9 exercise strategies for knee pain (2023)

This is one of those tips that is often repeated but often overlooked. I know I've conquered it more times than I can count, and I also know I've paid the price every time.

Trying to train through pain is a guaranteed losing battle. Even if you "win" and can deal with it in the short term, it always comes back to bite you in the butt, and usually much worse than if you had just given in to the onset of pain.

Now keep in mind that surrendering doesn't mean hanging it all up, giving up and handing over your man's card. It just means avoiding what hurts and listening to your body.

This last part is worth repeating: listenyoursbody.

For example, some people swear by the Peterson Steps for improving knee pain, but every time I tried them, they hurt.

Does that make them bad exercises? For me yes, but if they work for you, keep doing them.

Don't be tempted to do something just because you've heard it's right. If you try it and it doesn't feel right, ditch the groove and take a different approach.

A lot of knee pain in the gym stems from unbalanced programming that puts too much emphasis on the quadriceps and neglects the glutes and hamstrings, leaving people woefully weak and underdeveloped posterior chains.

It may seem counterintuitive, but to achieve the desired balance we're aiming for, we actually want to continue unbalanced programming - only the balance should be in favor of hip-dominant work over quad-dominant work.

In addition, hip-dominant movement patterns (deadlifts, bridging, etc.) are generally better tolerated by people with bad knees, so it's a good way to get a lower-body workout in the presence of knee pain when the squat and lunge are problematic.

An easy place to start is to do your dominant hip work first during the workout. This will allow you to give it your full attention so you don't blow it, and it will also serve as a sort of pre-exhaust for your legs so you don't need as much weight for quad-dominant exercises. it will further help take the stress off your knees.

If you came to me and said your goal was to star as Quadzilla in an upcoming blockbuster movie, I could tell you to do heel squats, lunges, and split squats in a short stride. bomb, and maybe even a few sssy squats for good measure.

That would certainly net you some huge quads, but it might not be long before your knees give out and you'll find yourself banging on the shelf with Ben and Jerry's and wailing as you watch your once stout legs wither to toothpicks.

Some people can do these exercises for years without a problem (and usually have big thighs to show it), while others get knee pain from watching them. For those in the latter category, stop trying to target your quads with a forward weight shift and learn how to sit and share the load with your hips while maintaining more of a vertical shin.

If you're concerned that your quadriceps aren't getting enough stimulation, remember that the most important factor in building muscle and strength is consistency, which means your primary goal should be to stay healthy in the long run.

Straps can be very helpful in facilitating consistent weight shifting to the rear and safely strengthening the quads.

Here are a few different ways you can use them to suit your needs.

For real one-leg work, such as single-leg squats and skater squats, attach one end of a band to a sturdy post (a power rack works fine) and tuck the other end behind your knee. From there, perform the exercise as you normally would. Watch the video below.

The band forces you to lean back to avoid pulling forward, putting strain on the hips and relieving the knee on the rep's bottom.

Here's the fun. As you ascend, it shifts from a hip-dominant movement pattern to a more quad-dominant knee extension (TKE), allowing you to strengthen the vastus medius (VMO) through a more knee-friendly range of motion.

You can also do something similar to working split poses like split squats and Bulgarian split squats, only it's better to attach the strap to a belt rather than behind your knee to make your position easier.

Make sure to set up with a longer stride so that your shin is perpendicular to the floor.

The band increases the demands on the quads because you have to constantly push through your toes to grip the floor and maintain stability, but it does so within safe joint ranges because it simultaneously forces you to sit comfortably and maintain a vertical shin to not get stuck. pulled forward.

To help build a good bilateral squat pattern, try hip belt cable squats, which I wrote about in more detailhere. A band is also on a pinch, but it's going to be hard to get enough of it

The cable doesn't drastically change your squatting pattern, but it still allows you to squat freely while reflexively learning to sit.

Lunges are generally not something I like for people dealing with knee pain.

The worst knee violations are forward walks and running walks due to the high degree of deceleration and eccentric stress. But even inverses, which are faster in nature, can be problematic.

Instead, I'd recommend starting with static exercises like split squats and then Bulgarian split squats that provide a solid base of support so you can set up with a vertical shin and maintain that position throughout the set.

The only exception may be slideboard reverse lunges, which is actually a hybrid exercise.

While it looks like a knee-dominant lunge pattern and you definitely use your quads to some degree, when done correctly it's actually more hip-dominant -- you pull yourself up to the starting position using your posterior chain.

In addition, the back leg never leaves the ground, so there is a higher degree of stability than with other lunge variants.

You can also try placing a band or bench directly in front of the working leg as a physical reminder to keep your weight on your heels and prevent the knee from moving too far forward.

With all of this, remember rule #1.

Reverse sleds are a great exercise that is comfortable for you and serves as both a rehabilitation tool and a muscle/strength builder.

Since making them a staple in my routine, my knees feel significantly better. I've even regained some of the muscle I lost in my right quadriceps, to the point where my legs are nice and flat again. I'm far from out of the woods, but it was a big step in the right direction.

At the time this photo was taken, I was basically doing nothing but backward sledding and hip-dominant work.

Sleds certainly won't replace lifting heavy weights, but they're better than nothing, and they can at least help prevent muscle loss in the meantime.

Here's how I implemented the sled into my program when I was unable to do significant knee-dominant work:

• Do it four times a week, so basically every workout.If I feel like I need to take a day off, I'll take it.
• I use a very simple method to choose the right weight.I keep adding weight until my knee hurts and then I pull out a plate. This is my weight for today. Some days it's heavier than others, but I don't worry too much about it.
• On days that focus on the upper body, I combine upside down sledding with the most important lift of the day: pull-ups, presses, etc.Between each set of this exercise (including the warm-up sets), I walk the sled the entire length of the gym, which is about 25 yards each time. Again, I'm not too concerned about the weight and just focus on keeping it pain free.
• On days that target the lower body, I do them at the end of the workout after hip-dominant work.Here I am using a timed method where I reserve a certain amount of time and just keep walking until the time runs out. I started with three minutes and slowly worked my way up to 10-15 minutes. This is much harder than it sounds.

They burn like crazy while you're doing them, but since there's no eccentric element, they don't paralyze you with pain, so you can use a higher frequency.

If you do them along with other knee-dominant work, 1-2 times a week is sufficient. In this case, I would do them before crouching and breathing to warm up your knees and work your quadriceps.

Usually I do them with a belt so I'm not limited by my grip, but here's a clever variation I like to use from time to time to get some bonus upper back work too. I couldn't think of a clever name for it, so I went with "Batwing" Reverse Sled Drags, because it's kind of like Dan John'sbatwing-concept.

Pull the sled toward you, then keep your elbows pulled down and back and keep your arms at your sides as you walk back.

Without a sled? Check out this article by Tim onmake your own sled.

If this is still not an option due to space constraints, try walking on the treadmill facing back with the belt closed and set at a slight incline.

This is a great exercise that can be used for recovery purposes or as part of a warm-up.

Stomps are usually thought of as a posterior chain exercise powered by hip extension, while TKEs are designed to strengthen the quadriceps (particularly the VMO) through terminal knee extension.

Put those two together and you have a good combination: hip extension, knee extension and a nice full range of motion.

Setup is key here. With a traditional band, you position the band closer to your heel and focus on pushing off with your heel. With this version, bring the band closer to your toes and consciously think about pushing off your toes. As your foot approaches the floor, squeeze both your quadriceps and glutes.

To encourage more hip extension, the toes should land slightly behind the heel of the opposite foot.

You can adjust the difficulty by choosing a thicker tire or increasing the height of the bar. I like to do this with the bar about mouth level, as this puts me in a starting position where my thigh is parallel to the floor.

Try adding a few sets to the beginning of your lower-body workouts as part of your warm-up, or on upper-body days for some low-impact supplemental work.

The days of jumping on the bike for 5-10 minutes before training seem to have passed in favor of stretching, auto-myofascial release, activation exercises, etc.

I certainly think things are important and I do it all myself, but I also think that 5-10 minutes of cycling can go a long way towards feeling better and having better workouts by helping to raise overall tissue temperature and "lubricate" the skin ". knee joints, as it were, by reducing the viscosity of the synovial fluid.

Generally I get on the bike as the last part of my warm-up just before lifting, but if it's very cold outside or early in the morning and I'm struggling to move, I'll do it first before I begin the rest of the warm-up.

I've heard conflicting arguments about whether you should train your non-injured limb. I've tried both ways and I'm all for training the good leg.

Some studies have shown that training one limb can increase strength in the contralateral limb, but I do it mostly for my mental state.

When I focus on whatable toI'm doing unlike what I can't, I'm feeling better and I honestly believe that positivity has a big impact on recovery. Whether you choose to believe the same is up to you.

As for the concern that exercising the healthy leg will create and exacerbate size and strength imbalances between the limbs, in most cases we are talking about a few months, tops. Realistically, you won't be building much muscle in that time anyway, so it probably won't make a huge difference.

I hope I've given you some great tips to take away and apply to your own situation so your knee pain doesn't stop you dead in your tracks.

However, proceed with caution. It's easy to get excited and overdo it. Even if you do "good" knee-friendly things, you can still do a lot of good things.

Less can often be more when it comes to managing pain, so keep that in mind as you go along. At the same time, an injury is no excuse to throw in the towel.

Find the balance and let loose!