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Training Legs with Knee Pain?


#1

Hey Guys,

So my situation is that I know that I need to work my lower body (thighs/quads) and gain size. I’m a relatively tall lifter 6’2", long limbs. I have no problems going through tough leg workouts, and putting in the work (I am a competitive amatuer bodybuilder).

My problem is that my right knee gets really sore after a knee/quad dominant workout. The way I do it now, is I train hips one day and quads the other day. But I really wish I could add more volume to my quads. But my knee pain really doesn’t allow me.

Does anyone have any suggestions from personal experience about trying to gain leg size while having to work through knee pain? Any suggestions would be greatly appreciated! thanks!


#2

A guy in my gym has a similar problem with squats specifically and for him, the problem was solved by doing both leg extensions and curls as a pre-exhaustion technique before squats. After that, he could do any squatting movement with no pain. A local bodybuilder also has similar problems but for him, just doing leg curls as a part of his warm-up routine was enough.

If you still can do tough quad workouts once a week but suffer from knee pains afterwards, I’d place my bets on you having some form issues.


#3

I’m recovering from a torn ACL/lateral meniscus and fractured patella. Not dealing with any real pain, but in terms of training around knee injury, pushing the prowler has been a very knee friendly quad builder for me. No eccentric loading to deal with.


#4

Ah, that explains a lot. There’s not really many actual workout styles or ways I could recommend with good conscience since I don’t know what you can and can not do without hurting yourself.

But I would recommend you test which specific exercises or movements allow you to hit your quads the hardest but still either pain free or with as little pain as possible. I believe finding exercises with most bang for your buck and building a routine out of them is your best bet.

Edit: Aaand apparently I mixed shit up and answered to the wrong person… But the recommendation still stands. Injury or no injury, find exercises that allow you to hit your quads the hardest while hurting your knees as little as possible.


#5

I will take that under advisement, haha. I’ve already got a pretty good way forward going. Biggest thing that reduced atrophy was flexing the quad as hard as I could, visualization, training the opposite leg hard, and that prowler work. I’m just now at the point where I can train it directly.


#6

exercises where your shin stays perpendicular to the floor tend to be the easiest on the knees. It’ll shift a little focus away from your quads and onto your hips/hamstrings, but if other shit hurts then needs must.

On the plus side, strengthening your hips/hamstrings will go towards fixing your knee pain anyway.


#7

Have you ever had an actual injury to the knee or is it “just” soreness in the joint?

In terms of training around knee pain, Ben Bruno has a bunch of articles about it, mostly from his experience coming back from knee surgery.
Knee-Friendly Quad Builders
9 Training Strategies for Knee Pain
Single-Leg Training Modifications for Knee Pain

Rather than trying to make an injured leg bigger, invest the time to make the leg healthier so you can train 100% in the long run. Not the fun answer, but still one to consider. Figure out what’s causing the joint soreness/pain and resolve it.


#8

It’s a soreness but after a workout it gets really sore… for days, and just that one knee. I definitely do have to get it checked out.
Definitely hate the thought of taking time off, because I’d like to do a contest later this year (oct/nov) and I need to put some size on now. But definitely appreciate those articles!


#9

I do leg curls before my squats, got that from John Meadows. It typically takes me a while to warm up with my lower body, but once I do i’m kinda ok… I have my good days and bad days… haha. But after a quad dominant workout, my knee is just shot, super sore…


#10

So a typical quad day workout consists of , Front squats, 6-8 rep range. 5-6 sets, then i follow that up with back squats but higher reps 10-12 and a more narrow stance. After that I go to the hack machine and do 4-5 x10-12 reps. I do start my leg workout with leg curls, and end them with some RDL. But i’m knee is shot for days after that. 3 days later i’ll do hip work, deadlifts, hip thrusts etc… and I still feel my knee sore… sucks… definitely appreciate everyone’s insight though!


#11

So how’s your technique on front and back squats? Not being able to track your toes with your knees tend to cause joint pain and my left knee with chondromalacia gets extremely sore if my knees go too much past my toes. I can do box squats and deadlift-stance box squats with regular flat soled shoes or no shoes but squats require a raised heel.


#12

so with my front squats, I am able to maintain good form, My knees def don’t go too much past my toes. I don’t go crazy heavy. I use knee sleeves and they help. If knee is full recovered, I can have a good workout, its just really really sore for days afterwards, My squat i don’t go that low. Maybe parallel, with a more narrow stance then traditional regular squats. As my workout goes on, my knee starts getting sore…


#13

How about your knees tracking your toes? If your toes point at a 35 degree angle and your knees go out in a 25 or 45 degree angle, that might cause knee pain. Also if your toes point too straightforward for your build, mobility and leverages, that can also cause trouble.


#14

Is it possible you may have some sort of kneecap tracking issue where it may be pulled one way or the other? (typically outward, away from the VMO) I had knee pain on and off for a long time until it got to the point the kneecap was popping over laterally to “reset” before I figured it out and addressed it. If I would have figured it out earlier though could have saved a lot of frustration. While I was taking some time away from really lifting to rebalance it, I did a lot of Bulgarian split squats to at least do something. It’s an exercise where it’s very easy to closely monitor exactly what your knee is doing and adjust accordingly, and could really hit your quads with some volume. Purely subjective, but I don’t think my legs shrunk during this period much at all.


#15

did you do anything for your knee pain besides the bulgarian split squats? I do plan on getting some x-rays done. I thought maybe it’s tendonitis or arthriitis (it runs in my family) but not sure how that would feel if i did have it.


#16

Start using machines, smith machine, leg pres, leg extensions, leg curls, until the pain goes away. Then I would start to implement regular squats again.

Make sure to hit high reps to get the tendons and ligaments strong enough to support your heavier weights (when that time comes) to avoid this happening again.


#17

Was this sudden or has it just built up over time? In my case I needed to loosen up the outer section of quad and work on getting the VMO to pull more, also needed to get more hamstring flexibility and strength. I had some PT, and did a ton of foam rolling, stretching, and various step up type exercises. I had similar symptoms of soreness after lifting, but you have to keep in mind there are so many other possibilities that may be aggravated by continuing work. If you’re having x-rays done, see if they can get one looking down on your kneecaps with your knees slightly bent. In my case this is what showed the kneecaps rotated outwards from where they should have been. I went to two different places, the first one took a limited amount of x-rays, the doctor told me I should never do squats, lunges or anything (recommended wall sits) and prescribed me an anti-inflammatory and muscle relaxers. The 2nd one took about 3x the x-rays, really took their time, and actually figured out what was going on. It can be tricky, but if you can get any recommendations it can go a long way to finding a good ortho. I emailed a local crossfit place (because those guys have to be getting hurt constantly), and they recommended a PT place, and they recommended the ortho. You need to find one that specializes in getting people back to being active, rather than just keeping old people pieced together enough to exist.


#18

thanks for your feedback , definitely appreciate it.
This happened after a while… If i was to stop doing direct knee extension movements, it’ll go away but when i start again it’ll come back. the more i stretch and foam roll the better it feels. The feeling is definitely around my knee cap. I know some Crossfitters, so i’ll ask him if they have any referrals that would definitely help. thanks again !


#19

I’ve tried that… unfortunately its not a particular exercise but a movement, and that movement is during the knee extension, so front squats, squats, hack machine… Leg press i can manipulate my feet placement so that it is more hips and less knee extension. I appreciate your feedback!


#20

May be worth trying to attack your IT band. It can get inflamed and track poorly. It’s remedied (at least enough to work out) relatively quickly with foam rolling and a couple of drills. Kelly Starrett has good stuff on YouTube. Might not be your issue, but for me this helps. Exercises that lock my hips into place and ask my knee to extend seem to make it worse - leg press. I can squat so long as I break at the hips deliberately, which is often tougher for folks in the front squat.