8 Reasons Why Quad Muscle Strengthening Absolutely Hurts Your Knee

Quad muscle strengthening is usually thought of as a number one go to exercises for most knee problems, but because of its attachment sites, it’s actually in the best position to destroy your knee joints over time. Sadly, I see way too many patients go through this problem.

In this video, I’ll be sharing with you eight reasons why quad muscle strengthening absolutely hurts your knee. But let me give you a disclaimer. Now I’m not saying you should never ever work out your quad muscles. In fact, after explaining these eight reasons why you shouldn’t work out your quad muscles.

I’ll go over about how to get exercise for your quad muscles, and a couple of situations where you should focus on getting quad muscle strength. These reasons aren’t in any particular order. So let’s get into the first one knee osteoarthritis, when your quad muscles that are on the front of the thigh right here, they come from the hip, and they attach them into the kneecap. Then they attach them to the shin bone.

When they’re too dominant in too strong, they pull the shin bone because of its attachment, up into the thigh bone, and that smashes these two bones together. This leads to gradual wearing of the cartilage on the end of the bone. And that’s what sets up osteoarthritis.

Eventually, the bone here gets rough surfaces, it starts to rub inappropriately, you get stiffness, creaking, cracking, crunching noises, and eventually it hurts and becomes painful to do everyday activities. And it’s because of this chronic over dominance over strengthening of this quad muscle on the front. And some people say well, I can have weak legs.

But even if you’re weak, your quad muscles are the dominant muscles of all your weak muscles, you can develop this excessive compression in your knee joint that sets you up for osteoarthritis. It’s just a matter of decades for some people even less than a decade, even a few years for them to develop osteoarthritis in their knee and eventually lead to debilitating problems.

And in extreme situations, this could lead to a knee joint replacement, some people get a partial knee replacement and some end up with a total knee replacement, which can be good for most people. But there’s still that underlying problem of the muscle imbalance having too much quad muscle strength or dominance can also set up a Baker says problem.

A baker cysts is when you get a puffiness behind the knee right here. The reason that happens is because when there’s that extra compression from the quad muscles, sometimes the lining of the knee joints, the capsules what it’s called, that’s what makes the fluid that lives inside the joint.

The lining will respond to protect the parts inside the knee by creating more fluid more of that joint fluid in an effort to gap the joint a little bit and create some space so that it doesn’t get rubbed on and compress too much when you’re moving.

The problem is when that fluid stays there. And if you keep generating extra fluid, because the of the structure of the knee joint, the back of the knee is the weakest spot of the joint capsule that lining and so it starts to bulge outwards and create that Baker cyst.

If that fluid production continues, eventually that Baker cyst can rupture, it can tear open, and that fluid will drain down into the calf area and start to cause other problems because you have fluid to deal with. Now on top of the compression inside your knee joint, this often leads to pain the lower leg especially when walking. Plus, if that imbalance is never fixed, you’re just a step away from getting knee osteoarthritis.

Now if we go back to the beginning, when the compression first starts in the knee joint, one of the first symptoms that can happen is just general knee pain. Without anything visible in an x ray, nothing like arthritis yet or a baker cyst, or anything more severe. If you go to the doctor at this point, they may diagnose you with something called patellofemoral pain syndrome. And they rarely have an explanation for exactly what’s hurting.

But usually when people have patellofemoral pain syndrome, they have pain behind the kneecap right here on the knee joint. And this happens because of that excessive compression from those over dominant quad muscles because they’re too strong or they’re the strongest muscle of your weakest muscles. It’s over compressing the kneecap against the thigh bone, and it causes irritation and pain.

When this happens in teenagers that are still going through they’re growing. Because of the way this tendon the patellar tendon here attaches to the shin bone, it can yank on these pliable bones if you’re still growing, your bones are going to be a little softer, and it can make a bump here called Osgoode slaughters disease, and that spa can get tender and painful as well.

It’s very much connected to patellofemoral pain syndrome, which the root problem of that is these over dominant, sometimes very strong quad muscles. Now at this point, the compression has usually not become chronic enough or bad enough to cause problems that you can see on an x ray or an MRI. So they would just call it patellofemoral pain syndrome.

But if it does progress, and you have signs of damage of the cartilage behind the kneecap here, then it becomes something called Kandra Malaysia patella contribution patella means that there’s thinning of the cartilage behind the kneecap. You can see this on an x ray if they take it at the right angle usually with your knee bends from this kind of view right here. or you can see that the lining of the cartilage is worn down because there’s less space in the joint.

This is a sign that the compression from the quad muscles has been significant for a while and it’s now starting to affect the cartilage behind your kneecap right there. In some cases, the cartilage back there can fray, it can become bumpy or not smooth and cause noise to happen inside your knee. And the root problem of this is those over dominant, sometimes very strong quad muscles that have been compressing that joint for a long time.

Now some people don’t get condemnation, patella, but they instead develop tendinitis or bursitis. These kind of go hand in hand, it just depends on which of those structures, which of those body parts inside your knee becomes irritated. First, if we’re talking about tendinitis, it’s usually this tendon right in the front middle right under the kneecap, that becomes irritated in the bursa, the bursitis.

There’s a bursa read behind that tendon right above the kneecap behind the tendon up here, there’s also bursts on the inner part of the knee and right in front of the knee joint right here to the front of the kneecap, those structures can also become irritated because of extra compression on the front of the knee that’s coming from the quad muscles up above the knee joint.

Now tendons are designed to take compression and bursa are designed to absorb friction. But if they’re over tension over friction, then they can become irritated because they’re not prepared for that amount of force. And that’s why you get tendinitis and bursitis. Taking the tension and friction off by using those quad muscles less tends to help out the situation.

We see patients improve with that all the time here in our clinic, in people with very strong quads, they have an increased tone, you have to have firm muscles in their quads, which pulls on that kneecap quite a bit and tensions a tendon in the bursa. And this creates an increased resting tension.

This is why these people when they’re sitting around, watching the movie having a meal, they all of a sudden start getting achy knee pain. And it’s because they’re getting compression on their knee from their strong muscles just pulling, it’s a massive imbalance happening in that situation. Getting the quad muscles to relax and getting the muscles throughout the hip and thigh in better balance is the solution to this problem.

Next is talking about the meniscus. The meniscus is this structure right here between the thigh bone and the shin bone and it acts like a cushion between the two bones and helps to absorb weight and helps the round part of the thigh bone to rest on top of the flat surface of the shin bone so that it doesn’t shift off too much. It’s got some flexibility when it moves. But if your quad muscles are very strong, then it starts to compress downwards.

Because the quads helped to pull these two bones together. It compresses the meniscus. And over time, usually when people hit their 40s, they start to get meniscus tears because of chronic over compression. If you’re very active, it’s possible that you can get a meniscus tear even in your 30s or 20s. Once you get a meniscus tear your knee health can change dramatically for the worst.

Some people even get surgery for this and usually are not the same afterwards. But simply addressing the root problem which is getting those quad muscles in balance with the other muscles around the hip and thigh tends to decompress the knee which decompresses the meniscus and gives it a chance to heal.

Nearly all meniscus cases even in severe tears can improve tremendously by decompressing the knee by fixing the root muscle imbalance. Next, let me tell you about ACL and MCL injuries. The ACL is a ligament that stands for anterior cruciate ligament that is deep inside the middle of the knee joint. And the MCL is the medial collateral ligament, which is another piece that holds the knee together on the outside here.

These two ligaments along with other ligaments in the knee, are important for holding the bones together as they move. Now they’re not muscles, they don’t make the knee move. They keep it together as it moves. Tears in the ACL and MCL tend to happen in younger people that are involved in sports.

But I think they’re highly related to people that have this muscle imbalance where the quads are too strong, and it’s making the leg move inappropriately. In fact, it tends to make the knee move inwards because if the glutes are weak, the glutes can’t support the hip bone up here, and is in a straight or slightly our position.

And if the quads are very strong, the inner thigh muscles, the groin muscles tend to work with the quads, and it will pull the knee inwards here, which tensions the MCL on the inside right here and the ACL. And if you’re chronically taking steps or your knee is moving inwards like this, you’re putting a low level stretch through your MCL and your ACL and it’s just a matter of time before breaks in you run into some serious problems from having those tear.

Sometimes there’s an accident where somebody falls into your leg from the outside and it pushes it over the edge and I always have to question Could that MCL and ACL have remained intact

 

even though somebody fell into the sight of that individual if they were moving better if they had better strengthen their glutes because I could see it a mile away when somebody’s got weak glutes and their knees are moving inappropriately.

That’s a big sign And a big giveaway for me as a specialist physical therapist that their ACL and their MCL are probably lacks and ready to tear with not that much extra force from the outside prevention of ACL MCL. Tears can shoot up dramatically by strengthening the glute muscles and not emphasizing the quad muscles so that you can have a stronger ACL and MCL for your sport activities.

The final reason why quad muscle strength can worsen your knee situation is let’s say you’ve gone through the extreme you’re a little older in your years, and you’ve ended up getting a knee replacement. Because those usually happened for severe advanced knee osteoarthritis.

In a knee replacement, they’ve cut off the ends of the bones here, they usually replaced the kneecap, and they put in an artificial pieces of the joint, sometimes there’s a partial replacement, we’re only one side of the joint is replaced. In order to preserve as much of the bone as possible, it can be a massive relief for somebody with severe end stage arthritis, because you’ll get so much mobility back and so much pain relief.

Because those rough, bumpy surfaces that created a lot of stiffness in the knee are no longer there. And now they have some mobility. But we often see patients that have gone through replacement surgeries, whether it’s a partial or a total replacement, continue to have knee pain, even years after the replacement. And very often they come in saying that they’ve been led to believe that it’s excessive scar tissue build up on the inside.

Or maybe they’re thinking that the surgeon did something wrong to their knee. Now I can’t speak to the surgeons work. I’m not a surgeon, and I can’t speak to the scar tissue build up either, because I can’t see on the inside of that joint.

But what I can usually see with these patients is that they have a massive muscle imbalance. And their quads are very strong, they’ve worked on that, and their glutes have not gotten much attention. So they’re compressing the knee joint too much. And even though they have artificial parts in there, that’s not what’s hurting them.

Now it’s other parts of their knee that they still have, that are generating pain because of that excessive compression from those quad muscles. And you know what, it’s only a matter of time for many of these individuals before they over compress and move their knee badly enough to loosen the hardware that’s been installed by the surgeons and possibly need a revision surgery where another replacement has to be done, because the hardware is no longer functioning properly, because they’ve worn it out.

And it goes back to this root muscle imbalance problem that can be addressed naturally by doing the right exercises, and de emphasizing quad muscle strengthening. So let’s talk about when quad muscle strengthening is good for you. quad muscle strengthening is best right after surgery, because after surgery or a traumatic injury as well.

I’m talking about where you get a lot of swelling, or maybe there’s been a fracture to the bone a tear to the muscle, because in those situations, the knee joints and the muscles around it tend to go into a shock situation, and they don’t function normally.

And it’s very possible that your quad muscles have shut down and they don’t work, you have to kind of reconnect your brain to them. To get them to work on command, you have to think hard about making your quad muscles contract. Now after a surgery or an injury usually don’t have function of your quad muscles for hours at most a few days.

But as you work on getting those muscles to contract, they tend to come back especially if they’ve been pretty strong for you in the past, they’ll come back pretty quick. But while they’re shut down, they’re not working good. during that short timeframe, that’s definitely a time to work on isolating a quad contraction on getting your quad muscles just to work and activate better.

Another time is if you have what’s called an extension lag, let’s say you had some sort of knee surgery. This usually happens with knee replacements and it doesn’t happen terribly often. But it does. And you can’t straighten out your leg all the way you go to pick up your leg and it comes up with a knee slightly bent like this.

But you can hold it up with your other foot. Or if somebody else can put a hand into your leg, it goes it has the ability to go there. But then when you try to hold it up on your own and just your it comes down a little bit, that’s called an extension lag. In that case, that’s a sign that your quad muscles are truly weak and you need to work on that.

And it’s important because every time you go to stand on your leg, if that if those quad muscles aren’t sufficiently strong and your knee can buckle on you and your knee, your leg will give way you need enough strength to at least not buckle.

But once your extension leg is gone, you can hold your knee pretty straight, it’s time to start focusing on other muscles, you’ve achieved enough strength to not let your knee buckle under you while you’re walking.

Now if you don’t have any of these two problems, or recent traumatic injury or surgery, or an extension lag, then you might be asking the question when will I ever work out my quads. And this video is intended as a bit of a response to the people that comments on some of our videos that say oh you talk about as glute strengthening and sometimes just foot strengthening.

You never really say when you’re going to work out the quads. Well let me tell you how the quads are supposed to work very clearly here. They work out secondary to other muscles because the prime removers in your legs. If you think about just walking, every time you take a step, your glutes should contract very well your foot muscles should engage.

If you’re going to go do a squat with both legs open, glutes should be squeezing on the way up. And they should be controlling the descent on the way down too. But what you shouldn’t feel is your quads dominating the motion. But if you work out enough, and if you walk enough, you’ll feel your quads get tired and your hamstrings and your calf muscles will get tired too.

But they should get tired, secondary to your glutes, and even to your feet. That’s how they’re intended. That’s how they’re built. The even though the quad muscles are quite big, they should not be more active than your glute muscles and they shouldn’t be stronger than your glute muscles.

The glute muscles up in the back of the hip over here should be the main muscle group driving you through your everyday motions. And through any sort of exercise even if it’s low level exercise, medium level or high level exercise glute muscles should be the main driving muscle to push you through most of your activities. And quads are really a secondary muscle.

If you keep your quad muscles as a secondary muscle group to the glutes and even the feet, then you’ll keep your knee joints decompressed and healthy for the long term. So you don’t run into any of these problems that I’ve talked about in this video and want to let you know that I’ve got a library of content for you going into deep dives of all these conditions that I talked about in this video.

You can find links to the playlists of each of these conditions down in the description below. As well as a few programs where we offer in depth rehabilitation guidance for fixing the root muscle imbalance where these quads are too strong and other muscles need to get stronger like the glutes and the foot muscles.

You can see the links for all these things down in the description below. If you thought this video was helpful, please give it a thumbs up share this with somebody you think needs to hear this don’t forget to hit that subscribe button and turn on your notification bell to that way you don’t miss any of the videos we put out every week and I’ll see you in the next video Buh bye.