Whether from gradual wear and tear, a muscular-skeletal imbalance, or a more serious injury, knee pain should always be dealt with at the onset of the discomfort. Any pain, no matter how small, is the body’s natural way of altering you to a problem.
According to Dr. Theresa Marko, a board-certified orthopedic clinical specialist in physical therapy, knee pain comes in different forms, sometimes from simply sitting too much or increasing your activity level all of the sudden, such as running mileage too quickly. “For this type of pain, you should absolutely ice and elevate the area of pain and inflammation. However, for a chronic injury (lasting six months or more), you should ice only if you have a flare-up, and definitely book in with a physical therapist who will get straight to the root of the problem,” says Marko. “Chronic injuries are usually alignment, trigger points, and general weakness all fighting one another.”
However, if ongoing stress is causing a wave of knee pain to come and go, it may be time to look at the surrounding muscles as tightness can cause tension within the knee area. According to fitness expert Eric Von Frohlich: “A lot of knee pain comes from direct impact and/or laterally instability-related issues.” He suggests lower impact exercises, such as rowing, to protect the knees. ”Rowing carries a low risk of injury since you are in a fixed plane, and people with injuries do very well with this form of exercise as it helps to strengthen their surrounding muscles, which can help their knees long term.”
For those who fall into the category of knee flare-ups and ongoing exacerbations, read on for the best stretches to alleviate knee pain.
Meet the Expert
- Dr. Theresa Marko, PT, DPT, MS, OCS, board-certified orthopedic clinical specialist in physical therapy and owner of Marko Physical Therapy, PLLC.
- Eric Von Frohlich is the founder of Row House. He has more than 25 years of experience in the fitness industry.
What Exercises Help Alleviate Knee Pain?
The hamstring is a major muscle at the back of the thigh which plays an active role in how we walk, jog, run, and jump efficiently. Stretching the hamstring is an important component in warding off knee pain as the more limber this area, the less tension and pressure on the knee cap. The following two exercises are suggested by Marko for targeting the hamstrings.
- Hamstring Stretch Lying Down With Belt: “Lie down on your back, bend one knee and place the corresponding foot on the floor. Put a yoga belt around the bottom of the toes on the other foot and pull the leg towards your chest. Hold for 30 seconds before releasing. Repeat three times.”
- Hamstring Flossing: “Lie down on your back, bend one knee in and place that foot on the floor. Hold the other leg with both hands behind your thigh. Straighten the knee to elevate the foot in the air, before lowering the foot and bending the knee. Repeat ten times. Rest and repeat again ten times, switching between legs.”
Calf and Quad Stretches
Similarly, tight calves and quadricep muscles can add unwanted pressure to the back of the knee, stressing the importance to stretch these muscle groups to avoid the onset of knee pain. The following exercises target these muscles.
- Calf Flossing: “Lie down on your back, bend one knee and place that foot on the floor. Put a yoga belt or band around the bottom of the toes on the other foot and pull the leg towards your chest. While the leg is in the air, point your toe up towards the ceiling, while pushing into the belt, and then relax the foot to pull more. Repeat ten times. Relax, and then repeat ten times, switching between sides.”
- Psoas and Quad Stretch on Arm of Couch/Chair: “Stand on the side of a chair or couch that has an armrest, placing your leg that is on the side of the couch on the cushion, with the top of your foot resting on the armrest,” outlines Marko. “Step your foot on the floor forward about a foot in length. Elongate your torso and make your hip as straight as possible while you push your pelvis forward to feel the stretch in the hip and quad. Hold for 30-60 seconds, then relax and then repeat three times.”
- Direct Quad Stretch Prone: “Lie on your stomach. Be sure your legs are together and not spread apart. Bend one knee and use the arm on that same side to reach back and pull your ankle to bend your knee more towards your buttocks. If this is difficult for you, use a yoga belt around your ankle and pull on the belt instead. Hold 30-60 seconds and repeat three times.” To intensify this stretch, Marko suggests squeezing your buttock and pressing your pelvis into the floor, or trying to gently lift your knee off the floor just slightly.
- Standing Quad Stretch: “Grab one of your feet or ankles and pull that heel to your buttock. Keep your knees in line with each other and feel the stretch down the front of your leg, aka your quads and hip flexors. This loosens the muscles above the knee joint, relieving tension and knee pain. Hold for 30 seconds on each side and repeat two times. You can also hold a chair or the wall to help you balance.”
In addition, Von Frohlich offers three alternative calf stretches: “Start by dropping your heels off the edge of a step to elongate the calves, hold for 30 seconds and repeat two times,” he outlines. Adding: “Runner’s stretch is also effective, where you step one foot forward and the other one back, with the back heel dropping to the floor. Hold for 30 seconds on each side and repeat two times.” Finally, he explains how rowing strokes on a machine are powerful in elongating the calves and providing a solid stretch in this region. “For a dynamic calf stretch, you can slowly pedal your heels back and forth, or simultaneously drop both heels toward the ground and raise them, repeating for 10 or so times.”
IT Band Stretches
Lastly, the IT Band, a length of muscle running from the hip to the knee, and down to the shinbone, is an area prone to causing a flare of pain and swelling at the side of the knees when it becomes too tight. “What happens in Patellofemoral Syndrome (PFS) is that the IT band gets tighter than normal and the quadriceps aren't strong enough to balance the pull and so the patella (knee cap), doesn't track very well. This causes pain around the kneecap when you move from seating to standing, going up and down stairs, and sometimes with walking,” explains Marko. Stretching the IT Band will help keep the muscle limber and functioning as it should.
- Crossover ITB Stretch With a Belt: “Lie down on your back, bend one knee and place that foot on the floor. Put a yoga belt around the bottom of the toes on the other foot. While holding the belt taut, pull the foot and leg across the body in a semi-circular motion towards the other leg. You should feel the stretch in your upper outer thigh. Hold 30-60 seconds and repeat three times.”
“The IT band is one of your hip abductor muscles and helps stabilize the outside part of the knee,” says Von Frohlich. “Stretching this area can help with smoother knee flexion as well as extension, and reduce pain in both the knee and the hip.”
- ITB Stretch: "Hook your right leg over your left, keeping your toes at the same level. Reach your left arm up overhead and lean your body to the right. This will provide a deep stretch along the IT band. Hold for 30 seconds on each side and repeat two times.”
Alongside stretching, Marko suggests a few exercises to alleviate tightness in this area, including rolling your IT Band with a stick, tennis ball, or foam roller; conducting side leg lifts, alongside slow one-leg squats on the downward movement, controlling the range of motion to keep track of the knee as it hovers straight over the toes. She also points out that if the knee deviates towards the midline, the movement has drifted too far and knee pain is more likely to ensue.
Listen To Your Body
Whether from overuse, gradual wear and tear, or an acute injury, knee pain can arise for many reasons. Regardless of why it’s occurred, knee pain should be addressed as soon as it occurs by a registered physiotherapist who professionally takes care of each individualized case. To keep your knees in perfect shape, incorporate a stretch routine into your daily activities for a sure-fire way to ward off pain, maintain limber muscles, and give your body that boost of healthy love it needs.