Knee pain can be a huge reason why you might not wanna train hard, or worse, not train at all. But it doesn’t have to sideline you despite what many people may think. There are still plenty of ways to get in quality training with bum knees.
When it comes to lifting, lower body lifts can largely be divided into two categories: knee dominant and hip dominant lifts.
Knee dominant lifts heavily involve the quadriceps because of the significant knee bend that occurs during the movement. Examples of knee dominant lifts would be squats, split squats, lunges, and single leg squats.
As you might imagine, knee dominant lifts place a heavy emphasis on, well… your knees! Who woulda thought?! These exercises are the movements that tend to make anyone with knee pain wince in anticipation of the pain they might experience if they perform these movements.
But worry not my achey knee fitness enthusiasts because there are still a wide array of lower body options at your disposal. This is where hip dominant lifts come into play.
Normally in a well rounded training program, you’d have an even mix of knee and hip dominant movements. But if your knees aren’t the best, you just need to shift you focus to hip dominant movements.
Your hip dominant movements include hip bridges, hip thrusts, deadlifts, RDL’s, and all of their variations, including single leg variations.
You can also include isolation movements for the hamstrings and glutes as well.
These movements place a larger emphasis on your posterior chain (glutes and hamstrings) compared to your knee dominant options. Because of this and the decreased role of the quadriceps now play, they tend to be better options for anyone with cranky knees. Here’s an in depth rundown of your options.
Conventional deadlift (from elevated surface)
Modified sumo deadlift
Single leg RDL
Hand supported single leg RDL
Cable pull throughs
Hip thrust/bridge variations
*Thrust means your shoulders are elevated on a bench. Bridge means you’re on the floor.
Barbell hip thrust/bridge
Banded hip thrust/bridge
Feet elevated hip thrust/bridge
Single leg hip thrust/bridge
Hamstring/glute isolation movements
Round back extensions
Quadruped hip extensions
Side lying abduction
Nordic hamstring curls
Bosch iso hamstring curls
Goblet box squat
Now it might seem counterintuitive to include squats and sled pushes (two knee dominant movements) on a list of knee friendly exercises, but these are the exception. Box squatting works your glutes and hamstrings hard because of the more dramatic posterior weight shift, usually alleviating knee pain, while sled pushes only involve concentric muscle contractions which, again, tends to spare the knees.
From here, you then have the choice to manipulate sets, reps, load, time under tension, speed, equipment… the list goes on.
Now realize that there’s a lot more that goes into knee pain than just what we’ve laid out here. Injury history, training history, technique… just switching to the lifts listed above might not cure all your problems.
But it’s a good start 🙂
Here’s what a simple 3 day, full body routine that someone might put together if they’re looking to spare their knees.
A1. Double leg hip dominant: RDL 3×5
A2. Core: inchworm 3×8
B1. Single leg hip dominant: single leg hip bridge 3×10/side
B2. Horizontal push: pushup 3×10
C1. Hamstring isolation movement: Nordic hamstring curl 3×5
C2. Horizontal pull: TRX row 3×10
D1. Frog pumps x100
A1. Double leg hip dominant: hip thrust 3×5
A2. Core: Plank w/ alternating reach 3×5/side
B1. Single leg hip dominant: hand supported single leg RDL 3×10/side
B2. Vertical push: split stance single arm press 3×10/side
C1. Single leg knee dominant: sled push 3x30yd
C2. Horizontal pull: cable facepull 3×15
D1. Glute/hamstring isolation: reverse hyper 3×25
D2: Core: Side plank 3x10s /side
A1. Double leg knee dominant: goblet box squat 3×8
A2. Vertical pull: chinup 3×8
B1. Double leg hip dominant: banded hip thrust 3×15
B2. Core: Deadbug 3×6/side
C1. Glute/hamstring isolation: Rounded back extension 3×20
C2. Core: 1/2 kneeling cable chop 3×10/side
D1. Horizontal pull: 3 point row 3×10/side
D2: Horizontal push: 1/2 kneeling single arm cable press 3×10/side