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Pain-Free Fitness: Knee Pain 101A

Knee pain sucks.

On the positive side: the anatomy of the knee is super interesting; several bones meet at the joint, several muscles cross the joint, and several ligaments hold the joint together.

Mariah Heller of Pain-Free Fitness

On the negative side: this complexity leaves our knees very vulnerable to injury and, sometimes, very difficult to properly diagnose and treat.

As a trainer and massage therapist (NOT a medical professional), my question over the last eight years has been: what works well for a large number of people? Once I was able to observe and experiment with enough bodies, I came up with a movement menu and decision flow chart for knee pain assessment and relief. I can't possibly cover every technique in one blog post (or even in one session), but this post will cover the tip of the iceberg and hopefully set you on the path to facilitating your healing.

The best part? You can take the steps in this blog in under ten minutes per day.


If you follow me on Instagram (@coachmariahpainfreefitness), I posted the following on Monday evening:

Mariah Heller Instagram @coachmariahpainfreefitness

Let's keep it simple and go through an example of each one, shall we?


1) Quadriceps Engagement

The simplest example of this is a straight leg raise. Lie flat on your back with one leg bent and the other leg straight. On the straight leg side, pull your toes back toward your face and try to straighten the leg as much as possible. Keeping the toes pulled back, lift the straight leg off the ground and raise it until your thigh is parallel with the other thigh. Lower the leg down slowly. Repeat for 1:00 per leg.


2) Balance Work

I love the low step up for balance work. Not only does it improve balance and stability, but it forces good technique for those of us with knee pain. Stand yourself in front of a low bench or curb. Take one foot, FULL FOOT, heel down, and place it up on the bench/curb. Wiggle your toes in your shoe and make sure your heel stays in contact with the floor. Pull your bellybutton into your spine, drive through your heel and push through the heel of the elevated leg. Balance at the top, and then SLOWLY lower yourself back down until your other foot lands back on the ground. Keep your core tight and your weight back in your heel here. Repeat for 1:00 per leg.


3) Lower Extremity Stretching

This one is rather vague, isn't it? In a nutshell, the quadriceps, hamstrings, and calf muscles all cross the knee joint. I generally have my clients stretch or do myofascial release on each muscle group separately to see what helps and what doesn't. SO do an experiment: on Monday, stretch your quadriceps (and hip flexors). On Wednesday, stretch your hamstrings. On Friday, stretch your calves. Observe which stretches seem to help the most, and do those more frequently. But you should still do the other stretches too. Just because. Do your stretch for 1:00 per side.


4) Hip Stability Work

Lots of ways to attack this one as well, but let's start with some simple bridging.

Lie flat on your back with both knees bent and heels digging into the floor. Tilt your pelvis so that your lower back presses into the ground, and lock your core into that position. Drive your heels down into the ground until your hips lift off of the ground, but keep the sensation of the hollow core and flat back. Hold at the top of the bridge for 10 seconds, and roll back down slowly, keeping the low back in contact with the ground between reps. Repeat for 1:00.


Questions? Comments? Send me an email at mariahpainfreefitness@gmail.com or contact me via social media on Facebook or Instagram.


Wishing you healthy knees!

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© 2018 by Mariah Heller. Pain-Free Fitness