Side Stepping Injury: 3 Ways to Train Around Knee Pain

John Rusin
Written By: John Rusin
September 27th, 2016
Updated: June 13th, 2020
14.5K Reads
Side Stepping Injury: 3 Ways to Train Around Knee Pain
Knee discomfort can really put a strain on your gains. Learn how to better avoid knee injuries and ways to continue to train around knee pain.

There’s no doubt that the knees are some of the most ornery joints in the body for most lifters.

For those of you who go to battle against the iron on leg day with reckless abandon, you know what I’m talking about.

Don’t think that knee pain is something that only happens to beat up old lifters.

No matter if you are a newbie who is trying to improve your strength and muscle, or an old veteran of the iron game who has been grinding out epic squat sessions for decades, the knees can become vulnerable to chronic pain, discomfort, and even injury.

What is it about the knees that make them so susceptible to injury and dysfunction?

How can we protect against it to train pain-free while also continuing to make huge strides forward in training? These are complex questions, but they come with simple answers. 

Here are three marquee tips to avoid tweaking your knees even more than they already are and ways to start implementing new tools to train intelligently for the long run.

1. Forget About The Forward Lunge

The forward lunge is one of the absolute staples of strength and hypertrophy training for the lower body for one simple reason; they just work. But due to the direction, muscular emphasis and hard deceleration requisites of this movement, they can be notoriously hard on the knees.

First thing first, if you are having pain or aches during or after a leg day which incorporates the forward lunge, let’s make sure that you are actually executing this movement with proper technique and form.

Male athlete performing forward lunges despite knee pain

The two requites I look for in a foundational forward lunge is the ability to control your knee position while also maintaining a staple and solid core position throughout all phases of the movement.

When you are lunging forward, the knee should not be moving in front of the toes too far, as this will increase not only the angle of the shin, but the shear force under the knee cap. As a general rule of thumb, do not translate the knee any further than a fist’s distance in front of the toes.

Related: 7 Alternatives and Modifications for Health and Hypertrophy

The second key to knee position is the angle of the kneecap in relation to the foot and toes. Many times, sloppy lunges will cause the knees to cave in, creating a valgus angle with the knees falling in towards midline. To quickly correct this, drive the knees out towards the little toe on the foot to create more usable stability through the hips and legs in general.

If these technique fixes do not alleviate front-sided knee pain, the next step is to forget about the forward lunge and replace it with the reverse lunge. The reverse lunge will target the use of the glutes and hamstrings to a greater degree while also limiting the forward translation of the knee.

This is one heck of a variation for lunging around knee pain, while also bringing up the posterior chain that is lagging in most anterior chain dominant athletes and lifters.

Check out the video below to visualize the difference between the forward and reverse lunge, and ways to quickly improve your form:

2. Prioritize The Right Squat Variation

The squat can be a confusing movement for athletes dealing with chronic knee pain. If you are force-feeding a particular type of squat that doesn’t fit your current body type or skill level, the squat can become a debilitating and brutal movement for knee pain.

But if you do your homework and choose the right squat for your current goals, which should be centered on pain-free training, the squat will quickly become a staple movement that you can progress and prioritize in strength and hypertrophy based training.

For most lifters, the barbell back squat is the go to variation to train this foundational movement pattern. While there is nothing inherently wrong with the barbell back squat, it does prove challenging for the lifter who presents with banged up knees from a few different angles.

First, many lifters will unknowingly lose proper depth as the knees start to flare up. While limiting depth may seem like a way to decrease stress on the anterior knee, it’s actually a double-edged sword that can spark a vicious cycle of pain and dysfunction.

Limited depth in the squat that progressively loses range of motion over time can cause a lifter to lose authentic hip dominant squatting strategies that utilize the big muscles of the glutes and hamstrings to improve the tracking of the knees, but also the emphasis to be taken off the quadriceps, which can be advantageous for de-stressing the knee joints.

Related: 20 Things To Know Before Barbell Squatting

We’ve all seen this type of apprehensive squat before from banged up lifters. The hard arch and totally vertical torso angle and the half squat depth that leads to a huge anterior translation of the knees forward are pretty unmistakable.

The anterior knee translation presents with the same problems as the lunge that was covered above, and the torso angle can actually cause increased stress through the spine and pelvis. But if you can’t squat deep without pain, what should you do?

Just as my preferred method to teach the proper squat pattern for youth athletes is to squat to a box, it is also my go to variation for banged up lifters looking to take stress off the knees while moving some notable iron.

Place a box that sits you around 10 degrees above parallel in the bottom position under your squats. Using a slightly wider foot position, cue your hips to dominate this movement.

The box squat as featured in the video below has the ability to move the knees through a greater authentic squatting range of motion, while also minimizing the stress of anterior translation.

Also, providing stability at the range of motion that provides the most challenges for banged up lifters is highly advantageous. Give this a shot, and train it in your strength and hypertrophy rep ranges.

3. Stop Crushing Your Joints Running

Now this seems like common sense, but we’ll review it anyways. If your knees are banged up, one of the last activities that you want to be partaking in to work on your cardio is running.

I am not against running, just against running with a poorly coordinated and painfully apprehensive gait cycle that is the common place for banged up athletes who are too stubborn to alter their training according to the presentation of their pain.

If every step that you take on a jog causes you pain, it’s safe to say that running is not the correct medium of fitness for you at this point in your training career. With a myriad of options on the cardio deck these days, choosing a lower impact activity like the bike, elliptical or pretty much any other machine that isn’t a treadmill can be advantageous.

Related: Complete M&S Database of Cardio Based Workouts

For those of you old school athletes that refuse to give up your runs, do me a favor and hear me out on this tip. The painful problem with running is not necessarily the amount of total steps or distance which you are running, but the cumulative stress of the bout which is usually moderate intensity and steady state.

If you have a choice, jump on a treadmill and increase the inclination a bit. This will change the angle of your foot strike a bit and will provide a more novel stimulus to your system. Secondly, try and incorporate some interval runs into your routine. Anything but staying at the same speed for a long distance will do.

From timing your intervals and increasing your intensity to target variable heart rate zones to instinctively running faster and slower in a Fartlek style run, your knees need novelty on the road, and will respond best to new stimuli.

Check out the video below where I explain the different options for athletes with banged up knees as it pertains to running and cardio: