My primary role as a physical therapist these days is to help runners in pain, but there is no complaint more common than knee pain. And as a run coach in Seattle, with hills galore, understanding how to manage knee pain is invaluable to my athletes.
I have found that there are a few key exercises that have been invaluable to the runners that I see and work with here in Seattle. Below, are a few of my favorites and some recommendations on how to program them into your routines.
Banded lateral toe tap
Ah yes, the toe tap. A staple. Here’s why I like this one:
As you run, with each time your foot hits the floor, you absorb forces through your entire leg, with your knee in a flexed position. As such, when struggling with knee pain, strengthening your knee in a flexed position is paramount.
You’ll flex your knee roughly 15-20 degrees and drive the knee forward over your toe. That’s right, drive the knee forward. This is is a really important piece of the puzzle. It’s important, because as you run, your knee translates over your toes to move you forward. Too often, I find that folks are afraid to drive their knee forward because someone told them once it was dangerous. Tip: It’s not dangerous.
Hold that position solid, keeping your shoulders and hips square over your feet. Tap your foot out to the side about 45 degrees away from your body.
With this particular exercise, the focus is actually maintaining a good degree of tension on your standing leg, verses, thinking about where the moving leg is moving.
Prescription: 4 sets of 12 repetitions with band around your ankles
Goblet Lunge up to March
You might be unsure if lunges are the best option for you in knee pain. I hear ya, these suckers are hard and undoubtedly not a favorite, but the trick here is to slow the movement down significantly.
By slowing the movement down, we force our musculature to contract and maintain time under tension. Sometimes when we’re in pain, slowing a painful movement down can be quite helpful at mitigating that pain.
And when it comes to knee pain, there is no better treatment option than exercises to strengthen the quadriceps and glute musculature. Give it a go.
Prescription: 3 sets of 6 repetitions 3s down|3s pause at the bottom|3s up
Single leg Romanian dead-lifts (RDL) up to march position
I love RDLs. Add in a march and you’ve suddenly turned this gem into a running drill and exercise.
If you’re wanting to perform these optimally, I encourage you to try doing them with a dowel first. Keep that dowel rod pinned to your back and sacrum as you rotate through your hips. A slight bend in the knee here is warranted.
Finish the motion in a tall march position. Standing leg locked strong at your knee, rooted in the ground.
Prescription: 4 sets of 8 repetitions
Step-up to march position
The last exercise that I might prescribe a runner with knee pain is the beautiful step up exercise. While some runners with knee pain have discomfort with this exercise, for most, if done with some of consistency, this can be a game changer for their pain and performance.
Again, performing these with intention is key, as it would be all too easy to launch yourself off the back leg and shoot up into that march position with ease. So, the goal here is to use the front leg alone, to get you to the top of the box.
Set yourself up in front of a 4-12 inch box (pick a box height that feels do-able), transfer your weight onto the front foot and press down into the box a bit, just to see how you feel. When you’re ready, you’ll press harder and harder and harder until eventually ALL of your weight is on the front leg and you can stand up tall and confident.
Prescription: 3 sets of 8 repetitions
I’d love your feedback! Leave a comment below, question or concern!
Head She Wolf