How To Deal With Knee Pain

Knee pain is very common, particularly in sports that involve a lot of knee flexion, knee impact, and are dominantly quad-heavy. These sports include trail running, biking, and skiing. This article goes over knee pain, when you should see a specialist, how to properly treat knee injuries, and strength and mobility exercises that strengthen the muscles that stabilize the knee to protect it from further injury.

Causes of Knee Pain

If you are experiencing chronic knee pain, it’s most likely because of overuse of the knee joint paired with lack of stability and mobility in the knee, hip, and/or ankle joints, though there could be a myriad of reasons. It’s important to remember that when you have knee pain along with swelling, you need to see your doctor. However, the ways for treating knee pain outlined in this article apply to all the different causes of knee pain.

Injuries

The most obvious cause is a high-stress injury, such as a torn or sprained ligament caused by sudden impact to the joint. More often than not, these injuries are caused by knee instability. For example, ACL tears are more common in females due to wider hips, which generally means less knee stability.

Overuse

Chronic knee pain is caused by low-grade, consistent wear and tear from most daily activities. Common reasons for knee pain in athletes include overuse without proper strength in the muscles, tendons, and ligaments surrounding the knee.

Arthritis

Arthritis in the knee occurs when cartilage in the knee joint breaks down. Bones rub together, causing stiffness, swelling, and overall pain in the knee joint. Overuse of the knee joint can lead to arthritis.

How to Deal With Knee Pain

RICE

The RICE method is an acronym for rest, ice, elevate, and compression. RICE is the most common way to treat knee pain; however, the RICE method has been proven to delay the healing process. The original creator of the RICE method, Dr. Gabe Mirkin, coined this method in 1978. Then in 2015, he publicly recanted his position, stating that recent evidence has shown ice to actually delay the healing process. There are now many scientific studies that show healing muscle, ligament, or tendon injuries do NOT include extended periods of rest along with ice, compression, or elevation. When injuries occur, there are three phases of recovery our body goes through: inflammation, repair, and remodeling. When you ice an injury, you are cutting into the first stage of inflammation needed for the body to recover. During the repair and remodeling stages of recovery, it’s very important to remain active to strengthen the injury and muscles around the injury. Movement of the joint, muscles, and tendons surrounding the area of injury is crucial at this stage to facilitate a full recovery and regain the full range of motion that was lost due to the injury. If your injury is painful enough to need icing, it’s recommended that you see a doctor.

Knee Braces

Knee braces can help protect and support the knee post-surgery. Compression of the joint can somewhat help alleviate pain; however, a knee brace has the most impact by providing peace of mind and a sense of safety while wearing the knee brace. There is a study that highlights the benefit of wearing a semi-rigid knee brace for offering pain relief and freedom of movement. However, this could be due to the knee brace limiting the amount of movement, which isn’t causing stress around the joint.

Physical Therapy

Physical therapy is necessary if you’re recovering from an acute knee injury and/or chronic knee pain. However, physical therapy does not have any progressive overload over time, so there is a limit to how much you can recover from a knee injury with just physical therapy. That’s why it’s important to prioritize knee strength and mobility in your strength training as you continue to recover.

Exercises for Knee Pain

The best way to help knee pain is through strength and mobility training that focuses on muscles that stabilize the knee joint. These muscles include the glutes, quads, hamstrings, calves, and shins. It also requires having a strong foundation (the feet) and ensuring the hips and core are healthy and strong. The most important movements to incorporate in your training are unilateral exercises. You also need to prioritize hamstring strength and mobility training, as the hamstrings stabilize the knee joint and help control its movement. It’s important to remember that mobility training is strength training that aids a joint in reaching greater ranges of motion. Improving hip flexor strength will also help with knee pain because they help maintain the proper alignment and stability of the pelvis during movements such as walking, running, and biking. While working on movements for knee pain, keep your pain level in mind. Work within a pain scale prescribed by a physical therapist. Most likely, the movements will cause a slight amount of pain; however, it is up to you and your physical therapist to decide what is an appropriate amount of pain. You can check out our YouTube channel for tutorials on dozens of strength training movements. Here is a list of movements that are suggested to help knee pain:  

Hip Flexion Lifts

There are many levels to hip flexion lifts. Level one is leg raises lying on the ground. Level two is what most people will do: a seated hip flexion leg lift. Level three is a straddle leg lift. Both legs are apart in a straddle, you push both palms into the floor, lean forward, and lift your feet off the floor.  

Side Leg Raises

Part of the hip that needs work if you have knee pain is the gluteus medius, which is a smaller glute muscle that stabilizes the knee and hips in the upper corner of the butt. Side leg raises are standing hip abduction movements to work the gluteus medius. Do this by lifting one leg to the side as high as you can while standing or laying.    

Horse Stance Squat

Another favorite movement for the gluteus medius, hip flexors, adductors, and quads is the horse stance squat. Have a wide stance with toes forward and squat.

Hamstring Work

 

Romanian Deadlifts

This is a hinge movement that can load the hamstrings and the glutes.  

Leg Curl

The leg curl is a hamstring isolation movement that can be done either seated or lying on a machine.  

Hamstring Stretch

PNF stretching is a great hamstring stretch. You lay on the floor, grab a fitness band or strap to strap the bottom of your foot. Lift your leg towards the ceiling and pull your leg towards you with the strap, while actively pushing your leg away. Do this for 5 seconds then relax. Alternate between pushing and relaxing.  

Single Leg Good Mornings

 

Jefferson Curls

Another good hamstring mobility movement with spinal mobility.  

Unilateral Lunges

All of them!  

Treating Knee Pain the Right Way

First and foremost, go to your doctor to figure out what is going on. If it is a chronic issue, you can incorporate these movements into your training. If you need to see a physical therapist, make sure you begin incorporating these movements into your strength training once you are done with physical therapy. Once your knee is feeling better, some movements are very important to incorporate to help prevent knee pain, maximize knee flexion, and take the knee joint through a full range of motion. This includes knees-over-toes split squats. And remember, unilateral training is most important. Want our free Training Guide for Knee Pain? Click Here  Want to learn more about knee pain? Listen to episode 191 of the Stronger Than Your Boyfriend Podcast: Knee Pain  

Sources Cited: 

Dries, T., VAN DER Windt, J. W., Akkerman, W., Kluijtmans, M., & Janssen, R. P. A. (2022). EFFECTS OF A SEMI-RIGID KNEE BRACE ON MOBILITY AND PAIN IN PEOPLE WITH KNEE OSTEOARTHRITIS. Journal of rehabilitation medicine. Clinical communications, 5, 2483.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9274778/