Knee pain is one of the most common achy-body complaints out there — it doesn’t matter if you’re young, old, a man or a woman, a gym rat, exercise newbie or weekend warrior.
Depending on the cause and severity of your knee pain, exercise can actually be helpful. (Image: twinsterphoto/iStock/GettyImages)
That’s because the potential causes of knee pain are wide-ranging, including deconditioned muscles, overuse, osteoarthritis, immune disorders and everyday accidents, says Andy Coggan, a certified personal trainer and corrective exercise specialist with Gold’s Gym in College Station, Texas.
But if you skipped the gym every time your knees were feeling less than 100 percent, you might never make any progress toward your fitness goals. That said, you also don’t want to worsen any potential injury.
There’s usually a way to safely work out with knee pain, no matter the cause or severity of your joint issues. In the most extreme cases — even if your legs are completely out of commission — it’s still important to train your core and upper body, and you can easily do so with exercises done seated and lying down.
Even if you feel like you can only work one leg, that’s OK! A 2012 study in the Journal of Science and Medicine in Sport found that training one leg results in small strength benefits in the non-trained leg, too, thanks to the neurological miracle known as the “cross-over effect.”
However, most of the time, the solution is as simple as finding pain-free ways to strengthen your legs — and knees.
If you’re already suffering from knee pain, the number one thing to watch for is increased discomfort. In general, your pain level shouldn’t increase by more than two points on a scale of one to 10 during or after any given exercise.
If any movement significantly increases knee pain either during or immediately after exercise, it’s best to cut that move from your routine or do a different variation so that it no longer causes pain, says Adam Rivadeneyra, MD, a sports medicine specialist with the Hoag Orthopedic Institute in Irvine, California.
For example, you can largely reduce stress on the knee during lower-body exercises by limiting how much you allow your knee to bend while still maintaining proper form. Try capping any knee flexion at 90 or even 45 degrees.
You can also limit how far your knee travels forward — either by bending more through the hips, cutting your motion short or taking a greater stance when in lunges, Coggan says. Keeping your weight balanced in the heel of your foot will also transfer excess weight to your hips and off of your knees.
If any exercise causes swelling or pain that lasts for more than two days, talk to a physical therapist or a physician with experience in sports medicine or orthopedics. It’s never a bad idea to play it safe and talk to a specialist if your knee issues are nagging or ongoing.
Increasing your lower body strength and stability is essential for managing and preventing knee pain. It can also help to limit any side-to-side force on the knee. When selecting lower-body exercises, “closed chain” ones in which your feet are firmly planted on the floor keep the knee in a more stable position, Dr. Rivadeneyra says.
Meanwhile, giving some extra love to the hips and core can help keep your legs tracking the right way with relation to the knee socket, Coggan says. “These movements will lead to greater quality of movement that will take stress off of the knee, decrease inflammation within the joint and shuttle healing blood to the area to speed the recovery process,” he says.
Here are 12 exercises from Coggan and Dr. Rivadeneyra to add to your workout routine when knee pain rears its ugly head.
If deep squats give your knees trouble, reducing the depth can allow you to strengthen the knee and surrounding leg muscles without damaging the joint itself.
- Stand tall with your feet between hip- and shoulder-width apart, on top of a resistance band, with the opposite end looped over your shoulders behind your head.
- Push your hips back and bend your knees to lower your body straight down about eight inches, until your knees are bent to a 45-degree angle, not letting your knees cave in or your heels raise off of the floor as you do so.
- Pause, then slowly push through your heels to return to start.
Lunging straight up and down — without stepping either foot forward or backward — adds stability and reduces impact to this common knee-dominant move. Meanwhile, maintaining a slight forward torso lean helps move stress from the front knee to the hips.
- Stand with one foot a few feet in front of the other (optional: hold a dumbbell in each hand).
- Lean your torso forward as far as is comfortable or until your shoulders and hands are directly over the middle of your front foot.
- Bend both knees to lower toward the floor as far as is comfortable.
- Pause, then press through the heel of your front foot to raise to start.
Warming up your gluteal muscles prior to lower-body exercise may help increase their activation to improve hip strength and stability. The result: better form and less pressure on your knees.
- Sit on top of a foam roller that’s running perpendicular to your body, and place your hands and feet on the floor.
- Shift your weight forward and backward to slowly move the roller up to the top of your glutes and down to the top of your thigh.
- Pause in any tender spots, breathing deeply until you feel any muscle tension release.
- Angle to one side, and then the other, to roll the sides of your glutes.
Your core plays a critical but often overlooked role in keeping excess pressure off your knees. Strengthen your core, or simply activate it prior to lower-body movements such as squats and lunges, with this exercise.
- Lie on your back with your arms and legs up in the air and your knees bent.
- Press your lower back into the floor, and brace your core.
- Lower one leg until your heel hovers above the floor while also lowering your opposite arm toward the floor above your head.
- Pause, then squeeze your core to raise your arm and leg back up to start.
- Repeat with the opposite arm and leg.
A popular physical therapy exercise, the wall press focuses on strengthening the gluteus medius muscle, in the side of the hips, to improve pelvic stability and single-leg balance.
- Stand tall next to a wall with feet together, the nearest foot about six inches from the wall.
- Bend the hip and knee of the leg closest to the wall.
- Press that knee and lower thigh, but not the foot and lower leg, into the wall.
- Hold, then repeat on the opposite side.
By focusing on bending and straightening the hip, rather than the knee flexion, deadlift variations strengthen the glutes and hamstrings while placing minimal stress on the knees.
- Stand tall with your feet hip-width apart and hold a dumbbell in each hand with an overhand grip in front of your hips at arm’s length.
- Pull your shoulder blades together and brace your core.
- Slowly push your hips back behind you, allowing your knees to bend slightly as you do so, to skim the weights down your thighs.
- Pause when the weights lower just past your knees, or you feel a stretch in your hamstrings.
- Drive through your heels and squeeze your glutes to thrust your hips forward to return to standing.
Improve lower-body stability by strengthening and activating the gluteus medius and minimus with this single-leg standing exercise.
- Stand tall on the edge of a sturdy bench or step, and transfer your body weight to one leg.
- Let the other leg hang off of the side of the bench, keeping both feet in line with each other.
- With the planted leg fully straight, drop the hip to lower the hanging foot a few inches toward the floor.
- Pause, then raise the hip until the hanging foot is just higher than the planted one. Keep the planted leg straight throughout.
Releasing tension in your hip flexors — which are notoriously tight in desk-workers and athletes alike — this bodyweight exercise activates your glutes and prepares your hips for lower-body moves ahead.
- Lie face-down on the floor, and prop your torso up on your forearms with a massage or lacrosse ball under your right hip crease.
- Bend your knees and rest the inside of your left leg and the front of your right thigh flat on the floor.
- Your right foot will extend toward the ceiling.
- Slowly lower your foot toward the left, then to the right.
Sometimes the cause of knee pain can be as simple as a super-tight calf. This drill can be performed both before and after exercise to make sure that your calf muscles aren’t tugging your knees out of alignment.
- Sit on the floor with your calves propped on a foam roller that’s running perpendicular to your body, and place your hands on the floor next to you.
- Squeeze your glutes to raise your hips from the floor so that your calves press into the foam roller.
- Shift your weight forward and backward to slowly move the roller up and down your claves, avoiding both the back of your knee and ankle.
- Pause in any tender spots, breathing deeply until you feel any muscle tension release.
This glute exercise is closed-chain for stability but keeps your feet planted on an elevated bench, rather than the floor, reducing pressure on your knees.
- Secure a bench perpendicular to your body and lie on the floor with your knees bent and heels on the edge of the bench hip-width apart.
- Place a mini looped resistance band around your thighs, just above your knees (or do this exercise without it).
- Keeping a flat back, squeeze your glutes and push through your heels to raise your hips until your torso forms a straight line from knees to shoulders and your knees are bent to 90 degrees.
- Pause, then lower your hips to the floor to return to start.
Strengthening the muscles not just above but also below your knee is critical to joint health. With calf raises, focus on the eccentric, lowering phase to improve mobility in the ankle and knee.
- Stand tall with your feet narrower than hip-width apart, and hold a dumbbell in each hand down at your sides
- Place the balls of your feet on an elevated surface so that your heels can sink below your toes with each rep.
- As slowly as possible, lower your heels as far as you can comfortably without losing balance.
- Pause, then press through the balls of your feet so that your heels are raised as high as possible above your toes.
Hone your lunge form, strengthen your glutes and improve your lower-body stability.
- Stand tall with your feet hip-width apart, the ball of one foot resting on a glider, and hold a sturdy object in front of you around waist height.
- Shift your weight to the planted (non-glider) foot. Slide your glider foot behind you, bending at your hips and knees to lower down as far as is comfortable into a lunge.
- Pause, then squeeze the glutes of your planted leg to draw your back leg to start.
- Make sure that your knee does not move forward or backward through the entire exercise. It should stay perfectly still, directly above your ankle.