Whether you are a 55-year-old office worker or a 35-year-old athlete, I’m sure you or someone you know has suffered from some sort of knee pain. While it can be incredibly frustrating, and potentially throw your training to the sidelines for a couple of weeks, there’s no reason why you should stop lifting with knee pain. There are ways to keep lifting effectively while making sure your knees are moving properly, and maybe even reducing some of your pain.
Before we get into it, you need to understand is that the knee joint is basically a hinge. All it wants to do is to flex and extend without anything impeding that movement. Many clients that we see tend to have movement flaws that are causing excessive guarding with the muscles around the knee joint, or just poor recruitment of muscles around the hip. I watch too many trainers just stick to upper body movements with their clients when the client complains of knee pain, but what they should really be doing is watching the client move, and restructure their programming to include exercises to improve their movement, and thus, reduce their pain.
The first thing we are going to do is take care of the soft tissue restrictions through the IT band above the knee. Consistently rolling the IT band releases tension on the lateral aspect of the knee, which contributes to a pretty strong lateral pull during a squat. We see IT band issues with a lot of our clients whose knees go valgus (drop inward) during knee flexion. To effectively roll the IT band, grab a foam roller and lay on your side with the roller perpendicular to your body, starting at the hip. Straighten and relax your bottom leg and pull your leg along the roller, moving it down the outside of your leg all the way to the knee. If you feel tension in any spots, stay on those spots until they release. Three or four slow rolls is recommended per side. Don’t rush it. The more you roll, the less painful it gets, and the better the knee feels.
Next, we are going to work on strengthening your glutes. In a society that places too much emphasis on sitting at our desks, the glutes tend to become weak from underuse. Since your glutes are your primary knee stabilizers, that’s a recipe for disaster. Bridges are our favorite glute warm-up exercise, but compensatory movements are usually quite visible through either the erectors or hamstrings. We have our clients place a tight band around the knees during their bridge, pulling the knees in so they have to physically force them out during the bridge, which translates into better activation since your glutes also produce hip abduction/external rotation. Make sure you maintain focus, keeping your abdominals braced through the entire bridge, and keep your knees pulled apart for the entire exercise.
Lastly, most people’s squat patterns suck. Always remember to keep your feet slightly wider than shoulder-width, turn your toes out slightly (five to ten degrees) and force your knees out from the hips as you lower. The more you drive your knees out, the better. That forces your glutes to work harder, which will help to stabilize your knees. Make sure you are sitting back in your squat. Your knees will go past your toes slightly, but you should be able to keep all of the weight on your heels and sit down deep, hopefully getting rid of a bit of knee pain.
The most important take away from this is that just because there’s pain, that doesn’t mean you shouldn’t train. If you’re a trainer, become educated so you can work to find exercises that won’t hurt, and that fix your client’s imbalances. You can’t ignore the legs to hope they just “get better.” The legs need to be strengthened to get rid of the pain, they just need to be strengthened properly, and with the best form they personally can produce with their limb lengths and levers.