Knee pain is something the majority of my athletes have had to deal with at one time or another.  Fortunately, it is relatively easily improved upon if you know the right flexibility and self myofascial release (foam rolling) exercises to do.  This article will go over what muscles can cause knee pain as well as provide pictures of exercises to improve soft tissue mobility and flexibility.

As always, consult your doctor first before embarking on a new exercise program, or if you think you have any structural damage to your knee from a previous trauma or recent injury.

Why Does Knee Pain Occur?

From my experience, the majority of exercise induced knee pain is caused by the quadricep muscle.  This of course is barring any structural damage to the knee itself that can include ligament tears, meniscal tears, arthritic changes, etc.  The quadricep is comprised of 4 muscles which include the rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis.  The quad extends (straightens) your knee and flexes your hip.  It is utilized mainly in the downstroke when pedaling, the freestyle kick when swimming, and the forward-swing/preparation/contact phases of running.  

When the quadricep becomes tight due to overworking or general fatigue it can cause quadricep tendonitis, patellar tendonitis, patellar tracking issues, and / or general knee pain due to creating an increased downward force of the patella against the trochlear groove.  The quadricep can also become overworked due to compensation.  In my experience, if an athlete’s glutes, core, and / or hip abductors are weak, then the quadricep will compensate to make up for them.

What Can I Do To Reduce My Knee Pain?

Fortunately, there are a myriad of things you can do to reduce and eventually eliminate your knee pain if it is being caused by non-structural issues.  These include:

• Getting a professional bike fit.
• Foam rolling to improve myofascial mobility.
• Stretching to improve muscle flexibility.
• Strengthening your weaker muscle groups which again are typically the glutes, core, and hip abductors to create a balance and decrease quadricep compensation.
• Icing your knee if it becomes sore after exercise to reduce inflammation.

Stretching Exercises For Knee Pain

• Ideal best time to stretch statically is POST WORKOUT.  The reason for this is because stretching a muscle statically will decrease its ability to contract which will result in a decreased amount of power produced.  We train too hard trying to increase our power and strength to reduce it right before our event!
• Stretches should be held for 30 seconds minimum.  Physiologically, it takes your muscle fibers ~30 seconds to relax enough to make static stretching beneficial and allow the muscle fibers to lengthen.
• Stretches should be performed in a comfortable range of motion, so no crying because it hurts so much, but you also want to feel like you are doing something too.
• Alternate each side with each consecutive stretch, so as 1 side is resting, the other side is being stretched.
• Perform the stretches 2-3 times each.
• Stretch out 2-3 times daily if you are really having an issue with your knee.  For maintenance, or if your knee only hurts after an intense or long event/race, once a day is okay.

Quadricep Stretch

Hamstring / Calf Stretch

Hamstring / Calf Stretch (Alternate)

Hip Flexor Stretch With Opposite Side Rotation

Foam Rolling Exercises for Knee Pain

• Find an area where you have some room to breathe, won’t be in the way, and are comfortable moving around in.
• Use a yoga mat or other forgiving surface underneath your body.
• Pick a foam roller density that gives you enough pressure, but doesn’t cause your eyes to water from the pain.  Usually the darker the roller the more dense it is.
• Spend a few minutes rolling each individual muscle group and always start with less time initially.  Once you have some practice rolling, you can spend more time on the muscles that are more of a problem for you and less time on the muscles that aren’t as tight for greater efficiency.
• When you find those pesky trigger points, work each one individually for 20-30 seconds and move on.  You can either hold direct pressure, or perform quick back and forth and/or rocking motions to release them.
• Smile at how good you feel and how loose those muscles are afterwards!

Quadriceps

Starting Position

Ending Position

Hamstrings

Starting Position

Ending Position

IT Band

Starting Position

Ending Position

Calves

Starting Position

Ending Position