If knee pain is holding you back in the gym, you’re not alone. In this post I’m going to breakdown the best gym exercises for knee pain. So if you’re focusing on getting stronger in the gym, or building consistent habits for overall health, your knee pain won’t be the thing holding you back for long.
But lately, there’s been this nagging knee pain that shows up during activities like squats, lunges, weekend sports or going up and down stairs.
Maybe you’re unsure of where to start to help manage your knee pain, or worried that something you might try may make things worse.
Or maybe it feels like you’ve tried everything and nothing is working
- Taking time off only to have the symptoms return shortly after you return back to the gym or activity
- Constantly stretching the hamstrings, quads or calves with little to no long term relief
- Wearing a knee brace to help give the knee added support
- Using ice or heat after a workout to manage soreness or inflammation
- Avoiding movements like squats and lunging all together but wondering how much more can you continue to modify
It’s frustrating, but there’s good news: You don’t have to stop training just because you have knee pain
With the right approach, you can continue working out safely while building strength and stability in your knees to help decrease pain for good.
In this blog we’ll break down the best gym exercises for knee pain so that you can move with confidence and ease in the gym
Common causes of knee pain in the gym
There’s several reasons why as an active adult you may be experiencing knee pain in the gym. These are the most common:
Overuse injuries
If you’ve recently started going to the gym, have recently gone back after taking some time off, or have recently increased sets, reps, weight or added in new variations of exercises, you could be experiencing knee pain due to an overuse injury.
Overuse injuries can be hard to manage because you have to walk the fine line of challenging the muscles and joints to get stronger to tolerate the workload required for activity, but at the same time avoid doing too much too soon which may flare your symptoms back up again.
Managing the load and stress on the knee while also providing the knee with strength and stability to get stronger is they to managing an overuse injury
Age-related changes
It’s true that as we get older our bodies start to change. However, it’s not true that as we age it’s normal for us to experience more aches and pains with activity. This is also true even if you played sports when you were younger.
Let’s take the example of a car. As a car gets older you expect that you have to do more maintenance to the car. There may be more upkeep you have to do as the car gets older to make sure the car still runs properly. But as long as you keep up with the maintenance and regular oil changes, you still expect that the car will get you to your destination while driving it.
Your body works the same way.
As you get older you may notice that you wake up with stiff knees. Or you might notice that the more active you are, the more your knees tend to ache. But this doesn’t mean you have to live the rest of your life with knee pain
Instead (just like with the car), you may just need to do some more regular maintenance to ensure that you’re still able to function and perform at an optimal level while keeping aches and pains to a minimum
A Faulty Foundation
Things like mobility restrictions, muscular imbalances or weaknesses, strength deficits or poor neuromuscular control can increase stress on the knees and contribute to knee pain during activities like squats, lunges and even day to day activities
In this case, modifying exercise to a tolerable level and focusing on rebuilding your foundation can help alleviate symptoms.
Think about a house. If you’re building a 2 story home on a weak foundation. That house is not going to be stable for long. Eventually, the cracks will start to show.
Your body works the same way. Without a strong foundation, adding weight and increasing intensity in the gym will only expose weaknesses and lead to more aches, pains, and setbacks down the road.
Your Form or Technique
Despite what you’ve read or seen online, there is no one perfect way to do a squat, or lunge (or most exercises). The reason being is that all of our bodies are built differently. So what works best for one person might not work best for someone else
However, with that being said, faulty movement mechanics or poor technique or form when lifting weights over time can contribute to knee pain in the gym. Things like knees caving in during a squat, excessive forward trunk lean and poor barpath control can all increase stress and load on the knees and increase knee pain when lifting weights.
Having someone not only assess your movements but help you navigate what the most optimal way to perform them is for you and your body can help you find long term relief of knee pain when in the gym. Being able to get actionable feedback and takeaways in order to improve mechanics of movements can be helpful in finding long term relief of your knee pain in the gym with movements like squats, deadlifts and lunges
Do you think your form or technique could be contributing to your knee pain in the gym? If you’d like an in-depth assessment and review of your form and movement mechanics with your lifts from a Doctor of Physical Therapy and Strength Coach check out our mini movement audit here.
Best Gym Exercises for Knee Pain
When navigating knee pain in the gym there are three main areas of focus. The first is your warm up. You want to make sure you’re properly preparing your body for the specific lifts and activities you’ll be doing in your workout, focusing on the areas of the body that when limited tend to cause more stress on the knees.
The second are the actual main lifts in your workouts. Finding ways to modify or adjust things that allow you to still workout and lift without pain.
The third are accessory movements that will help support progress over time. These are the best gym exercises for knee pain:
Warm up
It’s important to properly prepare the body for demands of the exercises or workouts you’re about to do. When you’re experiencing knee pain it’s even more important to make sure your body is properly warmed up. Here are three exercises I recommend adding to your warm up to help manage knee pain in the gym:
Terminal Knee Extensions
Terminal Knee Extensions with Step Up
Eccentric Lateral Tap Downs
The last movement is a lateral eccentric tap down. This exercise helps to strengthen the muscles around the knee and helps work on eccentric control and loading in the knee. I recommend performing 2-3 sets of 6-8 repetitions on each leg. The higher the box, the more difficult this will be to perform.
A key tip to performing this exercise is to make sure you’re keeping the hips level and prevent the hip of the leg that is tapping down to drop. If you’re having difficulty performing this movement you can allow yourself to fully put weight on the tapping leg at the bottom of the movement.
Main Lifts
Many people think that because you have knee pain in gym you should avoid lifting or working and that movements like squats, lunges and deadlifts are considered “unsafe” or “bad” for your knees.
This actually isn’t true at all. In fact, you can use movement to help strengthen the body and eliminate pain and in the meantime, make some adaptations to your training to continue to lift without flare ups. Here are two recommendations I have for your main lifts in your workouts:
Box Squats
Barbell box squats are a great variation to traditional barbell back squats because they allow you to still work on the squatting movement pattern but modify the range of motion to level that is tolerable and doesn’t increase your knee pain.
For an added challenge you can play around with the tempo and decrease your speed when performing these or add a pause at the bottom of the movements. If you maintain control over these as you do them, I promise you, you’ll definitely still feel the burn!
Heel Elevated Goblet Squats
Accessory movements:
Single Leg Hip Thrusts
Ankle Dorsilfexion with Heel Raise
Side Plank Hip Abduction
Should you keep working out with knee pain?
As a performance based physical therapist, I’m always in favor of keeping people moving rather than telling them to stop activity altogether—as long as they’re making smart decisions and staying safe. Here are some important things to keep in mind when working out or lifting weights with knee pain:
- Pain is feedback: pain doesn’t necessarily mean you’re doing damage or harm to your body. Just because you’re experiencing pain doesn’t mean you should or have to stop all activity
- Pain is not to be ignored: At the same time, you don’t want to ignore your pain. Mild discomfort that doesn’t worsen during or after activity can be okay, but sharp, shooting, or increasing pain is a sign to modify or stop and seek an opinion from a rehab professional
- Modify when needed: Working in partial ranges of motion, decreasing weight or modifying sets and reps are easy ways to control load and stress on the knees without needing to eliminate activity altogether.
If you feel or hear a pop, notice symptoms are getting worse over time, or it’s been longer than 6 weeks without full resolution of symptoms it may be a good idea to reach out to a professional. If you would like to do a virtual consult with our Doctor of Physical Therapy you can fill out this form here.
Final Takeaways
There are many reasons why you could be experiencing knee pain in the gym. Some of those include overuse injuries, age related changes, a faulty foundation or your form/technique. But just because you may be experiencing knee pain with movements like squats or lunges doesn’t mean you need to skip the gym or lower body day altogether. Give the exercises in this post a try and if you’re still having trouble reach out to a trusted professional.
Ready to get back to training in the gym without knee pain?
If you’d like to do a virtual consultation with me you can fill out this form here.
If you’re in the Denver area and would like to schedule an in-person appointment you can do so here.
