Why Your Knees Hurt During A Workout + What To Do About It

Do your knees ache every time you climb stairs, get out of bed, go for a job or bend down to do a squat at the gym? Does this keep you from your exercise routine for fear of increased pain and possible damage? Knee pain is one of the most common complaints I hear that keeps people from their workouts. If you're part of this group, read on for the possible causes of your knee pain and also how to fix it.

Here are two reasons your knees might have you on your knees during a workout, and exercises to combat the pain:

1. BUCKLING KNEES

When you squat down, do your knees stay pointing straight forward, tracking over your ankles, or do they collapse in toward each other? If it's the latter, you're increasing the strain on your knee cap (patella) and patellar tendon. Make sure your knees stay over your second toe and your shins are at an almost 90-degree angle to the floor when you squat.

This form will keep your knees from buckling in, keep unnecessary pressure off your knee caps and also prevent aches during squats, jumping exercises (during both take off and landing) and even stairs.

The reason for this buckling? It's most likely that your glutes aren't strong enough to support the movement. Doing simple exercises like bridges and clams can help train you to use and strengthen those butt muscles so you're able to contract them during activities, preventing your knees from buckling in. Now try it: stand up with your feet shoulder width apart and squeeze your butt like you had a $100 bill between your cheeks. Now try and bring your knees together. You won’t be able to hold on to that $100! That's how important those butt muscles are.

Bridge:

Begin by laying on the floor with knees bent and feet flat. Lift your toes off the ground and dig your heels into the floor. Using your glutes, lift your tush off the ground, moving your torso as one unit. Make sure there's a "straight line" from your shoulders to knees. Hold for three seconds, squeezing your butt, then relax and return to the floor. Repeat 10 times, then rest for 30 seconds.

Single-Leg Bridge:

Begin in the same starting position as the bridge, then lift your right leg off the ground and hold it up so your right shin is at roughly the same height as your bent left knee. Engaging your glutes, lift yourself off the ground by driving into your left heel, squeezing your butt and holding for three seconds. Relax and bring yourself back down to the floor Repeat for a total of 10 reps each leg.

Clams:

Lay on your right side on the floor. Place feet up against a wall, box, couch, etc, and bend knees and hips to about 70-degrees. Take a deep breath in and a deep breath out to place your pelvis in a neutral position. Now, while keeping your feet together and flat on the wall, raise your left knee away from your right leg while keeping your feet together, creating a diamond-shape between your knees. Hold this position until you begin to feel a burn in your glutes. Once you feel that burn, bring your left knee back down to meet the righ and repeat for 10 contractions. Repeat on the opposite side.

2. MUSCLE TIGHTNESS

Another big problem people have is muscle tightness in the hip flexor muscles and the IT band. If your hip flexors are too tight (probably caused by sitting too much) and you can’t fully extend your hips, you won’t be able to properly contract your glutes, again leading to your knees buckling in when you squat.

Tight hip flexors are the culprit of most lower-body issues from knee to back pain. They place the pelvis in a forward rotation, which then causes the entire back side of the leg’s muscles to stretch while shortening the lower back muscles. Tight hip flexors also change the tension and angle of pull on the Tensor Fascia Latte (TFL) and IT Band.

A tight IT band can cause pain in a couple of different ways. The IT band is attached to your knee cap and if it’s too tight, can pull the knee cap out of its groove and not allow it to glide smoothly. This can cause painful scratching on the back of the knee cap. Also, just by pulling the knee cap to the side, the direction of the forces that go through your knee are changed and can cause strain and pain on the patellar tendon.

To reduce tightness in these areas try these basic stretches:

Standing Hip Flexor Stretch:

Start in a split stance by placing your right foot in front and your left foot in back, with both feet pointing forward. Bend your right knee, keeping your left heel on the ground and back leg straight. Rock your pelvis forward and lean forward on your right leg. You'll feel a stretch in the front of your left hip. Hold for 15-20 seconds. Do the same on the opposite side, repeat again on both sides.

IT Band Twist:

Start in a seated position on the ground with your legs extended out in front of you. Bend your right knee, cross it over your opposite leg, placing your right foot on the floor outside the left knee. Place your right hand on the floor just behind you while placing your left elbow against the outside of your bent right knee. Push and twist your torso to the right side. Hold 15-20 seconds. Switch position to the opposite side, hold 15-20 seconds and repeat on each side one more time.

Foam Rolling:

Foam rolling is great for breaking up adhesions within tissue allowing for better movement both in the IT band and hip flexor. Start by lying on your side and placing the foam roller under the top of your hip. Roll over the IT band starting at the top of your hip and moving all the way down to your knee. Use your opposite foot and arm to guide you as you roll from top to bottom. Try to roll for a minimum of one minute per side.

To roll your hip flexor, start by lying prone on the foam roller and placing your upper thigh on the very edge of the foam roller. Bend your opposite hip and knee about 45-degrees each. Using your forearms and opposite knee, guide yourself over the foam roller for about one minute on each side.

Trigger Point Release:

Using a lacrosse ball to pinpoint some especially tight areas can also help with tightness. Lay face down on the floor. Place the lacrosse ball directly under your hip flexor and breathe as you allow yourself to press down onto the ball. Deep breathing allows you to relax and your tissues to release over the ball, releasing tension. Do this for about one minute per side.

Now lay on your side and place the ball along the top of your hip. This is the tensor fasciae latae muscle, the origin of the IT band. You can place the ball under several spots up here and then gradually move down the side or your hip.

All of these methods are helpful individually, but are best when used in conjunction with each other.