Why your exercise isn’t helping your knee pain

As you all know exercise is an important part of leading a healthy lifestyle. And if you’re struggling with knee pain, or other pain, exercising can help with your pain… and it can also make it worse. In this article I discuss the different reasons why the exercise you’re doing is aggravating your knee pain, or at least not making it better.

• The exercises are too hard

• The exercises are too easy

• You’re only stretching

• You aren’t doing enough

• You’re doing too much

• You’re doing the wrong exercises

• You aren’t incorporating nutrition

Exercises that are too hard don’t help knee pain

Your knee may still be in pain because you’re doing exercises that are too hard. While you’re recovering from an injury, or struggling with a non-injury related pain, not all exercises are created equal. I find many of my clients jump into doing squats and lunges because they’re told they need to strengthen their quads and glutes. This is absolutely true, and maybe more of strengthening the glutes than the quads. But, squats and lunges can be incredibly taxing on the knee and can cause and aggravate knee pain.

The exercises you choose should be challenging, but not painful. So you may need to adjust your exercise routine, remove the painful exercises, like squats and lunges and temporarily swap them out for something that doesn’t hurt, yet still challenges the muscles.

exercises that are too easy don’t help knee pain

Your knee may still be in pain because, although the exercises don’t hurt while you’re doing them, they could be too easy. If you aren’t challenging your muscles enough then they won’t get stronger. If weakness is part of the problem then you need a strength routine. A good strength routine will find a happy balance between challenging, yet not painful.

There is a caveat with this: in the beginning when you have significant pain, like your knee can’t do anything without screaming you do need easy movements. These motions will help keep the knee joint flexible, muscles flexible and help with circulation and draining any swelling that is caught up in the knee.

only stretching doesn’t help knee pain

Stretching is great. I love stretching. It’s actually one of my favorite parts of a workout, but it can’t be the only part of the workout. Stretching helps keep muscles flexible, and improve flexibility in muscles that are too tight. However, your knee pain is likely not getting better because you also need a strength routine. I know, I know, all your doctors say to stretch. Doctors are good at some things, but if they are not a physical therapist, an exercise physiologist or a kinesiologist they don’t actually know what they’re talking about and they may just use the term “stretching” in lieu of exercise, and they are using “stretching” as a catch all. What they should just say is exercise, and then the physical therapist, exercise physiologist or kinesiologist can delineate further the difference between stretches, strength, endurance, and cardiovascular exercises. 

Stretches will elongate the muscles over a period of time. Stretching is excellent to cool down from a workout and reduce the chances of having soreness from a workout. And stretching can help unlock a stuck joint (think a tight knee that’s been stuck in a straight knee brace for a month after ACL reconstruction). But stretching should be part of the overall picture, not the whole picture.

Incorporate strength training, endurance training and cardiovascular training into your routine, and use stretching to balance out the whole picture.

not doing enough doesn’t help knee pain

Maybe you are doing strength training and stretching, not relying just on one or the other. Maybe you aren’t doing enough of the program to help your knee pain. During a period of a lot of pain you may need to do some motions a few repetitions, but frequently throughout the day. When I have a tight or stiff knee from tweaking it on a run I do 5 heel slides in a row every hour I’m awake. When I worked in the traditional physical therapy clinic my colleagues were often shocked to hear that I recommended that to some of my patients after an injury or a surgery. I found that they were trying to do 30 repetitions in 1 sitting and then doing nothing the rest of the day. For a painful knee I find it much more beneficial to do a little at a time, a lot of the time.

Or after an injury you think you should rest, so you do. And for the most part this is correct, but how much rest? An injury that’s going to take care of itself with rest will take care of itself in 10-14 days. And even then part of that should be active rest. Active rest is where you are doing some kind of motion or activity just still avoiding the significantly painful motion.  Too much rest is going to be detrimental. If you rest for a month and then try to get back to the routine, let’s say running, and the pain comes back… rest wasn’t going to do it for you.

doing too much exercise doesn’t help knee pain

On the opposite end of the spectrum, maybe you’re doing too much. If you never give yourself rest then your knee can never fully recover. It’s not a no pain, no gain situation. Your body needs rest to recover. If you are a runner and you start a new program and you think you can run 3 miles and so on your first run after years of not running you go and run 3 miles. Then you do that every day for the next week, then you increase the next week to 4 or 5 miles every day. If you have knee problems your knee is going to scream at you. 

Or if you are lifting heavy weights, squatting daily, bulgarian split squats daily, and never giving your knees a rest: they will also scream at you.

Incorporate active rest into your routine. Don’t do the exact same exercises every day. If you like to lift weights daily, do an alternating routine where you are heavily using your knees within reason one day, and then the next day at the gym it’s less about the knees. This is why some people have a leg day and an arm day. I like to do a whole body workout whenever I work out, but I switch up the exercises if I’m doing that. So i have a routine for MWF, and a routine for TThSa and something else on Sunday.

Your body needs some rest to recover. If you don’t give your muscles enough rest, then the muscles can’t repair themselves.

You’re doing the wrong exercises for knee pain

Maybe you’re doing all the right things listed above: you’re doing exercises that aren’t too hard and not too easy, you’re doing enough exercise, not too much, you give yourself adequate rest yet your knees still aren’t happy. It may be that you are doing the wrong exercises for your problem. This is where you should work with a professional like a personal trainer, physical therapist, exercise physiologist, etc. These professionals can guide you through the right exercises to do to help your knee problem.

For example: someone with knee pain may be doing a lot of squats, lunges, leg extensions at the gym, and a bunch of ham curls. Maybe none of them in particular hurt their knee, but they aren’t incorporating the surrounding areas to support the knee. Knee problems can be caused by knee muscle problems, but more often they are caused by a weakness above (and sometimes below) the knee joint. Let’s talk about weakness above the knee causing problems. The hip. The hip prepositions where the knee will be in space. If the hip is weak the knee will dive in toward the other knee. This isn’t because the knee is weak. The knee mainly only goes in a sagittal plane of movement (forward and backward) but a knee diving in is a frontal plane (side to side) problem… what joint moves in the frontal plane? The hip does. If the outside part of the hip, and if the glutes at the hip are weak it’s going to make the knee dive. So in this case the person with knee pain needs to strengthen the glutes. They could work on quad and hamstring strengthening all day and not make any progress because those aren’t the problems. The professional you work with should be able to determine what area needs to be strengthened to improve the knee pain.

bonus Information!

You aren’t focusing on the nutritional component to help your knee pain

Finally, what if you are doing all the right things above, including working with a professional to make sure you are doing the right exercises, and you still have knee pain? It could be because you aren’t supporting your body nutritionally. You can do all the right exercises and not improve your strength or flexibility because you aren’t giving your body the nutrients it needs to do so. What do I mean by that? I mean you need to incorporate protein, good fats, and carbohydrates as your macronutrients. And then you need to incorporate your micronutrients like your vitamins and minerals to support your system. Most people don’t eat enough protein or good fats and rely too much on carbohydrates. Your body can utilize fats better than carbohydrates and proteins to give your body energy. 1 gram of fat will yield 9 calories, whereas 1 g of carbs or 1g of protein will yield 4 calories. What does this mean for you? If you need more energy after a workout your body will do better with more good fats, compared to the same amount of carbs. Your body can use that energy to repair anything in the body that needs to be repaired. Now for energy your body doesn’t like to use protein, but it can, and protein is very important for building muscle. So incorporating protein will allow your body to use those amino acids to build up your muscle that you’re trying to strengthen. 

Limiting your intake of sugar, saturated fats and trans fats can also help your body because they can all increase inflammation. If you’re recovering from a long run with a big ice cream sundae because you deserve it after that long run, it won’t give you much energy because it’s mostly sugar and definitely a lot of carbs. So your body will run through that energy and then you’ll crash from the sugar crash. You’d do better having some fruit, peanut butter and a handful of nuts.

Working with a nutritionist can help you determine the best meals and recipes to be able to maximize your recovery after workouts and on rest days to make it so your body can recover and heal.

There you have it. A whole slew of recommendations to handle your knee pain and why the exercises you’re doing aren’t curing your knee pain.

If you’re looking for knee pain relief check out this free guide I created just for you