Knee Pain from Imbalance

Do your knees get sore during or shortly after a workout?  

Have you been diagnosed with hot buzz words like “Patellar Tendonitis, Osgood Schlatter’s disease, and Chondromalacia?”  

Is there any Tibia Pain?

Does it seem like glutes and hamstrings won’t fire correctly during a workout/sports?

Do Runs leave your knees, hips, and quads sore but not the backside (Butt and hamstrings?)

Do You Have Tight hamstrings that just won’t or don’t stretch no matter what you try?

If this is you, you may have a quad/hamstring/glute complex that is sabotaging your workouts and making you spend more time and money at the doctor’s office.


Because of both the large response in typical athletes in the growth of the quads and the glutes and because of the incredible hormone response from the high-intensity workouts that have become extremely popular, there appears to be an increase in the condition of upper leg imbalance that is becoming somewhat routine in our clinic. In essence, the quads are OVERSTRONG in ratio to the hamstring strength.

 When this becomes imbalanced, typically I will see a low-grade patellar tendon hypertonicity or tendonitis. Pain to the lower area of the knee cap especially when the athlete has the knees bent (as is common at work, school desk or in the car) becomes increasingly annoying and occasionally debilitating.


Over the years, there have been some things that work better than others.

Stretching hasn’t been very effective, nor has foam rolling. Not by themselves. there are multiple issues involved, it takes a multifaceted approach to get back on track.

This protocol has been working on a great for fixing this issue.        

  1. Ice the tibial tubercle if it is actively irritated, nothing rehabs when it’s inflamed!
  2. then rehab, this order seems most effective.
  • Glute activation – grab your butt and make it contract -10 each leg & 10 both together
  • Glute contraction – mini squat with a squeeze (weighted if available)
  • Hamstring contraction – Chair hamstring contraction – (see below)
  • Quad (front leg) stretch – Couch Stretch and/or foam roller, TAK ball roll
  • Voodoo Band if available – Helix style Voodoo/Floss seems to work best!

This is a very reversible and easy condition to fix and should also show an increase in performance as the body gets back into the preferred ratio. To fix this issue, add some easy quad stretches and hamstring strengthening exercises. To add to that advice, don’t waste time strengthening the hams with traditional machinery, bending the knee with weights attached low will most likely just irritate the tendonitis anyway and the beef of the hamstring is at the proximal end near the glutes. I prefer lying prone with your knees bent and the heels digging into a chair. Get situated so the knees are at 90 degrees and use the hamstrings and lower glutes to do a hip thruster. Go slow, activate the big part of the hamstring and glutes. Put your hands right there to make sure you are making the hams fire.

Voodoo Band exercises if that works for you! Helix wrap – 100 reps of walking and sports specific movement

10 slow squats

 These are easy and in a few short days, you’ve stretched the quads and re-activated the hamstrings as well as got the glutes on board so that the balance and ratio are getting back to the right state. This routine is all you need to undo the problems. It seems that classic training seems to only address one aspect: stretch or strengthen. I’m saying, “Do both to get the fastest, most efficient results.”

 As I stated before, there is no one single reason why the quads are growing faster and at a quicker rate than the hamstring. More than likely it is any one or a mix of the following: technique, form, hormone response, genetics (muscle composition) or just that High-Intensity Work workouts wake up the lower body better than most programs and there is a focus on squatting in a lot of exercises. This will elicit a greater quad response. Most likely it is a combination of all these factors.

 If you suffer from this issue, try the techniques explained and see if you don’t respond quickly and see performance improvements. Add just one focused, effective routine and reap the results!

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