Chalk Talk #5 – Addressing Knee Pain

Knee pain is common in lifting, and it’s nearly 100% caused from a) poor mechanics and b) some sort of hip dysfunction. This Chalk Talk doesn’t get into lifting or movement mechanics, but instead addresses some palliative treatment and soft tissue work you can do to alleviate some of the pain.

Generally speaking, knee pain should tell you to work on hip mobility, especially with the rectus femoris. This muscle crosses both the hip and the knee, so if it’s tight, it’ll tug on it’s lower attachment near the knee (i.e. all of the quadriceps flow into a common tendon that attaches to the patella, which then attaches to the tibial tuberosity) and cause pain in the center of the knee, usually under the knee cap.

One thing we can do to try and alleviate tension is soft tissue work on the rectus femoris itself, and then on some of the other quad muscles.

Note that this precision soft tissue work works well when it occurs before stretching; it’s difficult to stretch a muscle that hasn’t had tension worked out of it. I like to follow this soft tissue work with the couch stretch, like in this video.

12 thoughts on “Chalk Talk #5 – Addressing Knee Pain

  1. Dear Justin

    Awesome video, thanks for all this great free info!

    Is it possible to do one on shoulder pain in the future?

    I know the shoulder is a very complex joint and there are many possible causes of it hurting. In my own case: eight months ago I injured my shoulder and developed a stubborn case of bursitis. Had to lay off all presses, chinups and squats/deadlifts due the severity of pain and weakness. Therapy helped some, but what helped most was re-establishing scapulo-humeral rhythm with overhead shrugs, serratus anterior work and lots of lower trap work. Still, my right shoulder is not yet completely 100% (though I’m pressing, chinning and squatting/deadlift again). I have to note that band pull-aparts, rowing and external rotator work did next to nothing. The problem was mostly with movement in the vertical plane (elevation) and also in the horizontal plane (almost no protraction caused by a weak serratus anterior).

    Do you have any recommendations and/or experiences with this injury? I have full mobility.

    Kind regards,

    Leeuwer

      • The original injury was nothing acute, as far as I know. It was an overuse injury that was caused by switching programs (more bodybuilding oriented, having more volume) and some improper cuing (constantly trying to cue “shoulders down and activate lats” in the deadlift, which further annoyed my shoulder joint). Finally it was aggravated by attempting to come back too soon.

        The pain is inside the shoulder. The muscles around are no longer painful (such as my upper trapezius) and the upper part of my chest (nearest to my shoulder) is less painful to the touch, but is still sensitive.

        Leeuwer

        • To further clarify: it was shoulder impingement caused by faulty movement patterns/overuse, leading to bursitis. On the MRI (?) scan the swelling is clearly visible. This was taken 6 months ago, though.

  2. Justin,
    As usual, great stuff. I am really excited about using this for my (constantly) sore knees.

    Expanding on your comments about hip mobility, do you have any recommendations for someone with sacroiliac joint dysfunction? I am constantly dealing with pain from my hip and my doctor basically has told me to just take nsaid’s when it hurts. But recently I irritated it pretty badly (again) and am wondering if you have any ideas for good self rehab. I have very flexible hips, stretch and do mobility work consistently, but always seem to get injured every few months. This last time I tweaked it just doing pallof presses (too much weight I guess).

    Any advice?

    • There is a Chalk Talk concerning the S/I coming out 10 Sept. In the mean time I encourage you to really focus soft tissue work on your quadratus lumborum and glute medius. If you aren’t focusing your mobility and soft tissue work on your hips, do so. You shouldn’t be focused on the back — you don’t need more back mobility. You need stability, and that is built with a focus on hip mobility.

      Also, see the Dr. McGill article I posted Monday. Start implementing the “big 3” immediately on a regular basis. Let me know how it goes.

      –Justin

  3. Justin,

    I’ve always been told that static stretching pre workout is a bad idea because you’re relaxing the muscle too much and then asking it to fire at full intensity right afterwards. Have I been mislead or are there exceptions to the rule? Thanks for the video.

    -Tommy

  4. These chalk talk sessions are a nice addition to the site, this one in particular, as right after doing the recommended work, my knee discomfort was erased.

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