Strong Glutes, Healthy Joints: Why Your Hips Matter More Than You Think

When it comes to joint pain, most people focus on the site of discomfort—such as the knee, back, or ankle. But what if the root cause lies higher up the chain? The gluteal muscles, particularly the gluteus medius and gluteus maximus, play a crucial role in stabilising your entire lower body. Weak or underactive glutes can disrupt movement, strain surrounding joints, and set the stage for long-term degeneration. In this article, we explore how strong hips support healthy joints—and why your glutes deserve more attention than you think.

The Kinetic Chain: Everything Is Connected

Your musculoskeletal system is a kinetic chain—a series of interdependent joints and muscles working together to create movement. When one link in the chain is weak or unstable, the others compensate. Over time, this creates uneven loading, muscular imbalances, and injury risk.

The hips are the cornerstone of this chain. They sit between the spine and knees, acting as a power centre for walking, running, squatting, and lifting. If your glutes don’t fire properly, nearby joints absorb the extra load. This can lead to:

• Knee pain or instability

• Lower back pain or stiffness

• Hip bursitis or impingement

• Anterior pelvic tilt and postural dysfunction

By strengthening your glutes, you support proper alignment, absorb impact more efficiently, and move with better control—all of which preserve joint health.

How Weak Glutes Cause Joint Trouble

The gluteus maximus is the body’s largest and strongest muscle—designed to extend the hip, propel us forward, and stabilise the pelvis. The gluteus medius and minimus control side-to-side stability and pelvic alignment.

When these muscles are weak or dormant:

• The knees may collapse inward (valgus collapse), increasing the risk of ACL injuries or patellofemoral pain

• The pelvis may tilt or rotate, causing compensatory strain in the lumbar spine

• The hamstrings and lower back muscles overwork, leading to tightness and fatigue

• Gait becomes inefficient, placing chronic stress on the joints

Many patients with knee osteoarthritis or chronic back pain show signs of gluteal underactivation during MAI-Motion™ assessments. Addressing the hip—rather than only the site of pain—leads to better long-term outcomes.

Strengthening Your Hips: What to Focus On

A comprehensive gluteal strengthening programme doesn’t just mean doing squats. It should address activation, endurance, and control, especially in weight-bearing and functional movements.

Key exercises include:

• Glute bridges and single-leg bridges

• Hip thrusts with controlled tempo

• Side-lying leg lifts and banded clamshells for glute medius activation

• Step-ups and lunges with proper alignment

• Lateral band walks for hip stability

Good form matters more than heavy weights. The goal is to train the glutes to engage during everyday movement—walking, climbing stairs, or carrying loads.

At MSK Doctors, we integrate motion capture technology and neuromuscular testing to guide patients in developing a hip-focused rehab or injury prevention plan.

Additional Patient Information

Glute strength is vital at any age—but particularly as we get older. Strong hips can prevent falls, maintain balance, and delay the onset of joint degeneration. For athletes, optimised gluteal control means better performance and fewer overuse injuries. For patients with arthritis, it’s a key part of joint preservation.

Don’t wait for pain to appear. If you’ve noticed instability, poor posture, or reduced power in your lower body, it’s time to get your hips assessed.

FAQs

Why do my knees hurt when my hips are weak?
Weak glutes cause instability in the pelvis, which alters your leg alignment. This can lead to inward knee collapse and overloading of the patella or ligaments.

Can glute exercises help my lower back pain?
Yes. Strong glutes reduce strain on the lumbar spine by stabilising the pelvis and allowing the back muscles to relax. They're often a missing link in lower back rehabilitation.

What if I already have arthritis—can I still strengthen my glutes?
Absolutely. Tailored gluteal activation and low-impact strength work can improve joint support, reduce pain, and slow further degeneration.

Is walking enough to keep my glutes strong?
Not usually. Many people walk with minimal glute engagement due to compensatory patterns. Targeted exercises are often required to reactivate these muscles.

How do you test for glute weakness?
We use clinical assessments, functional strength tests, and MAI-Motion™ gait analysis to detect weakness or delayed activation. This helps build a personalised plan.