If that was you in the last 6 weeks please stop reading this article and seek professional help and treatment for your knee pain. This is article is not for you. This article is for the people who have either previously had a knee injury which simply hasn’t got better after 2-3 months or your knee pain came about for no particular reason. Nothing happened. The knee pain came out of nowhere and didn’t go away or got worse.
The physiotherapy exercises for knee pain below are the ones we find most consistently will help people with this type of long standing knee pain. Long standing being effectively defined as more than 6 weeks. The reason it’s 6 weeks is that most tissue healing will take place within 6 weeks for all but the most severe knee injuries. Severe injuries being ACL tears, knee cap dislocations and some meniscal (cartilage) tears.
We’d prefer everyone to come to see us to rule out anything untoward. We do a whole body assessment and work out a bespoke whole body knee pain treatment plan for you. For those unable to see us, for whatever reason, we’re hoping this article will be the next best thing.
DISCLAIMER: Before we get into the good stuff please note that without consulting a professional prior to doing these exercises you do so at your own risk. If you choose to do so please ensure that you do all of these stretches and exercises not to pain. They will work better that way anyway.
If you do have any specific questions about your knee pain you can find more information on how we treat knee pain here: Brighton Knee Pain. We’re always happy to speak to you specifically to talk through your condition and explain your next best steps. Whether that’s to come see us or another approach. You can arrange a call back with a therapist on our booking page.
The Reasons Behind Our Knee Pain Treatment
Before we get to it I feel it’s important to understand the reasoning behind what we do. Some of you reading this may find this is alternative to exercises you have recommended before. The following two pictures help to explain some important knee biomechanical ideas to start to explain our alternative ideas. Firstly the concept of the Anatomy trains Deep Front Line shown below:
You can see how the muscles deep within the stomach are continuous with the knee joint capsule via the adductor muscles on the inside of thigh. We then need to consider also the femoral nerve which is the nerve that gives sensation in and around the knee:
Many of our exercises we recommend below are to optimise the length of the muscles and nerves in these two pictures. In so doing reducing the sensitivity of the knee pain itself.
Our 6 Best Exercises For Knee Pain
Not technically an exercise but our experience makes us strongly believe that posture and how we hold ourselves is very important in helping knee pain. A physiotherapy concept called adaptive shortening means if we put a muscle into a short position it think it should stay there. It adapts to being in a short position.
It is this short position that affects the principles in the pictures above and in so doing affecting the sensation in the knee. This is true when we sit for long periods of time as many of us do. It’s also the case when we limp for prolonged periods – a mechanism by which pain remains in an old injury long after the tissues that were damaged have healed.
The video below summarises how to hold yourself in what we call pelvic neutral. Don’t expect yourself to be perfect all the time. Just notice when you’ve gone too slouched or too upright and reset as we show below.
We’ve found with some of our clients maintaining a neutral pelvis is just too uncomfortable as it is too far away from where their body has adapted to be. If this is the case we recommend slowly moving somewhere between your current natural posture and neutral and give your body chance to adapt back the other way.
2. Lumbar Extension
The opposite of slouching and so good to do after a long day of sitting down. It affects all of the muscles of the deep front line above which have an effect on that femoral nerve we spoke about above.
The version we demonstrate in the video below (originally shot for runners but just as relevant for people who sit down) where we lie backwards over a Swiss ball can be a bit extreme. If you have any back pain we don’t advise doing this. An easier option is to simply lay back on your bed with your arms over your head. Particularly enjoyable after a long day! We try to make our rehab fun and enjoyable wherever possible.
In the video we also demonstrate another easier option which is sphinx and cobra position from yoga. If all of these prove too uncomfortable for you then simply lay on your back and do some nice relaxation breathing. This will work the diaphragm which is effectively the ‘start’ of the deep front line and help to start desensitising that femoral nerve that feels the pain into your knee.
Any stretches you do we recommend for a minimum of one minute at a time. Always pain free as we mentioned above. We can’t overstate that. You’re unlikely to do damage stretching to pain. But with the discomfort it makes it hard for your body to let go of the tension and relax those tight muscles. Less is more when it comes to stretching.
3. The Half Moon
The name says it all! Stolen straight from yoga. Make sure the feet are together and make like half a moon. Simple.
This affects the obliques and also the latissimus dorsi which become short and tight when your quadriceps do too much work putting extra pressure on the knees. This will also help release on low back problems caused by slumping too much. It affects this side body as shown in the diagram below:
Not only this but this connection into the ilioinguinal ligament can take pressure off the femoral nerve. Happy nerve means happy quads (the muscles in the front of your thighs) which equals happy knees. It can be as simple as that. Especially if you tend to get pain over the front of your knee cap.
An oldie but a goodie. Most likely to be most effective for pain towards the back of your knee but can still be important for knee cap pain. Or pain to the inside or outside of your knee due to the 3 hamstring tendons attaching either to the inside or outside of the knee.
As we show in the video below simply plonk your leg up on something that seems like a good height to you and lean into it. A bonus tip is that you can keep the foot pointing straight, to the outside or inwards – each will hit slightly different muscles fibres. Did you know there were 3 hamstring muscles?
5. Quad Stretch For Knee Pain
I would be surprised if you haven’t seen this one before. In the video we show you an important tip to make the most out of it. Simply pull your ankle up to your back side. The bonus bit here is to push the pelvis up and outwards at the same time. Think pelvic thrust. This should increase the stretch and help loosen those quads making the knees feel more lovely.
This is a really important concept. We’ve spoken about the femoral nerve a lot in this article but sometimes knee pain is due to the quad muscles simply being too tight. The knee cap is completely enveloped within the quad muscles. So tightness in quads can be a large factor in knee pain. The knee just happens to be the scape goat. This may be especially true for you if you’ve recently increased your training load and not given your muscles enough time to adapt.
6. Leg Pit Stretch For Knee Pain
Yes I did say leg pit! Your leg is a lot like your arm if you’re a geek like me and delve deep into the anatomy. This mystical ‘leg pit’ is home to our good old friend the femoral nerve. If you get into the same position as the hamstring stretch above and this time roll the foot all the way over so your inside ankle bone is resting into the surface you are stretching on. Now bend your standing leg to give yourself a suitable amount of stretch. Here’s a video to show you this process:
Knee Pain Exercises Conclusion
As we mentioned at the start you can’t beat an in depth 1:1 assessment of your specific knee pain but hopefully this is a decent second place if you can’t get to us or any other professional.
It’s really important that you don’t fear knee pain and having the reassurance from a professional that you don’t have anything structural to fear is a large part of the process. It’s very rare that the structure is the issue by the way. Unless you’ve done something particularly horrific to your knee which you will have known all about!
If you are in lots of pain and considering a knee replacement we would always recommend trying all alternative options before going under the knife. Here’s a previous article explaining the reasons why.
And there you have it. We hope this article has given you some hope that your knee pain won’t around forever. Hopefully we’ve inspired you to try these knee pain exercises or at least look further into what can be done about your knee pain. Rather that giving up and trying to accept that it is there forever.
As I mentioned above we’re always happy to discuss your specific condition, fears and situation. If you would like to talk through how we might be able to help then please fill out the form on our booking form here and ask to speak to a therapist and give us some details of the history of th condition and what you’d like us to help with.