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REHAB - How to quickly reduce knee pain

Updated: Nov 17, 2019

This is a quick article to help people who are experiencing sharp knee pain when running, squatting or loading the knee. It can be used to help relieve this pain through a few simple activities. We provide this information through 15 years of working with clients with such problems. If the pain is of a serious nature, has come about via a sporting or physical injury or does not reduce after these activities, please see a doctor of physiotherapist. This is by no means a diagnostic information piece. Pain in any joint in the body should be assessed properly by your trainer or medical specialist before commencing an exercise program. A fully comprehensive version of this article will be available in our ARTICLES section shortly and it will contain a much deeper explanation of all the factors at play in this situation.

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For anyone who has experienced acute sharp pain around the knee, in particular the knee cap, then trying these exercises will hopefully provide some relief to work on the reasons why such pain is occurring (see our full article). If a corrective strategy is not implemented then the same problem will most likely continue to occur.


Through many years and many clients’ experiences, we are going to focus on the tightness in the lower ITB (Iliotibial Band) and lower Quadriceps. This should help to alleviate the pain and allow for pain free movement at least in a walking action or moderate squatting movement.


The lower ITB (on the outside of the leg down near the knee) and lower Quadriceps (on the front of the legs) are high density areas of muscle, tendon and ligament fibres, both of which undertake large amounts of strain and play a massive role in the movement pattern of the Patella and thus whether it tracks properly in its groove on the femur. If the femur is getting pulled to either the left or right, then it can cause pain as it slides against structures that are not smooth articulating cartilage.


We will aim to release the lower ITB and Quad and then stretch out the quads, hamstrings and calves. Remember, this is a temporary fix to allow for pain free/reduced movement and to facilitate corrective exercises.


1) Release lower ITB and Quadriceps


Complete the foam roll exercises shown below for up to 10 minutes, repeat every day and even twice a day if required to enable pain free corrective exercises. Watch the attached videos if you need more clarification.

  • Lie on your side and place the elbow directly underneath the shoulder to support the upper body.

  • Stabilise the shoulder by drawing the shoulder blade “down and back” and place the other hand on the ground in front of the body to provide balance.

  • Place the roller under the leg just above the side of the knee.

  • Engage the core and maintain a neutral spine.

  • Use small, slow back and forth rolls of about 15-20cm in length from just above the side of knee and moving up the leg.

  • Rotate the body internally and externally and continue to slowly roll back and forth, pausing on “sore spots” for 20-30 seconds.

  • Continue this right around until rolling on the front of the leg (quadriceps) just above the knee.

The non-released leg may be bent at the knee and the foot placed on the ground in front of the leg being rolled on to reduce the amount of pressure on both the releasing leg and the supporting shoulder. Keep breathing constantly, however, large breaths can be taken when on a painful spot to help it release. This technique is very effective in this area.


The use of a tennis ball instead a roller in this situation can also be effective.

  • Sit in a chair and keep leg relaxed and slightly extended.

  • Place ball on the ITB and with a flat palm, apply pressure and slowly roll back and forth as above.

  • Continue this as above around to the front of the leg.


2) Stretch the Quadriceps, ITB*, Hamstrings and Calves


Once the ITB and lower Quads have been released, it is time to stretch the main muscles around the knee. Foam rolling these areas first will help to create a deeper and more effective stretch. Hold each stretch for 30-60 seconds and repeat 2-3 times for each leg.

*the ITB is strong connective tissue that does not really stretch like a muscle. When we refer to stretching the ITB we are referring to the ligament itself but also mainly the surrounding area itself.


Quadriceps

  • ​If using a towel, wrap it around the ankle and hold the ends in one hand.

  • Pull the foot up towards the glutes (pelvis)

  • Keep the knees side by side and push out through the hips.

  • Stay straight and upright through the upper body.

  • Do not pull the knee behind the other knee.

  • If using a towel, repeat the above procedure and grab further down the towel if a deeper stretch is required.





ITB

  • Lie in a supine position with both legs bent at knees and feet on the ground at shoulder width apart.

  • Allow the left knee to fall “inwards” towards the right foot.

  • Lift the right foot and place it on the left knee.

  • Use the right foot to push the left knee towards the ground,

  • increasing the stretch felt at the hips and side of the knee.

  • Attempt to keep the left shoulder on the ground and the left hip as close to the ground as possible.

  • For variation and/or a deeper stretch, move the left knee across the body further or away from the centre line and either bend the knee more or straighten the leg.


Hamstrings

  • Stand tall with one leg resting on a bench on the heel. Make sure that leg is slightly bent at the knee.

  • Maintaining a neutral spine, slowly bend forward towards the toes making sure not to rock forward on the back foot.

  • Gradually straighten the bent leg whilst pushing back through the hips.

  • One arm can reach towards the toes if a deeper stretch is desired.







Calf


  • Place one foot up against the pole with the toes pointing upwards.

  • Place the other foot behind for balance

  • Hold onto the pole and pull the whole body forward whilst also pushing up off the back foot.

  • Keep the hips forward and the upper body upright



This short series of foam rolls and stretches will help to release the tight structures around the knee and provide enough relief to start the corrective exercises and stretches required for long term pain relief. This may include knee, hip and foot stability exercises, more foam rolling and stretching of other areas such as the calf, glutes and hip flexor and movement assessments and analysis.


Another form of immediate relief may be gained from taping of the knee joint. There are many ways to tape the knee and the stuctures involved. However, we strongly suggest you see a qualified physical therapist is you wish to take this path.

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