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

1) Lunge actually does more TFL activation than glute medius or maximus (Power, 2013), which was shown by EMG assessment in published research study. Their are many better exercises to choose from if you have a muscular imbalance involving the TFL and glutes. I am thinking 90/90 split squat will show similar activities as the movement pattern is very similar. I dont know why the TFL activation is high perhaps its because its an eccentric contraction of the TFL during the downward movement. 

I can flex my glutes. For example I stand here writing this I can contract my glutes easily. Even rhythmically to the beat of a song. However, my physiotherapist said I was not contracting my glute medius at all during the clamshell when he evaluated me. It could be due to weakness or just dysfunctional motor pattern. However, I have been doing the clamshells at home for almost a week now, and I feel activation and eventually a burn in my glutes now. It is certainly possible your glutes are weak if your quads are always tight. Also, weak hamstrings might also be contributing.

2) Regarding the pigeon pose-  No and Yes – I can pigeon pose with good warm up, smashing, and stretching and easing into the position. Its pretty painful tho and I dont think I am doing it fully correctly in terms of body alignment and posture (I might be cheating, but no way of knowing unless someone watches me). The physiotherapist used a different test were I was lying down back against a table. I had my femur up with tibia bent 90 degrees. He would bend it in internal and external rotation and compare both sides. He noticed my right is a lot worse than my left in terms of external rotation ROM. 

3) Yes. Their are 2 effective ways
1) Position yourself similar to a piriformis stretch to add a hip opener/external rotation mob component. Perform a hip thrust holding the pirformis stretch. Hold position at top for 3 seconds. Go back down slowly. Thats 1 rep
2) Performing it while holding knee to chest in the leg your not thrusting with to limit lumber extension and to better isolate the glutes.

I am doing the plank in my routine but I dont know if it is an effective exercise as it also activates TFL and quadriceps. I might also consider adding box squats to target my posterior chain and to help learn squatting motor pattern.