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How to REALLY Reduce Knee Pain

0 - How to REALLY Reduce Knee Pain

Jessica Bento, Physical Therapist (Co-creator of DVRT Restoration, Pelvic Control, and Shoulder Course)

One of the top complaints that I get as a therapist and as someone in the health and fitness industry is knee pain. Specifically knee pain when squatting. I hear a lot of times people just stop squatting due to how bad it hurts, I even hear therapists that just tell their patients not to squat, which drives me crazy because I know there are easy fixes to helping someone with knee pain squat better and to squat pain free. Telling someone to just stop doing something should be a last resort, in my opinion, especially when it comes to a foundational movement pattern such as squatting! Don’t get me wrong, there are cases where the knee joint is just too destroyed, but this is rare, I had people say to me they have “bone on bone” and they will never squat again…and guess what?! They end up squatting paint free with a lot of the drills we will go over.

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It’s super easy to get caught up in the “cool” of fitness. Except for the fact the people that need our help the most aren’t the ones most likely to blow up social media. Yet that doesn’t mean their achievements are any less amazing and often they actually are more awesome! _____ A great example is @mfitnessforlife great work with this inspiring 72 year old woman. It would be easy for this woman to write off fitness as something she can’t do or care about anymore. Instead she completely rocks out these Ultimate #Sandbag Press Out #squats . She knows that her fitness and health have to be important to her not others. While probably unknowingly she inspires us as professionals to remember what achieving #fitnessgoals is really about. Living a better life! #personaltrainer #physicaltherapy #ultimatesandbag #womensfitness #womenwholift #sandbags #corestrength #absworkout #crossfit #strongnotskinny #fitmom #sandbagworkout #fitforlife #girlsgonestrong #hiitworkout #strongwomen #sandbagtraining #performbetter #movementculture #movementismedicine #kettlebell #squatchallenge @perform_better

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Getting great hip mobility, strong legs, and NOT have the knee pain that so many think comes with squats comes down to really understanding movement. 

So why do people have pain when they squat? Well, for me, there are three reasons (I could go into more, but let’s just start with three so this doesn’t turn into a novel ). Number one, the hips! Why would the hips have anything to do with knee pain??? Well, as physical therapist Gary Gray says, “the knee is a rather dumb joint…it does what the hip and foot tell it to do.” It really is a dumb joint and I hate to use such a word  but its true, the knee really only flexes and extends, kind of the middle man. 

PelvicStab1 1 - How to REALLY Reduce Knee Pain

If you look at the joints above and below, for this instance the hip, the hip has so many degrees of range of motion and has some of the biggest power houses when it comes to muscle activation.  So poor hip strength and poor hip mobility can really cause poor knee control and stability, the knees can “cave” in, they can move into painful positions. That is why we focus so much in DVRT on core and hip strength especially when it comes to getting people to squat better and be pain free. 

So what’s the second reason people have knee pain when it comes to squatting? Well, like I said the knee does what the hip and foot tell it to do, so we are talking about the foot. When someone has poor ground engagement, poor foot/ankle mobility and or poor control at the foot and ankle complex the same thing can occur, the knee gets all crazy and gets pushed into positions of pain, positions not ideal when squatting.

Lunging and squatting knee pain is often related to first and foremost not engaging the feet right to give us that strong foundation.

And lastly, what else can cause knee pain when squatting??? Well, a bad squat will cause pain. Poor form, poor understanding of the movement, poor load placement for the individual can all cause increase discomfort.  Also as mentioned a bad squat can also occur from hip and ankle issues too. May times it can be all three of what I talked about causing issuess. 

So lets not completely stop doing squats because our knees hurt, lets first figure out if can problem solve the issue by fixing the above three things. 

So how can improve on our squat? I talked about foot engagement, and that’s a great place to start, so many times a simple cure such as, “grab the ground with your feet” can instantly improve ones knee pain, I know for myself, if I loose that foot engagement I can easily get discomfort in my knees as I have torn meniscus. So gripping the ground with your feet, that’s where you can start. 

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Bad knees plague even the most well intended fitness programs. Especially when we see the knees collapsing in many common exercises like #squats . Most coaches realize this is an issue and try to attack it with a host of corrective exercises. Blaming the the #glutes , core, you name it! Those are part of the equation, but the reality is that everything starts from the ground up and that means the feet first!! Using the @perform_better XL mini bands we can get the feet engaged which starts to get the knees in the right place and fires up the glutes and #core . … 🏋️‍♂️Here I demonstrates how we fix the knees and the #squat at the same time by providing feedback, creating tension, and activating the kinetic chains of the body. By using the mini bands we get feedback upon the feet and the hips while the slow and deliberate pressing out of the Ultimate #Sandbag creates core tension and connection of the lats/core/ and glutes that instantly improves our knee angle and mobility in our squat . … 🏋️‍♂️Using our #DVRT methods in teaching better movement allows you to get people to be successful sooner and just as important, show them that exercise doesn’t have to hurt! This can be a great foundational squat, warm-up, or a #corestrength drill for more advanced lifters. Making people successful faster gets them training more consistently and achieving their fitness goals!

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You can even place a mini band under the foot to help understand what gripping the ground means, having someone try and pull the band out  from underneath the foot will really tell you if you are truly getting the ground engagement. 

Placing mini band around the legs just below or above the knee will also add in allowing the individual to create tension and push the band out when descending into that squat. Cuing “push the knees out” will help create that stability the knees crave. 

When it comes to load placement, a great place to start is with our DVRT Press Out Squat as it helps to counterbalance the individually with out placing load upon the body, it also creates the upper body and core tension that is needed to help stabilize in the squat. 

Below are several drills to focus on the hip and core to get a stronger squat and to progress with that knee stability. 

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One of the biggest misconceptions of movement is that all variations of a movement are equal. For example, people often assume we should use every form of #squat rather than trying to understand which squat is best for us and our #fitnessgoals . . For example we use our Ultimate #Sandbag press out squat to create core stability which helps us pattern proper mobility of the squat. . We can only load the press out so much so we can then move to a #kettlebell goblet squat that requires us to use more load but doesn’t give us as strong of that dynamic #plank as the press out. However, we shouldn’t need as much feedback from the core after we patterned the first series. . Eventually we can be limited by how much we can hold with the Kettlebell and moving to Bear Hug gives us an opportunity to still get positive feedback from the load to drive us into the squat but due to the position we can make the weight much more a part of our body. . These are a few of the examples of better #squats , check out the rest of this series and realize the little differences can be profound.

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