Stop "Living With" Your Knee Pain

(My recommendations below are pulled from my own experience working alongside physical therapists and working with many, many women that experience knee pain. This is not intended to diagnose your unique situation or be a substitute for physical therapy or other interventions. As always, your doctor knows best.)

About half of the women I train mention having issues with their knees. They experience pain with squatting, kneeling and going about their daily life. It’s aggravating and somewhat limiting, but for most women they simply deal with it and work around their knees. The pain might be coming from around the kneecap or on the sides of the knee, but it's not going anywhere. But why live with it, when the solution is sometimes so simple?
 
Do you battle your knees? Do you avoid certain activities and movements because they hurt? Have you silently given up and decided to just “live with it”?
 
Here’s the cool thing:

Most of the women I have seen with painful knees can resolve the issue after only a month or two of doing the right things. 

No more knee pain. Gone. 
 
What?! Yes. And here is what I do with them:
 
1. First, we try to identify if it’s a bigger issue. If the pain is acute and very intense and is associated with swelling, then there’s probably something more going on. If this is the case, I recommend seeing a doctor and having an MRI to see exactly what the problem is. An MRI will determine if there is a ligament tear or arthritis, which usually requires additional treatment and specific therapy. If the issue is simply a matter of bad joint function and some cranky tendons, then we can usually deal with it pretty quickly. 


2. Place on hold any aggravating activities. I’ll ask what makes it hurt, and the answer is usually obvious: running, playing tennis, squatting down low, lunging, twisting it a certain way in yoga, etc. It’s best to stop doing any movements that might be making it worse, and give your knee time to heal. Chances are it’s inflamed, and continuing to move in a certain way doesn’t allow the inflammation to go down. Icing and taking an anti-inflammatory also help to reduce inflammation. I recommend icing a couple times a day for 15 minutes at a time. Once your knee is pain-free and stronger, you might be able to continue these activities.


3. Mobilize what needs to be mobile. Certain joints surrounding the knee joint are meant to be flexible, or mobile. Your hips and ankles need to be able to move freely, unencumbered. When they’re tight, the knee joint ends up moving more than it should. This can place extra stress on the joint.

I recommend foam rolling like crazy, which loosens up these muscles and helps them move more freely. Work on the side of the thigh (the TFL & ITband), the inner thigh, the hip flexors, glutes & calves. Here is a video that teaches you how to foam roll.

And then stretch your calves, stretch your hamstrings and hip flexors (I like this stretching series), stretch your inner thighs (like this), and stretch your glutes (like this).


4. Make the knee stronger and more stable. This begins with proper technique. Focus on proper alignment, making sure that with every exercise your toes and kneecaps are pointing straight forward. As you bend your knee, it should not fall inward or outward (like the pictures below, on the right). Also, as you bend your knee, it should not push out over your toes. This is especially important for someone with long legs.

good knee alignment for a squat

poor knee alignment for a squat

good knee alignment for a lunge

poor knee alignment for a lunge

​(A simple trick I use to correct a knee that falls inward like this, is to place all your weight along the outside edge of your foot, creating a nice big arch under your foot. This usually prevents your ankle and knee from collapsing inward.)

​Additionally, think of good technique like this: when you bend, sit, squat or lunge, it should feel like you’re holding the weight of your body in your hips, not your knees. Stick your booty way out…seriously. Exaggerate the booty-stick-out and you’ll probably get it right. This takes the pressure off the knee joint and places the weight of your body in your hips, where it’s much stronger.

good squat technique with the weight in the hips

poor squat technique with the weight in the knees

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​5. Make your hips stronger. It’s not enough for your hips to be flexible, they must be crazy strong, too. Women with strong hips rarely experience knee pain. Why? Because the muscles that come from your hips determine whether your knee stays in good alignment. They are the support structure for everything below.

What muscles am I talking about? Primarily your glutes, but also your inner and outer thighs, hip flexors, and quads. Make these strong and your issues will probably start to dissolve.

The "Build-A-Butt Workshop"

Try these exercises. I call this my "build-a-butt workshop". It makes your hips much stronger and encourages good technique for your legs.

Miniband squats
Miniband sidestepping
Miniband monster walks
Miniband bridges (same as this bridge, just put a band around your knees)
Split squats
Side split squats
Single leg dead lift

Combine these movements will good mobility drills and a totally body strengthening program and your knees will feel so much better.


You don't have to live with it. Don’t just live with your knee pain, especially the moderate, nagging pain that so many women deal with. I’ve seen this type of pain totally go away with many of the women I’ve worked with, and it usually doesn’t take long. Take ownership of your body and do something about it!  ​​

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