Knee pain going up stairs or uphill specifically is due to an issue (typically weakness) within the gluteus maximus muscle (glute max). This is a powerful muscle that is used to help extend your leg at the hip. This muscle makes up about 70% of the iliotibial band (IT band), a thick band of connective tissue running down the outside of the thigh and connecting to the knee. Because of the connection to the IT band, weakness in this muscle leads to less lateral stability in the knee causing the knee to cave inward. This puts more strain on the medial and anterior collateral ligaments (MCL and ACL), and more compression forces through the lateral knee. Low back pain is also common with weak glute max muscles as they help with hip hinging and picking objects up off the floor.
Where is the dysfunction coming from?
Often these muscles will weaken due to an old injury or compensation from instability in the hips. Balancing and strengthening the muscles of the pelvis through various myofascial therapies can help when this is the case.
The glute max muscles, and many other muscles of the pelvis, are related to our reproductive organs (prostate, testes, uterus, and ovaries). This means if there is some stress or dysfunction in our reproductive organs then it is very likely and common for there to be low back pain, or knee pain, due to pelvic instability.
Conditions that may lead to a weakness in the glutes include, but are not limited to:
- Low testosterone
- Low progesterone
- High estrogen
- PCOS
- Prostatitis
- Ovarian cysts
- Cancer (prostate, testicular, ovarian, or uterine)
- Uterine fibroids
- Benign prostatic hyperplasia
- Epididymitis
If you have had chronic knee pain going up stairs with no resolution in pain with a musculoskeletal approach it may be time to have your hormones tested. Ideally use a salivary test for steroid hormones as this will tell you the amount of free hormone there is. Most standard blood tests for steroid hormones will test the total including hormones bound to protein. Hormones bound to protein are not used by the body until in dire need. So, knowing how much free testosterone, estrogen, and progesterone you have will give a better picture of what the body is currently using.
Living with chronic knee pain is certainly not normal, work with a holistic doctor that will look at all aspects of your health and start living pain-free.
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