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Exercising with Knee Pain
Fitness | March 04, 2016
Knee pain is incredibly common. But it shouldn’t be. I’ve written about this before, but knee injury is only the result of poor or improper alignment of the knee joint with other load bearing joints in your body, like your hips and ankles. I’m passionate about this subject because I’ve recently been certified through the Egoscue University as a Postural Alignment Specialist. It’s helped me to understand how crucial alignment is to your body’s health, function and prevention of injury.
Part of my mission is to help you exercise every single day. And you can’t do that if you’re in pain. If you’re currently experiencing any pain you should consult your doctor first. But once your doc has cleared you to work out, you can try postural therapy to help relieve discomfort and properly align your body. I’ve made several videos explaining how to perform the Egoscue Method exercises (or menus, as we call them), which can help relieve discomfort or pain. You can check out the whole postural therapy series here, where I’ll take you through the postural therapy step by step, no matter where it hurts.
All of that aside, whatever the cause, many people are living with knee injuries and/or pain. Does that mean you should throw in the towel as far as exercise goes? Of course not! There are lots of ways to stay in good shape while also taking it easy on your knees.
Many experts also advise swimming, cycling, walking, and/or any kind of dancing that doesn’t involve a lot of jumping or squatting (e.g. salsa dancing) as good cardio options for people with knee problems.
But there are lots of ways you can modify your regular exercise routines so you can keep up your current level of fitness.
First of all, warm up, cool down, and stretch. It’s vital always, but especially when you’re working with an injury to warm up properly before you exercise, cool down after, and stretch.
When you’re working with any kind of knee injury or issue, it’s important to avoid any motion where you’re flexing your knees deeply, especially if you’re also holding added resistance (like a kettle bell or weights). You’ll want to avoid deep squats and lunges. It’s also a good idea to stay away from high impact activities, like jumping or running.
Here are some examples of exercises or exercise styles that should be safe to do when you have knee problems. Remember, if you have an injury, or think you might, always run an exercise program by your doctor to make sure it’s safe and effective for you.
5. Upper Body Work. Same idea here. You don’t need your knees to work your back and arms. I’ve recently started working on perfecting pull-ups in my new Black Diamond series. Pull-ups work your shoulders, biceps, triceps, back, core, and skyrocket your heart rate. You can also try push-ups (as long as you don’t need to do them on your knees) and those are fantastic for spiking that heart rate as well. Although not all of the moves in my Black Diamond series are ok for people with knee problems, most of the exercises should be acceptable. Watch any workout once through before attempting it so you can eliminate anything that would be taxing on your knees or put you in a flexed-knee, weight bearing position.
Again, if your doctor has cleared you to exercise and you still have knee discomfort, try my postural therapy video for knee pain. I’d love to know if it helped you. Also, let me know if this is a helpful list for working with a knee injury or if I left your favorite easy-on-the-knees move out of my list!
If you have pain and you’re doing your best to try and stay active, I am so proud of you. I personally have a lot of experience with pain and I know how debilitating it can be. You can get through this and you will. And I hope my postural therapy videos bring you some relief.
Private Member |
I’m currently recovering from a running knee injury and I still work out with you here all the time! My Physical Therapist just recommended that I only squat until my thighs are parallel to the floor, instead of the AtG deep squats, and also I just modify the jump squats or jump lunges by removing the jump part. After continuing working out like this for the past several weeks, I’m already well enough that I can include up and down jumping exercises – like basic jump rope or just jumping in place, so I’m well on my way back to normal. 🙂
I love your site so much, thank you for all that you do Zuzka!!
Private Member |
seattle, washington
Pretty comprehensive list. I would suggest aided deep squats. So either using a strap or machine to reduce the load. It keeps the range of motion but prevents injury.
Private Member |
I am a physical therapist; I have significant arthritis in both knees; and I can deep squat with the best of them without knee pain. How? Because I have excellent squat form. I recruit my posterior chain (glutes and hamstrings) to lower down and use my quads and glutes to drive back up. It’s not about “bad knees”, it’s bad form that does people in. In the majority of patients I see with knee pain, they have horrible squat mechanics.
Here’s a simple, 3-point check to initiate a good squat: (1) Eyes up. (2) Shift your weight onto the outside of your feet (off your in-step). (3) Start your squat like you’re pushing a door open with your butt b/c you’re carrying something… Throughout a squat your weight should be in your heels to your shoelaces – never have your weight over your toes.
Another common cause of knee pain is poor range of motion/mobility to the joints above and below the knee – aka the hip and the knee. When you deep squat, you should be able to keep both heels flat on the ground. People with a history of a bad ankle sprain can lose the necessary range of motion in the ankle to do this. As a result, increase stress reaction forces are transferred to the knee. (See a physical therapist to help regain this essential motion.) If you can’t deep squat, limited hip range of motion/mobility may be the cause. I HIGHLY recommend Zuzka’s Power Yoga Split Series to help with this. And again, a licensed PT is another great source for help with any mobility issue.
Private Member |
usa
Thanks Celeste and Zuzka for the great advice. I tore my ACL completely off of my femur last year and I can do squats with careful form. And you’re right, if I don’t, I sometimes end up with some pain and not just my injured knee. I am going to focus on how you say you perform squats in the down and up movements using the proper muscle groups.
Private Member |
Did you have ACL reconstruction? I tore mine and had surgery in 2012. The BIG thing with ACL tears, especially if you’re not having the surgery, is to strengthen your hamstrings. The ACL and the hamstrings work together to prevent the tibia (shin bone) from shifting too far forward (aka anterior translation). Single leg deadlifts, kettlebell swings, and bridging on a ball with hamstring curls (by rolling the ball towards you with the hips in the air) are great hamstring exercises you can do at home. I’m not saying skip squats or lunges, but give your hammies a little extra love to help stabilize that knee.
Private Member |
usa
I haven’t had the surgery yet but plan to so I can run again. Thanks for the good advice about strengthening the hamstrings because I thought I needed to focus more on the quads. 🙂
Private Member |
Quads are important to prevent weakness. Without thinking about it you’ll favor the good leg for stuff like leaning on or pushing/stepping off with. So don’t ignore your quads, but give those hammies a little extra love.
The surgery isn’t that bad. The big thing to remember is somewhere between weeks 8-12 after surgery your knee will start feeling normal again. This is the time I call “The Stupid Period” because this is the time when the grafted ligament is at its weakest. I was so ready to start running around 9 weeks but just had to keep telling myself to not do anything stupid and wait. At 12 weeks I had good strength and range of motion and was ready to start running.
Let me know if you have any questions about the surgery or recovery. I’ve been a PT for 9 years along with having gone through the surgery myself.
Private Member |
usa
Thanks so much for the info and advice. You seem to be a very good and knowledgeable PT. I will need a PT after my surgery. Not sure where you’re from but do you have any recommendations in the south Austin area.
Private Member |
Why thank you! I love ACL rehab. It’s a great process to watch a patient go from crutches to running again in a few months.
I’m not in that part of the world, but I went to PT school in San Antonio with the Army-Baylor Doctorate of Physical Therapy program (one of the top PT programs in the country). Check out Texas Physical Therapy Specialists. I know they have locations in Austin. The original clinics in San Antonio were founded by very accomplished Army and Air Force PTs, not my classmates but former grads/faculty of the Army-Baylor program.
Private Member |
curitiba, parana, brazil
Hi Zu…I felt little discomfort on my knees after using power bands but I am sure by tomorrow everything will be fine.
Private Member |
seattle, washington
Actually what really determines your ability to squat deeply is your skeleton. If you have a long torso, short tibia and long femur you can’t squat at all period! Even with a perfectly designed body for deep squats if your ankle is messed up you can’t squat deeply.
Private Member |
seattle, washington
This video should explain what I mean: https://www.youtube.com/watch?v=Av3LO2GwpAk
Private Member |
seattle, washington
I was thinking about what I wrote. You can change your femur’s moment arm by widening your stance. So you could possible squat.
Private Member |
Really interesting and great comments. I have had trouble on and off for almost 5 years with one of my knees. I only recently came to the realisation that it could be due to my foot – slightly flat due to an annoyingly misaligned big toe knuckle joint (OK it’s a bunion, but I hate the sound of it) Could the misalignment of my load bearing big toe be at the root of my knee problem?
I have improved hip flexibility and overall strength so can do pretty much all Z’s exercises, just now and again, I’ll squat too low or bounce too hard and wham, I’m feel it for weeks.
Private Member |
Hi zuzka and hi everone,
I’ve been following your workout program for beginners for 3 weeks now and I was so in love with it ( made me feel so good inside and ouside ! ) But now with my knee injury problem ( I have very flat feet I assume that’s the problem because when looking in a mirror I don’t fond my posture that bad…) I can not workout anymore following your beginner program because it includes a lot of lunges and squats in almost every workout (cardio, strength or kettelbell). It is so frustrating because I am just left here, not knowing what to do as I am not strong enough to take any other of your exercises for abs or upperbody for example. And my bad habits are coming back, getting inactive again and eating junk food to compensate that feeling. I was so enthusiastic about finally getting in the best shape of my life, I am now so disappointed because there s just basically nothing you can do about flat feet. Probably will stay a fat cow for the rest of my life now 🙁
Private Member |
I had an impact injury at 18 playing high school basketball. I can still do squats just fine, it’s lunges that give me problems. Having said that, I have not let that stop me from working out. I just do another exercise that works the area until we move on to the next exercise. It’s just like modifying a recipe. I don’t think parsley has any flavor, so I substitute cilantro. Find ways to plug in other exercises to keep you going. I’m 52, and I can still place my palms flat on the ground, I can still keep up. That saying move it or lose it, is no joke. Keep moving, because the older you get, the harder it is to keep starting over. Your state of mind (Just DO it) also plays a big role. Sometimes I’m tired. I don’t want to. If I don’t, I know I may not tomorrow, either, and before you know it, you’re in a rut. Lastly, I have no medial meniscus, no cartilage in my knee at all. They took ACL and wrapped it around my knee cap, because of my knee instability. I use a strap on both knees, and just keep it moving. My Ortho is amazed that I don’t do steroid shots, eat NSAIDs like they’re going out of style, or plan to have surgery again anytime soon, even though my knee looks like a snow globe with all of the bone chips floating around in there. WATER (90 oz. a day) helps keep the inflammation down, for ME. Someday, I’m going to need surgery again, but until then, I’m just going to keep on MOVING! Thank you, Zuska, for your awesome site!
Private Member |
ga, united states
Thank you for all these links! I’m currently dealing with knee pain and it got father than I should’ve. I am doing bunny slope program and icing them. I will do the knee postural video to help too! I feel like I cannot stop training. I want to reach my body fat goal and you are helping me get there. I have a ball coming up in April and I need to get a little more fit to look fabulous in my dress.