3 Poses to Heal Knee Pain

Article by Lucas Rockwood

Anatomy of the Knee

Let’s take a closer look at what’s going on in this important area of your body.

• MCL and LCL: Your medial collateral ligament (MCL) connects your femur (upper leg bone) to your tibia and is a very common site for minor knee injuries. Your lateral collateral ligament (LCL) connects your femur to the fibula (lower leg bone). Injuries to either collateral ligament are common, but usually minor, and very simple techniques like supportive wraps and braces can often help to stabilize the knee while healing.
• ACL and PCL: Your anterior cruciate ligament (ACL) connects your femur to your tibia bones right in the middle of the joint and is responsible for as much as 90 percent of your knee’s stability. The posterior cruciate ligament (PCL) crosses directly behind the ACL and plays an important supporting role. In fast moving sports like football or rugby, ACL injuries and even ruptures or tears are common. This is a major injury usually requiring medical help and even surgery. ACL and PCL injuries are uncommon in everyday activities and casual exercise.
• Quadriceps Tendon: Your quadriceps muscles connect to your patella (kneecap) with the quadriceps tendon. If damaged, the pain from this tendon will usually manifest on the top of the knee above your kneecap.
• Patellar Tendon: Your kneecap is connected to your tibia (shin bone) with the patellar tendon. When injured, pain will often be felt just below the kneecap or on the tibia itself.
• Meniscus: Two cartilage rings act as shock absorbers between your upper and lower leg bones. These tissues are frequently damaged and torn. If your knee pain comes and goes, and if you feel your knee sometimes grinds bone-on-bone or locks in place, these symptoms are an indication of a potential meniscus tear. Meniscus surgery is very common, but while it tends to be minimally invasive and initially very effective for removing pain, any removed tissue will not regrow and your meniscus will remain compromised forever.

Where is Your Knee Pain Coming From?

Once you have a better idea of the source of your knee pain, and more importantly which movements trigger it, you can adapt and modify your movement and recovery patterns to work around that area so as not to aggravate it.

As an example, if you identify your medial collateral ligament (MCL) as the source of the pain and feel it’s most painful during deep squats, you can modify and adjust your squat depth to take extra care of that area. You might also experiment with an elastic knee wrap to give some support.

Here are three simple self-tests to help you isolate and identify the source of your knee pain:

Stand On One Leg

Whichever knee hurts, stand on that leg and balance. Turn slightly to the right, then slightly to the left, and then bend your leg a little. With a pen, attempt to isolate and draw on your skin exactly where you feel the pain so you can attempt to get a better understanding of which tissues are involved.

Squat Test

If you’re having trouble isolating the pain point by standing on one leg, try gently squatting and rising either with both legs at the same time, or doing single leg lunge squats. Can you isolate the region or regions where the pain originates?

Number 4 Stance

Bend your knees slightly in a half squat. Place the heel of your affected leg up on top of the opposite knee, rotating your injured knee leg laterally (outward). Are you able to isolate the pain point now?

Healing Your Injured Knee

Shortly after injury, the healing process begins. Inflammation stimulates neovascularization where new capillaries are formed in and around the damaged tissue. Tendons, ligaments, and cartilage are mostly avascular, meaning they have little to no blood supply. As metabolically slow tissues, this new blood supply is much needed, but even still, healing is much slower than in blood-rich areas of the body.

The most common misconception is that inflammation and pain are bad, and if you ice or medicate it away, you are helping your body to heal. In fact, the opposite is true. There is a time and place for analgesics and anti-inflammatory drugs, but using them immediately following an injury is counterproductive. Your body has an incredible ability to self-heal, and with all the best intentions, most of us get in the way of this and often make things worse.

While no one likes to feel pain, if it’s tolerable, you’re much better off listening to those sensations. Pain is your body’s way of communicating which movements are helpful and which should be avoided following an injury. If you take 600mg of ibuprofen, most pain will diminish or even disappear. Assuming the injury is healing, you’ll often go right back to the movements that will then deepen the injury. A huge percentage of all serious knee injuries start off as minor injuries that are ignored and worsened through the use of pain killers and continued activity without modification.

The next common misconception is that the best way to heal an injured knee is to simply immobilize it. What if you just elevate your leg on a stool, watch a TV series, and give it a few weeks to heal up? If you don’t use it, you won’t aggravate it, and it’ll surely heal faster, right? Wrong. Your tendons, ligaments, and cartilage heal through scarring, and scar tissue needs movement and stimulation to form in an organized fashion where the fibers align rather than bunch up. A lumpy, clumpy scar on your meniscus, for example, might itself turn into a problem later down the road, so movement is key. Scar tissue is initially made of collagen type III, which is faster to form but less resilient. Through gentle load and use, that type II collagen turns into the stronger and more desirable type III, so again, movement becomes medicine.

3 of the Best Corrective Knee Exercises

Download the PDF pose chart

One-Legged Wall Sit

• This pose will gently stress the ligaments, tendons, and cartilage of your knees.
• Position your back against a wall, squat into a seated position and make sure your ankles are directly underneath your knees for optimal joint stability.
• Elevate one foot on top of a block. Place the other foot flat on the floor.
• Squat as deeply as your comfort level allows. The deeper you go, the more challenging it will be.
• Aim to hold for one minute, then swap sides so your other foot is on the block.

Static Sissy Squat + Variation

• Stand about six inches away from a wall with your feet and knees together.
• Squat your knees into the wall.
• Steeple your hands (fingers together, hands in front of your chest) and look straight ahead.
• Keep your spine neutral throughout (neck long, spine long) and the weight through the balls of your feet.
• Inhale and exhale slowly through your nose and hold this position for one minute.
• Repeat as above but squeeze a block between your thighs, just above the knee.

Isometric Step-Down

• Place one foot on a block or the bottom step of a staircase.
• Place and hold another block between your thighs, just above your knees.
• Steeple your hands for balance.
• Step down with one foot until your toes are on the floor – your standing leg (on the block or step) will be bent, your other leg should be straight.
• Hold this position for a minute, inhaling and exhaling through your nose.
• Release the block and your legs and repeat on the other side.

Knee Exercises & Pain

If you’ve had an impact injury, a slip and fall, or any knee injury that leaves you unable to walk, please see a doctor. These exercises assume that your knee injury is recent and intense. As a result, they are very conservative by design. You will need to progressively increase load and intensity within a couple of weeks.

In all cases, you should never push through pain, and even these gentle exercises should be modified or even skipped if you feel any sharp pain while practicing. Some people falsely believe things need to get worse before they get better, but when it comes to connective tissue, you need to consider all increases in pain as a sign that you’re doing something wrong.