Knee pain can often be debilitating and frustrating. I know this as someone who has suffered from months of knee pain and also works with injured clients on a daily basis.
Instead of falling victim to pain that prevents regular exercise and movement, finding modifications to safely exercise around the pain is important. With that being said, the first step when experiencing pain should always be to find a knowledgable professional in your area to be evaluated. Resolving the issue needs to be your primary focus and not just working around it. But in the meantime, here are some alternate ways to challenge the body which may allow pain-free movement at the knees:
When in doubt, knees out!
Positioning of the knees can change the amount of stress throughout the knee joint. In many instances, I have found clients who feel less pain and a more stabile position when utilizing a “toe out” stance.
The sumo squat has been something that has worked for me personally. While being completely unable to perform traditional squats, even bodyweight, the sumo squat allowed a position that drastically reduced pain in the knee. Not to mention I was still able to lift significant weight.
Some keys to performing an effective sumo squat are to never turn the toes out further than the knees can track. Finding a wide position where the knees properly track with the 2nd toe is important. Next, focus on “screwing” the feet into the ground and rotating outward. This will engage the glutes and provide better control to the femur. Getting the hips involved will provide better alignment and support to the knees.
Put your ego aside and use assistance
Assisted exercises can work wonders for exercising with knee pain. In particular, the TRX is a fantastic tool that helps offset some bodyweight, while allowing you to sit back into various knee dominant exercises.
One thing that is common, especially with anterior knee pain, is that pain tends to increase the farther forward the knee travels past the toes. Being able to sit back into the hips while creating a vertical shin can be a useful solution.
Several exercises utilizing the TRX which can be worthwhile, are: the squat, split squat, reverse lunge, and single leg squat. This exercise list increases in difficulty and can be used as a progression as each movement is tested and mastered, before moving on to the next.
Incorporate hip dominant movements
The last modification is to actually stay away from larger degrees of knee range of motion all together. This is possible with hip dominant movements, such as: the Romanian deadlift, single leg deadlift, lateral band walks (with minimal knee bend), and hip bridging. The beauty in these movements is that the knee maintains its bend and thus encounters very minimal amounts of stress.
When I experienced knee pain, hip dominant movements were the most reliable to minimize or eliminate pain while still exercising with some intensity. It is also very likely that improving function of the hip can be beneficial for the knee. Since the hinged, knee joint is sandwiched between the mobile ankle and hip, incorporating hip strength and stability exercises can be a worthwhile strategy.
Like I mentioned before, none of these recommendations are given to resolve your injury but as a way to find movements which allow you to exercise with minimal pain. Be patient and willing to adjust throughout the process. What works for me may not work for you, and vice versa. Every case of knee pain is different and that is why trying several different modifications is important.
By: Garrett McLaughlin, MS, ATC, CSCS, ART