When you’re younger, you can usually exercise to your heart’s content without worrying about pain or overtraining. Unfortunately, every year increases the compound stress on your body, which increases the possibility of injury to your joints. Your knees in particular take a huge beating, making knee pain a common challenge.
The knee joint is one of the most commonly injured joints in the body, with its prevalence increasing over the past 20 years 1 as our population attempts to become more active, or alternatively as it becomes more sedentary and overweight. The big question is whether it’s okay to continue exercising through knee pain, or whether it’s necessary to rest or see a health care professional.
Most Common Types of Knee Injuries
Whether or not you can exercise with knee pain is determined by the cause of the pain. In some cases, continuing light activity can actually help the healing process. In others, it can prevent you from fully recovering.
Generally, knee injuries can be attributed to one (or more) of the following three categories:
A contusion is the medical term for a bruise. It is generally caused by a direct impact to the knee (such as falling), or by something hitting the knee (like a ball or club).
These are generally the least worrisome of knee injuries. In this case, follow the rules of PRICE (protect, rest, ice, compress, and elevate) until swelling is reduced and the knee is no longer painful.
If you notice that the swelling is deeper inside the knee and that your range of motion is not improving but instead becoming more limited, it may be helpful to see a health practitioner.
2. Sprains, Strains, or Overuse
A sprain is a stretching or tearing of ligaments, the fibrous tissue that connects two or more bones at a joint. A strain is a stretching or tearing of a muscle or tendon.2 This category includes other minor injuries, including overuse and irritated or damaged cartilage.
There are many possible sources of knee pain, including quadriceps and patellar tendonitis, arthritis, inflammation, etc. Most of these injuries tend to occur from poor mechanics or overuse. Generally, it’s ok to resume activity once the irritability of these symptoms has decreased.
After a week or two of rest, and once the pain has subsided, ease back into exercising. Pay extra attention to maintaining proper form and alignment during every exercise. If pain continues to last for several weeks, as may happen with some tendinopathies, seek a health practitioner who can help you recover more quickly than you could on your own.
3. Meniscal or Ligamentous Injuries
There are several ligaments that help to stabilize the knee. If your knee buckles inwards, you hyperextend, or you hyperflex your knee during activity, then you might have strained a ligament.
If at anytime your knee feels loose and unstable (especially compared to the other knee), you should see a health professional (an orthopedist or a physical therapist) who can do a physical exam to diagnose the injury.
If the knee feels stable, you can attempt to recover on your own assuming you meet all of the following criteria:
- A decrease in swelling that continues to improve (or no swelling at all).
- Weight bearing on the injured leg doesn’t hurt. (For example, you can stand on the injured leg pain-free).
- You have full range of motion without pain.
- Exercise does not increase pain (and may actually decrease pain).
- The injured knee feels just as stable as your other knee.
Keep Exercising, But Don’t Ignore Pain
The old adage “No pain, no gain” primarily refers to muscle soreness, NOT joint pain. As long as your pain doesn’t increase while working out, or lead to increased joint pain afterwards, you should feel comfortable continuing to exercise.
If you feel that only specific exercises aggravate your knee, such as anterior knee pain during squats, I recommend taking a break from those painful movements and focusing on strengthening different muscle groups instead (for example, the posterior chain with deadlifts). Always exercise in moderation, maintain proper alignment during every exercise, and take adequate rest between workouts to decrease the mechanical stresses to the knee.
Knee pain is just one example of common weight lifting injuries. If you have more questions about knee pain and exercise, ask me in the comments section below.
- Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT.Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data.Ann Intern Med. 2011 Dec 6;155(11):725-32. doi: 10.7326/0003-4819-155-11-201112060-00004. ↩
- Hamilton BH, Best TM. Platelet-enriched plasma and muscle strain injuries: challenges imposed by the burden of proof.Clin J Sport Med. 2011;21(1):31-6. ↩
My knees have cracking sound when I get out of my bed early in the morning. But usually before getting up from my bed, I did cycling in the air with my two legs then lift up my right leg several times (about 5 times), left leg flat on the bed & vice versa. There is no more cracking knee sound. May I know whether this is the correct way of exercising my knee to reduce the cracking sound or knee pain. Hope to get a prompt reply from you. Thank you.
This is a very good way to start your morning. The “cracking” or crepitus is generally ok, as long as it is not associated with pain. Moving your joints helps to increase joint fluid circulation, and as you warm up, your tissues become more elastic. Both will help to reduce the crepitus and cracking.