Knee pain is a common complaint among female runners. Most of the time it is assumed that the area of pain is also the origin of pain. However, this is frequently not the case and it is important that we look at the big picture. Weak "cheeks" or gluteus and hip external rotator muscles play a large role in knee pain production in females.
Because females are built with wider hips the knee joint does not fall directly below the hip socket different pressures are dispersed thru the knee joint when compared to men. The angle that is created between the hip socket, knee cap, and shin bone make up what is called the Q Angle.
Picture from: smartfeetsavannah.com 
Picture from:jmaxfitness.com
You can see from the picture that the Q angle can also be thought of as the degree of "knock knees”. Due to this natural alignment, women are predisposed to abnormal pressures on the knee. To normalize pressures, strong muscles are necessary at the hips to stabilize the knees. These muscles primarily include gluteus maximus whose main function is to pull the thigh back and away from the body, and the deep 6 external rotators. The rotators are responsible for rotating the thighs and knee outwards. These two groups of muscles create movements in the direction opposite the pull of the Q Angle providing fewer abnormal forces on the knees.
Weak "cheeks" can cause:
· Patellar femoral syndrome
· Lateral tracking or dislocation of the patella
· IT band syndrome
· Over pronation in the feet
· ACL tears
The larger the Q angle, the more likely you are to experience an injury. New mothers are also more susceptible to these types of injuries due to hormone induced ligament laxity.
In addition to regular stretching after a run, it is important to strengthen the glutes and deep external rotators as well. Below are a couple ideas for doing just that.
Bridge with knee straight and rotated out
Clam Exercise
