knee pain

Are you causing your own knee pain?

Are you one of the 100 million people who suffer from knee pain? Knee pain is one of the most common ailments among Americans, and if you don’t address it now, the pain will only get worse. Use these 40 physical therapy tips for knee pain to create a knee plan.

42 Knee Pain Plan Tips

What is your knee pain plan? Add one or more of the following knee pain tips to manage your daily pain.

1. Don’t avoid the pain

You cannot run from or avoid the pain. Even if you numb it for a while, the underlying issue continues to linger. Acknowledging the pain is the first step for successful treatment. Plus, once you admit the pain, you will recognize daily changes to make for reducing or preventing pain in the future. Wouldn’t it feel good to live the day pain free? This can alter your brain and change your motor pattern and make you more sensitive to pain.

2. Do visit a physical therapist

Physical therapy is not only for injuries, post-surgery recovery, and older people. Most people will benefit from physical therapy. A physical therapist is a health professional who doesn’t want to operate; he wants to rehabilitate and prevent your knee pain. A physical therapist can diagnose your knee pain and provide you with a comprehensive treatment plan.

3. Swap your shoes

Shoes play a big role in your knee pain. Worn soles, flip flops, narrow toes, uneven platforms, and small sneakers all cause knee pain. They throw off the position of the body, affecting the alignment and load on the knees.

4. Stop running

Well, for now. If you experience knee pain during or after a run, you need to work on your run. Give your knee a break and reconsider your running plan. Knee pain is common among runners, but you can take steps to prevent the pain and strengthen your muscles.

To improve knee pain while running, reduce your running schedule until your pain goes away. Next swap out your running shoes. When you run, run on soft surfaces and start a strength-training program that improves your muscle strength in and around the knee.

5. Rest it

When you feel knee pain, stop the activity right away. Elevate your knee and give it a rest. Remember, avoid painful movements! The body is pretty smart, if it is painful, something isn’t right!

6. Ice it

While resting your knee, apply ice to the area to reduce pain. Ice works by the Gate Theory of Pain and by reducing nerve conduction velocity. The reasoning behind ice has been scrutinized. I wrote about this in detail for Swimming World Magazine. Here were my conclusions:

I recommend ice in a few scenarios:

  • Have high pain and need some relief? Try some ice. It won’t cure the pain, but it can help for about 60 minutes. This window could help you move better, preventing other musculoskeletal injuries and compensations.
  • Have an important practice or competition and need relief? Try some ice. It may limit inflammation and muscular strength and gains, but oh well, you’re not looking for a training response, but performance.

7. Don’t cross your legs

When sitting in a chair, do not cross your legs at the knee. Sit with your knees at a 90-degree angle.Crossing your legs can alter nerve mobility and mimic knee pain. Also sitting with your legs straight can cause nerve stretching, increasing nerve sensitivity and pain.

8. Step away from the stairs

If you are experience knee pain when you take the stairs, limit the number of times you go up and down the steps. You don’t have to avoid the stairs completely, but you can reduce the pressure on your knees by limiting the number of trips you take. Take the elevator or escalator instead a couple times. The stairs are likely causing pain with a medial knee collapse, causing overstress on the inside of your knee. This occurs from weakness and can improved by increasing your hip and leg strength and/or reducing your force on the steps (mass is a factor in force, so reducing weight may help). Once one or both of these areas improve, return to the stairs.

9. Don’t stand lock-kneed

Pay close attention to how you stand when you are in a relaxed position. Are your knees locked tight, or is there a slight bend? Be aware of your body position at all times. Stand in alignment to reduce pressure on your knees and ankles.

10. Avoid sweeping your knees to the side

Pay close attention to how you sit. If you sweep your legs to the side, or you favor the W-sit, you are putting unnecessary stress on your knees, hips, and ankles.

11. Move during the day

Knee pain is common among office workers who sit in chairs all day. The increase in desk jobs, internet, and remote work has increased the number of people suffering from joint pain. The term is “office knee,” and if you get up and move more, you can avoid its wrath.

12. Change your running gait

Runners are familiar with joint and knee pain [read our 5 tips for reducing knee injury]. The gait is to blame in many cases. To correct your running gait, train your muscles with these easy exercises you can do anywhere:

  • Stand with your back to the wall, not touching the wall. Lift one leg up at a time and tap your toe to the wall behind you.
  • Butt kicks: Stand with your feet shoulder-width apart, and run in place, trying to kick your butt with your heel each time your foot comes off the ground.

13. Stop running and walking on concrete

Concrete is rough on your knees, especially if you strike the ground with your heel. If you can, stick to the grass or sand. Switch up your running surfaces instead of sticking to the pavement and concrete every day. Switching running surfaces teaches your body how to adjust, and it prevents repetitive strains.

14. Fix your lunge

Your workout can cause significant knee pain and injury, and the squat and lunge are likely culprits. The pain doesn’t come from the exercises, rather the technique when completing the exercises. Common mistakes include leaning forward, caving knee, and caved foot. Improper form when you squat or lunge causes muscle imbalances and instability, and you run the risk of overextending the knee. Instead of doing a forward lunge, try this lunge progression:

Lunge Progression

  1. Alternate leg stance for 30 seconds
  2. Static Lunge
  3. Alternating Reverse Lunge
  4. Alternating Forward Lunge
  5. Alternating Reverse Weighted Lunge
  6. Alternating Forward Weighted Lunge
  7. Walking Reverse Lunge
  8. Walking Forward Lunge
  9. Walking Reverse Weighted Lunge
  10. Walking Forward Weighted Lunge
  11. Bulgarian Deadlift (rear-foot elevated lunge)
  12. Weighted Bulgarian Deadlift
  13. Bodyweight Valslide Reverse Lunge
  14. Barbell Walking Lunge
  15. Barbell Zercher Walking Lunge
  16. Dumbbell Contralateral Load Deficit Reverse Lunge

15. Fix your squat

Don’t go crazy with a squat right away. Try this squat progression guide to get a better, pain-free squat.

Squat progression

  1. Wall sit
  2. Arms overhead squat
  3. Squat
  4. Single leg negative squat
  5. Single limb squat

16. Improve ankle flexibility

Get your ankle moving to reduce the stress on your knees. Ankle stiffness causes knee pain because you change your body mechanics to avoid the pain. Your ankles are your foundation, and a weak foundation increases the risk for injury. To improve ankle flexibility, try these exercises.

  • Dorsiflexion and plantarflexion
  • Ankle rotations, clockwise and counterclockwise

17. Go for a swim

If you experience frequent knee pain when playing sports or during your regular workout, take the weight off your knee without stopping your exercise plan. Hit the pool. Take your workout to the pool to increase your success and reduce your pain.

18. Avoid the couch

Rest was one of the first tips for reducing knee pain, but don’t spend days on the couch. You have to get up and move around. Prolonged sitting on the couch increases stiffness.

If you can’t get up off the couch or bed because you can’t put weight on your knee, try these exercises while you are laid up.

  • Straight leg raises
  • Glute Squeeze

19. Start a strength training program

To address knee pain, start a strength training program. Don’t focus solely on your knee and legs. Work with a personal trainer to get a full-body workout that promotes healthy movement, whole-body function, and balance.

20. Decrease Swelling

Control knee swelling with knee wrap, anti-inflammatory foods, and/or anti-inflammatory medication. Wrap the knee to control swelling, but don’t immobilize the knee for too long. Again, immobilizing the knee causes stiffness, and more pain.

21. Bolster your knee

When lying on your back in bed or on the floor, put a bolster directly under the bend of your knee. You can use a rolled towel, a bolster device, or a folded pillow.

22. Control your weight

Weight plays a significant role in knee pain, and with 75% of the population being overweight or obese, joint pain is a common complaint. The more weight you carry, the more stress you put on the knees. Losing just 11 lbs. takes a tremendous load off your joints, about 50%.

23. Find a Physical Therapist who does subtalar manipulation

The Subtalar Joint is a joint in the foot, specifically in the ankle region. Subtalar manipulation is a foot manipulation technique that aims to improve inversion and eversion to improve mobility. If you feel tightness in your ankle or have difficulties with your deep squat, the reduced ankle flexibility can cause knee pain and increase knee stress.

24. Don’t avoid the warm-up

You must get moving before you tackle your workout. Warming up improves muscle and joint function, it preps your body for the workout, and it reduces injury.

25. Keep track of the pain

To tackle your knee pain, you need to understand its habits. Think about the times you feel the knee pain, track the progression, determine what promotes relief or exacerbates the pain, and write it down. Journal your knee pain and present your findings to a physical therapist.

26. Heat it up

Can’t warm-up due to pain, try to use a shower, heat pad, or sauna to heat the area. Heat can make the knee feel better!

27. Stretch the calves

Increase muscle length in and around the knee. Try these effective knee and leg stretches for release.

28. Stretch the hamstrings

Try these hamstring stretches. Remember: work around the knee for pain relief.

  • Lie on your back and bring your knee to your chest. Interlace your fingers behind your thigh, while keeping the other knee bent. Slowly, extend your bent leg out until you feel the stretch in your hamstrings, and hold it for 30 seconds.
  • Lie on your back and place one leg straight on the floor with the toes stretched up. Lift the other leg straight up and prop it up on the wall for resistance in the stretch.

29. Self-Myofascial Release (SMR) IT Band

Try these techniques to ease tightness in the IT band. Self-myofascial release just means self-massage.

30. SMR TFL

The TFL, or tensor fascia latae, is a small muscle in the hip that is responsible for stabilizing the hip, and flexing and abducting the thigh. It connects at the hip and runs into the IT band, which as you know, connects to the knee. Try this technique to release it and improve hip internal rotation.

31. SMR the Quadriceps

Use a foam roller or tennis ball to roll out tightness in your legs. Take a look at the guide here.

32. Try dynamic mobility

A mobile knee is a healthy knee. Mobility training keeps your knee joints lubricated and flexible, which allows you to move easily. Try these mobility exercises.

  • Lie on your back and bring your knees up. Perform egg beaters, moving the legs in circular motions, like you would do in the pool. Do this for 30 minutes.
  • Stand with your feet shoulder-width apart, bend your knees, and rotate your legs in and out like butterfly wings.

33. Use a topical cream

Use a topical cream to relieve the pain. This is only a temporary solution. You need to address the knee pain to prevent and treat it when the topical cream wears off.

34. Try an over-the-counter anti-inflammatory

Anti-inflammatory medications are called NSAIDs, or Nonsteroidal anti-inflammatory drugs). You know them as Naproxen, aspirin, and ibuprofen. These medicines control swelling. If you take NSAIDs to control swelling, never take them with alcohol, take them with food, and drink plenty of water. NSAIDs can cause GI damage and internal bleeding. Always talk to your doctor and pharmacist first before starting any new medicine.

35. Try Non-surgical medical treatments

Don’t be afraid to try new, non-invasive therapy techniques. People who suffer from knee pain often turn to acupuncture and Reiki for relief. You can also talk to your doctor about PRP (Platelet-Rich Plasma) injection therapy.

PRP injections are the athletes and anyone else who experiences significant pain that does not go away. The therapy takes less than an hour to perform, and the physician uses the patient’s own blood to provide relief. The medical provider draws the patient’s blood, and then separates the platelets from the blood. Once the platelets are isolated, the physical injects them, guided by an ultrasound machine, into the affected area.

PRP therapy requires strict recovery methods and physical therapy to restore movement within 3 months.

36. Eat a joint-healthy diet

If you experience inflammation in your knees, caused by arthritis or not, incorporate joint-friendly foods into your diet. These foods are not a cure, but they are loaded with vitamins and nutrients that may fight inflammation and boost your immune system.

Joint-friendly foods are high in omega-3 fatty acids, anthocyanins, Vitamin K, C and D, and C-reactive proteins. Common anti-inflammatory foods are whole grains, berries, fish, garlic, olive oil, nuts, and citrus fruits.

37. Adjust the seat on your bike

When riding a stationary or regular bike, adjust the seat so that your legs extend when you pedal. If your knees are bent the entire time, you will feel the pain after you are done. Sit up higher in the seat, or if you are on a recumbent bike, sit back further.

38. Fix your posture

Poor posture is a joint killer. When you have poor posture, you put unnecessary pressure on your joints and certain muscles. You also train your body to adopt certain holding positions that are hard to change if you are unaware of them. Holding patterns become your new norm, and it can cause excess wear and tear on your muscles, bones, and joints.

39. Stretch those hip flexors!

Your knee movement comes from the hips. That is why is it critical that you improve hip and pelvis strength. Try these exercises:

  • Stretch the knee, hips, and quads with the half-kneel stretch. Place a folded towel on the floor and kneel down in one knee. Make sure the leg not on the towel is at a 90-degree angle. Use your hand to grab the ankle of the bent knee on the towel. Pull it up until you feel the stretch in the hamstrings. Hold for 30 seconds.
  • Hip Internal Rotation
  • Rectus Femoris Stretch with Band

40. Strengthen the quads

Try a few exercises to improve knee strength.

  • Wall squat with ball: Stand with your feet shoulder-width apart and your back to the wall. Place a ball – basketball, soccer ball, or kickball – between your knees. Bend your knees into a squat until your legs are at a 90-degree angle. Hold the position for as long as you can up to 10 seconds. Slowly straighten your legs and return to the standing position.
  • Step ups onto a small step or stool: Place one foot on the step and plant the other foot on the floor. Lift the foot off the floor and allow it to dangle for 5 seconds. Switch sides.
  • Quadricep stretch: Stabilize yourself on the back of a chair or the wall. Put your feet together, and then bend one leg back. Try to touch your heel to your butt. Hold the foot with your hand and hold the stretch for 30 seconds if you can.

41. Get buns of steel

Work your glutes to ease your knee pain. Your glutes need to fire properly for healthy knee movement. Try these glute exercises to firm up your buns and to ease knee discomfort. Tighten your rear during every workout!

  • Superman: Lie on the floor with your arms stretched straight out in front of you. Squeeze your buns and lift your limbs off the ground. Hold for 10 seconds. Do this three times.
  • Glute Bridge variations: Lie flat on your back and bend your knees. While your feet are planted on the floor, squeeze your glutes and lift them off the ground. Thrust your hips ups until the top of your body is flat. There should be a straight line from our knees to your neck.

To increase the exercise, elevate your feet onto a bench. Your knees should be at a 90-degree angle. Again, thrust your hips up, squeezing your glutes together. Hold for 30 seconds.

42. Talk to your doctor

If the pain in your knee is unbearable, talk to your doctor. You may need to see a specialist if your knee is arthritic, or if it requires surgery. Signs you need to call your physician include that won’t go away, unable to put pressure on the knee, knee gives out, or bruising and swelling that won’t subside.

Don’t suffer through knee pain any longer. A physical therapist can give you tips and tricks to use during the day to combat the throbbing, swelling pain. Don’t stop moving if you want to feel better, just move smarter.

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References:

  1. Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med. 2007;41(6):365–369.
  2. Messier SP, Beavers DP, Loeser RF, Carr JJ, Khajanchi S, Legault C, Nicklas BJ, Hunter DJ, Devita P.Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat. Med Sci Sports Exerc. 2014 Sep;46(9):1677-83. doi: 10.1249/MSS.0000000000000293.