Strategies for Dealing With Chronic Knee Pain

Being active is a vital and special part of life.  Movement of all kinds — dancing, biking, hiking, skiing, playing tennis — are all just plain fun.  But, what do you do when being active brings pain?  While exercise can maintain your joint health it, too, can cause pain.  Strains, sprains, tears, and swelling are often a disappointing part of an active lifestyle. 

Knee pain is often a common concern my clients have.  While knee pain may feel like an obstacle, it doesn’t have to completely limit your lifestyle.  


Your knees are designed to absorb a huge amount of pressure.  Your knee is absorbing about one and a half times your body weight with every step you take.  Imagine how much pressure is absorbed by the knee when you run or jump!  That type of pressure causes regular wear and tear, and can take its toll on your knees.  

The knee has two shock absorbing pads of cartilage called menisci.  In addition, there is cartilage protecting the ends of the leg bones.  All this cartilage will wear down over your lifetime.  The cartilage can wear down to the point where bone rubs on bone causing pain, stiffness, and swelling. The disappointing part is that the more active you are, the higher the likelihood is of experiencing knee pain.  

Now no one expects you to give up your favorite activities just to prevent normal wear and tear!  Instead of reducing your activity, simply add some basic practices to your life to help deal with knee pain.

Balance Your Quads and Your Hamstrings.

Strengthening the muscles around your knee helps to stabilize the knee joint.  Additionally, leg muscles absorb some of the stress on the knees. 
To begin, I recommend focusing on balancing the strength between the quadriceps and the hamstrings.   The quadriceps are location on the front of your leg, above the knee.  Hamstrings are located behind the leg, above the knee.  They are opposing muscle groups.  Imbalance in opposing muscles groups can cause joint problems and increase your risk of injury.  For example, if your hamstrings are tight, your quadriceps are prevented from fully contracting and may weaken over time.  Making sure that quadricep/hamstring strength is balanced is important to prevent dysfunction and injury.

The step-up exercise is a great exercise to target the muscles around your knee.  The lowering phase of the movement is also a great way to consciously practice absorbing shock on the knee. Make sure you lower yourself slowly back to the ground and that you cushion the landing by using your foot and bending your knee to absorb the pressure as you return to your starting position.   Additional exercises to manage knee pain include:

Exercises to strengthen the quadriceps include:

Quarter Squats

Laying Ball Leg Extensions

Box Squats

Exercsies to strengthen the hamstrings include:

Laying Hamstring Curl

Ball Hamstring Curl

Dumbbell Standing Romanian Deadlift

You can find demonstrations of these exercises in the STF Exercise Library.  

Stretch and Foam Roll Your IT Band.

As you get older, your muscles tend to naturally become stiffer. Coupled that with normal wear and tear, and you could start to feel some significant knee pain.  One way to reduce the symptoms is to increase your range of motion in the knee joint.  Ensure your hamstrings and quadriceps are stretched. Additionally, foam rolling your leg will help loosen the iliotibial (IT) band.  The IT band runs along the outside of your leg, and connects the iliac crest (your hip bone) to the tibia (the lower leg bone).  Tightness in this band can pull the knee out of alignment, causing swelling and pain. Foam rolling the area, as well as other parts of your legs, can help reduce knee pain.

To foam roll, simply lay on your side with a foam roller under your hip.  Move your body over the foam roller so the roller travels between your hip and your knee.  Keep light pressure on your leg.  Foam rolling may be uncomfortable.  

Work with a Physical Therapist. 

If you are having severe knee pain, I recommend speaking with a physical therapist to have your knees evaluated. Knee and hip problems can disrupt your normal gait or walking pattern.  This can restrict your joint movement or weaken your muscles over time and eventually lead to injury.  Improper running form, for example, can increase the force in every stride, exacerbating wear and tear.  A physical therapist can assess your gait and can help you relearn a proper gait to deal with current injuries, prevent future injuries, or help you rehabilitate following a hip or knee replacement surgery.

Lose weight. 

In addition to increasing your risk of osteoarthritis and/or knee injury, being overweight puts more pressure on your knees and makes them more prone to deterioration.  The best way to lose weight is to combine exercise and healthy eating.

“How am I supposed to exercise when my knees hurt?” you ask.  There are a multitude of exercises that reduce the pressure on your knees!   Elliptical trainers, stationary bikes, pool workouts, and upper body activities all minimize the pressure placed on your knees while still allowing you to get your heart rate up and expend calories.  Find a way to incorporate these options into your week to give your knees and hips a break.

In addition, eating a balanced diet full of fruits, veggies, lean cuts of meat, low-fat dairy, complex carbs and water will help you lower your body weight and reduce the pressure on your knees.  If you are exercising every week, but your diet is not in check, you can still gain weight.  You can’t out exercise a bad diet.

Knee pain is common for most active people.  It can be a sign of normal wear and tear, however, it come sometimes be a sign of a serious injury. Differentiating between the two is important and might be difficult to decipher.  It is recommended that you see your doctor if you can’t:

  • Bear weight on your knee 

  • There is significant swelling present

  • You can’t fully extend or flex your knee

  • There is an obvious deformity present, or 

  • If you feel that your knee is unstable or could give out at any minute.

If ever in doubt, it is better to err on the side of caution and have your doctor clear you for exercise.  Remember, fitness is a lifelong journey.  You must plan for the long haul, not the sprint….  especially if you are dealing with knee pain.  

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