Training Around Knee Pain, Part 1

Several years ago, I began to experience regular knee pain. This was extremely frustrating for me as I love training legs and am on my feet all day long for my job.

Fortunately, with a few tweaks to my training, more attention paid to technique, and a renewed commitment to warmups and foam rolling, I was able to greatly reduce the intensity and frequency of my pain and return to a normal training routine.

Knee pain can be extremely frustrating but it doesn’t need to derail your training. This first article provides some of my favorite warmup and cardio strategies to reduce knee pain and better prepare yourself to train safely. The second part addresses ways to modify your lower body training.

I have used these techniques myself and with my clients with great success. Please be advised that if you experience intense, debilitating pain or your pain persists for several weeks, you should see or medical professional.

Warmup

Before you do any training, I recommend completing a dynamic warmup to engage the glutes and hips and mobilize your hips and ankles. You must understand how to use your glutes when training your lower body, and activation drills help you get more in touch with these muscles.

I always begin all of my training sessions with a set of glute bridges. Some other activation drills include clams, fire hydrants, lateral band walks, and bird dogs. Try adding a resistance band to these exercises to make them more challenging.

People with knee pain often lack mobility through their hips and ankles. In addition to the activation drills above, complete a few mobilization drills to promote proper joint movement.

Some of my favorite hip mobility drills include hip rockers, split-stance rockers, half-kneeling hip flexor stretches, 90-90, 3-point lunge (sometimes called spiderman lunge or groiners), and fire hydrant circles.

To mobilize your ankles, complete a few sets of this wall ankle drill or inchworms to round out your warmup.

Foam rolling

Foam rolling may help relax overactive muscles and reduce knee pain. However, many people approach foam rolling incorrectly and therefore waste their time.

Instead of quickly rolling back and forth over an entire muscle, take your time and go slow. Look for spots that feel particularly tender and hang out on top of those. Take a few deep, slow breaths and try to feel the muscle release.

Pick one or two problem areas each time you roll so that you can devote 2-5 minutes on each muscle. The areas most commonly responsible for knee pain include the adductors (inside your thigh), IT band (outside your thigh), quads, and calves. You can foam roll at the start or end of your workouts.

Knee-friendly Cardio and Finishers

Bicycling – both on a stationary bike or on a real bike – is a great way to get in cardio without aggravating knee pain. Many physical therapists prescribe cycling as part of a knee rehabilitation program. Be sure the seat on the bike is not too low; your leg should be almost straight at the bottom of your pedal and not crunched up at a 90 degree angle. Riding a bike with clip-on or strap-in pedals allows you to take more advantage of your hamstrings on the upstroke.

Swimming is another great training option for people with knee issues. There is almost no impact when you swim, making it a very joint-friendly option.

Be cautious and ease into running. Always complete a dynamic warm-up before you run and foam roll a few times each week. Always wear appropriate footwear for your body. Start with a walk-run approach that has you alternating between periods of lower and higher intensity. If you continue to experience knee pain, meet with a running specialist to analyze your mechanics or consider switching to a cardio modality that you can tolerate better.

I also love heavy sled pushing and pulling as a finisher in the weight room. This exercise gives you a great full-body training effect without putting much strain on your knees. If your gym doesn’t have a sled, you can use an overturned box stacked with weight plates.

In part 2, I discuss how to train your legs if you have knee pain. 

Want to work on squats and deadlifts without exacerbating knee pain? Download your free copy of my ebook Squat and Deadlift School below. I share the exact progressions and exercises I use to help clients feel strong and confident with these exercises, including ways to modify your training if your knees are bugging you.