Knees Behaving Badly
Why Everyone you know has Knee Pain, How to Train Around Knee Pain, Exercise Video for Knee Prevention and much more.
My Not-So-Happy Knee Club
Nearly everyone I know has dealt with some form of knee pain during their fitness journey. Let’s name a few of my subscribers: Filippo - tore his meniscus with a Muay Thai kick. Alessandro - tore his meniscus and partially injured his ACL during judo. Emanuele - irritated his meniscus on an epic long-distance bike ride. And me? I banged my knee in judo practice at 12 — a small injury that quietly evolved into patellar chondromalacia years later. And the list goes on. But here’s the thing: even those without a clear injury often experience knee discomfort, especially with repetitive sports like running.
A very common type of knee pain is the kind that occurs under the kneecap. Why? One possible reason is imperfect patellar bio-mechanics — something many of us have. Women, in particular, are more prone to this due to differences in hip-to-knee alignment. And those who are new to knee pain often fear something catastrophic is happening — right, Emanuele? However, occasional pain isn’t something to panic about; it’s an opportunity to understand pain (click here for popular post) and to train wisely around it — strengthening the muscles that support the knee and helping the patella "float" more smoothly.
So — let’s take a deep breath, relax, and dive into my strategy for managing knee pain.
Training Around Knee Pain
To start with I believe there are two crucial steps:
Try not to let the pain destabilise your mind, or affect how you show up in other parts of your life. Don’t let knee pain spill over into your work or your relationships.
See a physician. To understand what is happening and how to approach your recovery. I wouldn’t advise stopping your whole body from moving - it’s a classic all or nothing mentality.
Now, assuming your physician says you can continue training, your goal should be to keep training all the areas you can. And for painful areas, find movements that you can get stronger without making pain worse. Let’s break down this approach more clearly.
Scale Back, Get Curious, Then Build Up
Scale Back: Reduce the load on the painful area using one or more of these strategies:
Lighten the load — even down to bodyweight — until the pain is manageable (around 2 out of 10).
Slow it down — move more deliberately, increasing time under tension instead of relying on fast, dynamic movements.
Avoid impact — skip plyometrics or other high-impact drills.
Add stability — use hand support, machines, or switch from unilateral to bilateral movements.
If movement is unbearable: use isometric contractions
Get curious:
Adjust the angle — elevate your heels, change the bench position, or shift your body alignment.
Swap the movement — choose new exercises (see my knee-friendly list below) or related variations, like a front squat instead of a back squat.
Change the tools — experiment with dumbbells instead of barbells.
Explore different activities — for example, cycle instead of run, which is more concentric and less impactful, while still strengthening the knee.
Build up. As your recovery progresses, gradually increase the load, range, and duration of your movements to gently test your knee. Some discomfort is normal along the way, you can expect echoes of the old pain to resurface from time to time. Sometimes it’s hard to know whether it’s the body speaking, or the mind playing tricks on us. Ughhh.. or, as my girlfriend likes to sigh: “Ufftttt.” ^.^
List of exercises that can build a strong and healthy knee:
Here’s a list of knee-friendly exercises, ordered from the most conservative onward. Check-out the video below to find-out my favourites! I still include some of these exercises in my training even outside of rehab.
Peterson Step-Up — excellent for isolating the vastus medialis oblique (VMO), muscle, often undertrained compared to its opposite muscle; this exercise can support better patellar tracking and reduce pain.
Isometric Wall Sit — a secure way to build endurance around the knee joint; this exercise is generally the first choice in rehabilitation programs.
Isometric Quadriceps Contractions – a safe way to activate the muscles responsible for knee stability, without moving the joint.
Single-Leg Squat Variations — step-ups, box step-downs, and similar movements to build unilateral control.
Assisted Step-Back (or Reverse) Lunges — generally less painful than walking lunges, as they require less forward translation of the knee.
Single-Leg Glute Bridge (elevated)
Leg Press — offers controlled angles and progressive loading.
Sled Push Variations — especially dragging, which is highly effective for the VMO.
Other Must-Do Work
Hamstrings — crucial for strength balance and ACL protection (hip thrusts, bridges, RDLs, hamstring curls).
Tip: Tempo Romanian deadlifts may help to focusing on non-painful ranges
Calves & Tibialis — calf raises, tib raises (particularly important for runners).
Tip: target the soleus with a rotary calf machine and slightly bent knees — also protective for the ACL.
Stretching — vital for knee decompression; regular stretching can literally take pressure off the joint.
Tissue Release — use tools like foam rollers, massage balls, or manual techniques to ease tightness and improve mobility around the knee.
Lastly—and beyond any specific exercise—the most important thing I can leave you with is this: believe. Believe with everything in you that you will return to doing what you love. I know what it’s like to think it’s over — I was the first to think so for myself. But you have to want it, and you have to believe it. Pessimism often feels like the “realistic” choice. Hope can seem naive. But I’ve learned that hope and positivity aren’t just nice ideas — they change outcomes. Doctors may give you timelines and predictions, but medicine is not engineering. Your body can adapt in surprising ways and surpass all expectations. It’s never over until it truly is.
Playlist of the month
Quote of the month
“Something that everyone knows is not worth knowing.” Jason Zweig
Widely accepted “common knowledge” can sometimes be superficial or unexamined. Real insight often comes from questioning the obvious, seeking out what others overlook, or doubting consensus when it seems too comfortable. Do YOU agree?
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