Training Around Knee Pain, Part 2

In part 1 of this article, I explained how to warmup and foam roll to address knee pain. I also looked at which cardio options are the most knee-friendly.

Part 2 digs deeper into how you should modify your training when your knees are acting up. Please be advised that if you experience intense, debilitating pain or your pain persists for several weeks, you should see a medical professional.

Prioritize Posterior Chain Training

Depending on the severity of your pain or injury, you may not be able to perform knee-dominant exercises like squats and lunges right now.

Luckily, you can get a great training effect, build muscle in your legs, and get stronger by using exercises that primarily target the glutes and hamstrings. These exercises put much less strain on your knees and may actually help alleviate some of your knee pain in training and daily life.

Glute Bridges and Hip Thrusts

I have all of my clients with knee pain perform some variation of glute bridges or hip thrusts. These are some of the best exercises to directly target the glutes.

They are also very versatile and can be loaded a variety of ways depending on your goals. I program bodyweight bridges in my warmups, heavy barbell hip thrusts as a main lift during training, and high-rep band bridges and hip thrusts as a finisher. Get creative with how you use these exercises and don’t be afraid to go heavy once you master proper form.

Deadlifts

Another favorite exercise for those with knee pain is the deadlift. This exercise allows you to train your entire legs without putting as much direct strain on the knees. Be sure to choose a deadlift variation that doesn’t cause you any knee pain and that you can perform properly. Sumo deadlifts and trap bar deadlifts may be a better option than conventional deadlifts becasue they require less mobility and less knee flexion. I also like the Romanian deadlift because it allows you to hinge from a standing position, which again requires less mobility and less demand on the knee.

Other Options

Other great posterior chain exercises include good mornings (with bands, kettlebells, or barbells), back extensions, leg curls, kettlebell swings, and leg press with your feet positioned high and wide on the platform. Add in some isolation work for the smaller muscles in the glutes and hips. Some favorites include lateral band walks, seated machine abductions, and standing cable abductions. These exercises work best with light weights and high reps.

Adjust Knee-Dominant Exercises

Dealing with knee pain doesn’t mean you can’t continue to use knee- and quad-dominant exercises like squats or lunges. However, you will need to keep a very close eye on your form and consider making some tweaks to the way you load or perform these exercises.

It is extremely important to prevent any inward buckling, called valgus, of the knees. Allowing knee valgus puts tons of strain on the joint and may be contributing to your pain or injury.

Pay attention to your foot position. Your weight should be evenly balanced between your big toe, little toe, and heel when your foot is flat on the floor. Think about driving through your heel when completing single-leg exercises or leg presses to further engage the glutes and hamstrings. I also cue clients to spread the floor apart with their feet during squats.

Squats

There are several ways you can tweak your squats to reduce knee pain. Because some of these tips are contradictory, it’s important to experiment and find what works best for you.

Many people will benefit from widening their squat stance slightly and sitting back into their hips. Box squats are a great tool to learn how to sit back more into the squat and take more advantage of your posterior chain. Use a slightly lower back position when back squatting to accommodate this new stance.

Other people find that increasing their squat depth actually reduces their knee pain. If you tolerate it, try using a high-bar back squat or a front squat to get into an ass-to-grass squat. Front-loaded goblet squats also work well in this context. No matter how you choose to squat, be extremely careful to keep your knees out over your toes throughout the entire lift. Think about spreading the floor apart with your feet.

Unilateral Training

Choose single-leg exercises that keep your knee in a safer position. Single-leg deadlifts and RDLs are a fantastic exercise to build posterior chain strength and improve knee stability.

When clients are ready to reintroduce single leg knee-dominant exercises, I always start with split squats and step ups. I only progress to lunges when clients have demonstrated they can perform these two exercises with good form and without pain. Some clients never return to lunges, and that’s totally okay.

If you are experiencing knee pain, chances are good that you have poor mobility, weakness in some key muscles, or are performing exercises with shoddy technique. Try incorporating these strategies in your workouts to address these problems and build better training habits moving forward.

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.

One Reply to “Training Around Knee Pain, Part 2”

Comments are closed.