How to Train Around Hip or Knee Pain

Many adults will experience hip or knee pain, yet the pain need not stop you from staying active and doing the things you love. Having a “modify” rather than a “stop everything” attitude, will pay off. You can try these changes.

Reduce Training Volume

• Avoid sudden increases in volume; it’s a recipe for injury as your tissues can’t repair themselves as fast as you break them down.
• Let’s say you typically run 2 miles four times a week, but some lateral hip pain is starting to develop. Try keeping your distance the same, but only run 2-3 times a week. You’re still doing the activity you love, just at a lower total volume.
• The additional time off may give your body time to heal.
• Remember: Stress + rest = growth. Stress + stress = breakdown and injury.

Change the Range of Motion

• If you have pain doing deep squats, a box squat from a non-painful height could be a good modification.
• You will work your muscles in the same way, yet the box helps you avoid going too low.
• Shortening the movement can allow you to perform it without as much pain.

Adjust the Weight

• If you feel pain when lifting a specific amount, try less weight. You can increase repetitions.
• For some, body weight is enough to cause pain. If so, use assistance. For the hips and knees, TRX straps really help moving in and out of lower positions.
• Holding a bar or countertop could do the same thing.
• Exercises like planks can be adjusted for your level of movement.

Go "Weightless" to Keep Active

• Get in a pool; buoyancy takes weight off your joints.
• People with joint issues like osteoarthritis love to exercise in the pool as it allows them to do many motions typically painful on land.
• If things like walking hurt, try the same activity in the pool.

Train "Around" the Areas of Pain

• When a certain muscle or joint is just too sore, give it a rest, but stay active working other muscle groups.
• For example, if you strained a groin muscle, which primarily pulls the leg inward, keep your hip strong by continuing to work the muscles that extend and abduct the hip.
• Appropriate rest for injured areas while preventing atrophy in healthy areas is key.

Change the Exercises

• Start with lower-impact activities. If running or walking hurts, try cycling. You still get cardiovascular work with less stress on joints.
• Open-chain exercises, which are any movements where the limb is not in contact with the ground, may be good options; you can choose the resistance.
• An example is lying on your side and lifting your leg to work the outside glute muscles or using a knee extension machine to strengthen your quads.
• Both pool work and open chain exercise can be more comfortable since they put less compressive force on joints.

Remember that hip and knee pain is common, but with some modifications, you can keep active despite it. Staying active is vital for recovery and for overall health at any age. Avera Physical Therapy can help you develop a plan for activity and exercise, no matter what challenges you face.

Learn more about how Avera Physical Therapy can help.

Nicolas Albers Demonstrates Exercise Modifications

If body weight is enough to cause pain, use assistance. TRX straps really help moving in and out of lower positions.

A box squat from a non-painful height could be a good modification. The box helps you avoid going too low.

Open-chain exercises like this knee extension may be a good option. Other examples include the clamshell and hip adduction exercises.

Use a knee extension machine to strengthen your quads. This machine can be more comfortable since it will put less compressive force on joints.

About the Expert

Nicolas R. Albers, PT, DPT, OCS

Physical Therapy

Nicolas is a Doctor of Physical Therapy and Board-Certified Orthopedic Specialist with Avera Therapy – Fitness Center.

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