7 Workout Routines Secretly Causing Knee Pain

Running isn't always to blame for a bum knee. Take precautions in yoga, boot camp, and CrossFit to ensure knee injuries don't get you sidelined

A bum knee can derail your training season and banish you from your fave fitness classes (no fun!). And while most of us are usually careful to protect our knees, it's the tiny things that put us in the most danger. After all, while people assume running is the No. 1 cause of knee injuries, runners don't have any more knee problems than anybody else, says Sabrina Strickland, M.D., an orthopedic surgeon in the Women's Sports Medicine Center at Hospital for Special Surgery in New York City.

The more pernicious problem? Injuries from boot camp style classes, CrossFit, and even yoga, where people are working out with poor form, Strickland says. "Women specifically tend to have anterior knee pain, patellar overload, or patellar femoral syndrome-it's all the same thing: irritation to the kneecap."Sweat safely by avoiding these seven common training pitfalls.

Learn to Lunge Correctly



Squats can stress your knees, sure, but lunges can too! Done incorrectly (or too frequently), lunges with poor form can lead to irritation of the kneecap, says Strickland. That's because overuse and poor alignment add stress to the joint. In some cases, a little bit of arthritis can cause pain as well, says Strickland.

Avoid Injury: Strengthening your quads, hamstrings, and hips (through moves like squats and lunges with proper form!) can help avoid injury. Your leg muscles help stabilize your knee, so the stronger they are, the more of the burden they can absorb, lightening the load on your joints.

Master proper lunge form: Keep your front knee in line with, but not extending past, your ankle. You back knee should reach straight down toward the floor, in line with your shoulders and hips. Your posture should be upright with gaze forward, shoulders down, and abs flexed. Limit lunges to three times per week and 10 to 15 minutes per session, depending on your fitness level, Strickland says. "You've done too much if your knees hurt during or after your workout," she adds.

Vary Your Group Fitness Schedule


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Too many intense classes-from TRX and boot camp to CrossFit-put your knees at risk. Again, your joints bear the brunt of overuse and poor form. Jumping-as in all those burpees!-is particularly stressful: Your patella presses against your femur with a force of up to 12 times your body weight, as opposed to 1.8 times your weight while walking on level ground.

Avoid Injury: "Technique trumps everything," says trainer and Westin Well-Being Council Member Holly Perkins, who recommends a five-point body check for safe strength training: grounded feet with lifted arches, knees pressed outward, butt squeezed, core braced, and shoulders anchored back and down. Lighten the load so that you can maintain perfect technique on all but the last two reps of any set, Perkins says. (Your form can break down to 70 or 80 percent of the ideal only on the last two reps, she says.) And mix up your sessions to avoid working the same muscle groups (and pressuring the same joints) daily. Head to high-impact or weight training classes every other day at most, especially in the first few months of a new routine, she adds. "Don't do the same class three days in a row," Strickland advises. "The more you mix it up, the less apt you'll be to injure something."

Ease into Hill Training


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Too many hills-while running outdoors or riding an elliptical machine-can torch your patella. "Hills require more work on the part of the quads, which means a higher load on the knee cap and front of the knee," says Strickland. "It doesn't mean you can't do hills. But you need to be in adequate shape."

Avoid Injury: Runners should prep for hill work with quad and hip abduction strengthening, Strickland says. Clam shells, side leg raises, and squat walks target the gluteus medius-the muscle responsible for swinging your leg out to the side. Each exercise can be done with or without a resistance band. Leg extensions and squats target quads. Ease into hill training only after you have a solid fitness base that includes strength training. And, again, don't do too many, too often. Head for the hills every other day tops, Strickland says.

Optimize Your Yoga Form



"So many patients say, 'It hurts when I do warrior pose,' which is essentially a lunge," Strickland explains. "It's because they don't know how to optimize their form. They don't have a enough hip strength, are letting their knee roll in, and end up putting too much stress on their kneecap."

Avoid Injury: Start with a smaller class or position yourself closer to the instructor to learn the correct technique for each movement.

Modify Barre Moves


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"I do barre classes, and when I look around the room, I'm amazed at how many people aren't sitting deep enough into pliés or squats because it hurts their knees," Strickland says. "If it's hurting you, squat down only as far as feels comfortable for your knee. There's a difference between tiring your muscles and hurting your knees."

Avoid Injury: Modify moves like pliés so you don't feel knee pain. Instead of aggressively tucking your pelvis, aim for a more neutral position, and only turn your feet out as much as is comfortable. When it comes time for those deep knee bends, go low only if you're pain-free. Otherwise, bend just to your line of comfort. When in doubt, talk to your instructor to see how you can modify any move that's bugging you, Strickland says.

Strengthen Before Stairs


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Before you take on your office stair challenge or that tower climbing race, prep your legs with strength training that targets your quads, like straight leg lifts. "So many people come in after stair challenges with really sore knees because their quads aren't strong enough to support them," Strickland says. Like hills, stairs place an extra load on your knees-as much as 3.5 times your body weight when going up stairs and five times your body weight when going down, according to Massachusetts General Hospital Department of Orthopaedic Surgery.

Avoid injury: Strength train to beef up your quadriceps, hamstrings, and other muscles that support your knees before tackling stair workouts. Try straight leg lifts, single leg dips, hamstring curls, wall squats, and other knee stabilizing exercises, suggests the American Academy of Orthopaedic Surgeons.

Shape Up Before Kickboxing


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"You can't have a chronic knee problem and do kickboxing. It requires a fairly perfect leg." Limbs are getting twisted, you're moving in new ways, you need to have stability-anything can happen.

Avoid Injury: "Before you do a kickboxing class, you should be in pretty good shape-stable, with good balance and core strength," Strickland says. Only tackle kickboxing and sparring martial arts if you've got a solid general fitness base and have been weight training, Strickland advises. Check your balance with a single leg squat in front of a mirror before heading into class, she recommends. Need to work your core? Try planks and bird-dogs to train your abs and glutes, and side planks to target your obliques.

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