13 Training tips to Relieve Knee Pain
July 26, 2016
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Knee pain is miserable, especially when you’re trying to build a bad-ass, athletic body. And chances are if you routinely lift heavy, jump, and sprint, then your knees have barked at you a time or two.
Even more frustrating, knee pain occasionally comes out of nowhere to throw a wrench in your training, making life and lifting miserable. But, should your knee pain be a sporadic pain in the ass, it’s time to get rid of it. First, get checked out by a doctor if you think the injury is serious. This blog is not meant to treat, cure, or prevent an injury, but only speaks to my experience as a coach and athlete. Moving on.
This article gives you the tools to get your knees healthy, so you can get back to crushing your workouts.
And if you’re one of the lucky few who’s never battled knee pain?
Even better. Follow my lead, and you’ll be a lot less likely to bust up your knees while still building and strong, athletic body.
Here’s a list of training tips to relieve knee pain for your workout repertoire.
Change your Jumps
Jumps are excellent for staying athletic and powerful.
The problem?
Jumps are stressful on the knees, especially multi-response jumps and broad jumps.
Multi-response jumps are multiple jumps performed in rapid succession, rather than one at a time. The problem here isn’t always the jump, but fatigue and a breakdown in technique. Most lifters rush their technique and end up minimizing hip and knee flexion on landing, shocking the joints rather than absorbing impact through the muscles.
Broad jumps are a standing long jump. While great for explosive horizontal power, lots of lifters only jump out, instead of up and out. If you just jump out without a focus on getting vertical height, you subject the knees to tons of shear stress at high speeds. No Bueno!
Either drop broad jumps if you have knee pain or focus on jumping “up” as much as out, with a low volume of two sets of three jumps.
Knee Friendl(ier) Jumps
Static Jumps:
Static jumps require you to start loaded, just like the bottom of a squat before jumping. In this position you negate the storage of elastic energy, making the static squat jump a great way to build static strength and explosiveness.
Plus, since there’s no countermovement, the jump is less complex. This minimizes the chance of poor takeoff and landing technique, like the knees diving in (valgus collapse).
Box Jumps: Box jumps offer a reduced stress on impact due to the box while allowing you to work on technique. Pause and stick each landing, then step off onto a shorter box. Don’t be one of those nimrods jumping backwards off the box for time, that’s idiotic and a good way to jack up your shins, not your vertical.
Medicine Ball Back Toss: While not an actual jump, back tosses use the same explosive hip extension pattern as jumps. They’ll still get you explosive and athletic, but with much less stress on your knees.
Hip and Glute Activation Warm-Up
One problem with sitting on our asses all day is that it decreases muscle activation in the hips and glutes.
Not only does this zap us of booty gains and more Jessica Biel-esque backsides (which is a terrible thing for Mankind in general), it’s a recipe for knee and back pain.
So, in the best interest of humanity, knee pain, and back pain, spend more time activating your dormant glutes.
During your warm-up, hit gluteus maximus and gluteus medius activation. This provides greater support to the knee (and lumbar spine) once it’s time to workout.
Pick one exercise focused on hip extension and one exercise on abduction and add them to your warm-up for 1 set of eight reps each. Instead of rushing, pause and hold position at the end range of every rep for activation.
Hip Extension Exercises (primarily gluteus maximus, also the hamstrings):
2:1 Supine Hip Thrust:
Hip Thrust:
Quadruped Hip Extension:
Hip Abduction Exercises: (Gluteus Maximus, Gluteus Medius, Gluteus Minimus, and Tensor Fascia Latae)
Clamshell: Bonus points for gazing into the eyes of passersby:
Lateral Band Walk:
Quadruped Fire Hydrant:
Hit the Bike
I get a ton of clients recovering from knee injuries via local PT’s and soft tissue practicioners. One habit working across the board for knee pain and performance is hopping on the bike for 10 minutes before training.
Activation drills are great, but we tend to fall in love with mobility and stability drills at the expense of basic warm-ups.
Before your training, spend a few minutes increasing body and tissue temperature while lubricating the knee joint on the bike.
Wear layers to speed up the process, break a light sweat on the bike, then move onto your activation drills and dynamic warm-up.
Improve Hip and Ankle Mobility
It makes perfect sense: When our knees hurt, we should focus our attention on the knee, right?
Not exactly.
With most injuries, problems can originate above or below the joint. In this case, a lack of mobility through the hip or ankle can be the root cause.
Hip and ankle mobility are common struggle points across the board. Thus, it would behoove oneself to improve hip and ankle mobility for performance and injury reduction.
Try these mobility drills out as part of your warm-up.
Groiners:
Inchworm:
Wall Ankle Mobilization:
Put ya Thang Down Flip it and Reverse it
Yes, this is a Missy Elliot line, but I’m talkin’ about lunges. Forward walking lunges and short stance split squats lead to higher tibial inclination and shear stress. That’s a complicated way of saying the further your knee goes over your toe, the more stress there is on the knee. Now, that doesn’t mean the knee tracking forward is a bad thing, far from it. But, if you suffer from knee pain, I’ve found it best my clients reduce shear stress.
In the first picture, the knee pushes further forward over the toe when stepping forward. This hits the quads harder, my stresses the knee.
When knee pain strikes, reverse the movement to keep a vertical shin.
Deload and Change Stances
A lot of injuries are the result of never backing off exercise intensity or changing movement patterns. To be a strong badass, you shouldn’t be a one-trick pony. Get strong with multiple techniques of the big lifts.
If you’re a powerlifter it’s fine to specialize. Otherwise, change foot position, bar position, and technique on your lifts to eliminate weak points and imbalances. I wrote a full article on micro progression here.
Otherwise, follow a periodized program like and back-off heavy weights every six to eight weeks.
To eliminate the confusion, follow a program like my Power Primer 2.0 to make consistent, injury free gains.
Widen your Squat Stance
In narrow and high bar squats, the knee tends to pass the toe, increasing, shear stress at the knee. Unless you’re blessed with exceptional dorsiflexion and genetics, this can add up to excess stress and pain.
It’s a double-edged sword, but widening your stance and externally rotating your feet shifts loading to the hips and lower back. This hammers your glutes, hamstrings, and adductors, but also stresses your hip and lower back joints. In excess, neither is good, so switch up your squat stance to prevent overuse at any particular joint.
Hip Dominant and Hamstring Work First
Since deadlifts are more hip dominant, you’ll decrease shear stress at the knee while giving the glutes and hamstrings a huge training effect. Since most of us train what we see in the mirror (hi abs and biceps), anterior-posterior balances are common. Deadlifts and posterior chain dominant exercises fix that in a hurry.
Still, be careful and note how your knees react, as compressive loading during deadlift lockouts is still stressful. If this is the case, test out stability ball hamstring curls for 2-3 sets of 8-12 reps before training, or avoid axial loading for a few weeks.
Do Reverse Sled Drags
Sled Drags are one of the best ways to build massive quads without aggravating your knees. Use them before, during or after training for pain-free quad training and building massive legs.
You’re able to hit a huge training volume without a ton of joint pain as there is no eccentric stress. You’re pulling a sled against weight and the resistance of friction, making reverse sled drags one of the best pain-free quad builders.
Front Squats Instead of Back Squats
On one hand, front squats use a narrow, quad dominant stance that leads to more shear stress than most wide-stance back squats.
But, you’ll use less weight and thus, decrease compressive stress on the knee.
This provides an interesting trade-off. Every knee is unique, and some people struggle with heavy compressive loading whereas others have pain from greater shear stress.
Nothing in training is absolute and what works for me might not work for you.
But, the decrease in loading (and compressive stress) might let you train hard without knee pain.
Add Single Leg Work
Single leg work is tricky. Too much, and you’ll overstress the knee.
But, more often than not, years of heavy squats and deadlifts have left you ripe with asymmetries and imbalances that if unattended, trigger pain and injuries.
I’d advise first getting to the point when your knee pain is no longer present. Then, add single leg work back in to address your weak points.
Unilateral exercises like lunges, single leg RDL’s and pistol squats attack these imbalances by:
-Increasing balance and proprioception
-Training the lateral subsystem and knee stabilizers (adductors, abductors, deep spinal stabilizers)
-Providing a change of pace in your training
Start with reverse lunges and long-stance split squats. Then, use exercises like 2:1 accentuated eccentric pistols to a box to improve muscle activation and eccentric control.
Possible Supplementation to Improve Joint Health and Inflammation Markers
Make sure you’re covering your foundational basics first. That means sleep, eating high-quality food, and focusing on recovery. 90% of the time, this is what’s missing.
But, in the case you’re looking for an extra boost, these supplements might help.
- Glucosamine and chondroitin (for their possible joint-regenerating effects). I like Stronbone from Onnit.
- Fish oil supplements (to help balance fatty acid profile, battle inflammation, and arthritis)
- Curcumin (to battle inflammation and soreness)
Admittedly, research is all over the board on joint supplements, but when I’m in pain I’m willing to test supplements that “might” make a difference. This is your call.
Reduce stress, sleep, and eat well first, but understand joint stress is part of the game with heavy training and you might need to an extra hand.
If it hurts, for the love of god stop doing it.
A few years ago, I was sprinting, jumping, cleaning, and squatting heavy on the regular. Even after a chronic knee injury, I kept slamming my head into the wall.
One of the best lessons I learned from Coach Loren Landow was to take my ego out of it.
Amidst my bitching, he asked, “If your client had the same injury, would you do (insert exercise)?”
The lights went off.
Ask yourself the same question. If you don’t have clients, pretend you’re programming for your mom.
Even if you “win” and tough it out with a steady dose of Advil and Biofreeze, you’ll lose the long game.
Remember, what goes around comes around, especially when training through pain.
Don’t be a hero, no-one cares about the time you squatted through pain when you’re laid up after getting a scope and looking stone-eyed at three months of rehab.
Training Tips to Train Around Knee Pain
These exercises and tips aren’t only for those of us with bad knees, they’re essential in prevention. After all, the best way to prevent pain in the first place to take proactive steps. Anf if you think an injury is serious make the smart move and go see your doctor. And that means knee friendly training to stay healthy and performing like an athlete for the long-haul.
P.S. I know this was a ton of information. If you found it useful, please share and pick up a quick and easy knee prevention guide. It’s Free.
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Great! These exercises will be very useful for those of us experiencing knee pain. Will definitely learn the videos and will share it also to my friends. Thanks for the share!
Thank you, Dr. Ben!
Great article! These exercises are clearly explained to reduce knee pain. Thanks for sharing such an article!
[…] loads being lifted compared to back squat. This means potentially more gains with less pain. This guide will help with knee pain as well […]