:
anterior pelvic tilt:
1) tight  and dominant hipflexors/quads
2) weak glutes
3) incorrect motor pattern (quad dominant movements, inefficient hip hinging)
4) weak core: not engaging the deep abdominal muscles***
Lateral pelvic shift and anterior pelvic twist on right side:
1) Weak core: not engaging the lower right deep abdominal muscles 
How would a weak lower right deep abdominal muscle cause Tight IT band and Knee Pain:
-Naudi Aguilar talks about the cause of knee pain/IT band tightness is probably not glute medius weakness and it probably is weak deep core muscles (TVA) leading to poor transverse rotation and pelvic instability in the frontal plane. 
-Excessive pelvic motion in the frontal plane would cause incorrect biomechanical load transfer through the thigh/femur unto the knees causing tight IT bands and then lateral tracking of patella and knee pain.
-My pelvis is shifted laterally on the right side. This causes my IT band to always feel tight and leads to the IT band pulling on the patella. When I consciously shift my pelvis more towards the left and try tightening my lower right abdominals the IT band loosens. This positioned cant be maintened however as it is artificially created my lots of effort. In my natural state my pelvis reverts back to shifting to the right side must likely caused by weak lower right abdominals.
How to strengthen deep lower right abdominals?
– Would anyone know how to do this? I dont know how to target the right side without getting the left.