Addressing Knee Stiffness for Squatting and Running

We commonly evaluate runners and lifters for knee pain that’s stopping them from squatting in the gym and from performing single leg focused exercises. I typically like to get them into a few kneeling positions to screen where these limits may be coming from and to establish a baseline of tolerance to deep knee flexion with weightbearing.

For example, generally this looks like someone with right knee pain being unable to reach their bottom to their right heel and may be 4-5 finger widths away from being able to do so. This gives us some pre-treatment data to compare with and cuts away from guessing whether we can make rapid changes in their pain. 

Here are some go-to movements in the first few sessions once I’ve established a painful kneeling deficit coming from primarily a stiff knee.

Reverse Nordic with Tibial Internal Rotation

Perform 2-3 sets of 10-12 reps, focusing on maintaining hip extension and actively driving the feet through the foam roller to engage the quads during this exercise.

½ Kneeling Reverse Nordic

Same goal here as above, now just progressing to unilateral work for greater progress. Perform 2-3 sets of 10-12 reps, focusing on maintaining hip extension and actively driving the feet through the foam roller to engage the quads during this exercise. Range of motion will be less here, just to note.

Squat Wedge with Hand Assist

Lastly, I like to get some form of tolerable deep squatting on board ASAP. Most people can tolerate working towards their end range, though I advise them to monitor pain so that it stays tolerable and isn’t worsening during or after this. Remember, the knee hasn’t worked into this depth in some time, so we don’t want to do too much too soon after not enough for too long. 

Seeing some changes but still want a more individualized approach to your rehab? If you want to learn how to take control with some expert guidance and treatments to optimize your performance and longevity, then that’s exactly what we provide at Zenith Performance Physical Therapy. Call or text us at 562-502-1767 to schedule a free phone consultation and come in for an evaluation! 

Thomas Bilodeau, PT DPT, USAW-L1

Zenith Performance Physical Therapy 

ICE Certified Specialist: Orthopedics, Fitness Athlete, Older Adult