5 Big Tips To Train Your Lower Body With Knee Pain (2016)

5 Big Tips To Train Your Lower Body With Knee Pain (2016)

5 Big Tips To Train Your Lower Body With Knee Pain

I wrote a 3 part series on my knee pain from a basketball injury. I thought it went away for good, but I got the same injury again because I played too soon. Aside from back pain, knee pain is the second most annoying and painful injury that you can have (in my experience). I just got back from the physiotherapist and he told me that I tore ACL which sucks big time. The only thing is that he doesn’t know if its a small tear or a big one, he said that I have to get an MRI done to know for sure. If it’s a small tear then I won’t need surgery, but if it is then I will need it.

I’m not turning this injury into a pity party, i’m just saying that stuff happens and you can’t go back, you can only move forward and learn from the past. Basketball is a great sport and I do love it, but I guess I was just at the wrong place at the wrong time when the injury happened. My physiotherapist said that 99% of the basketball players who came to see him came for knee pain which doesn’t surprise me at all either.

The sport requires cutting, pivoting, jumping, landing, shuffling, boxing out, changing speeds and directions. It makes sense that there will be a high risk for knee injuries when playing a game like that. I had my fun with basketball, but I think that it just isn’t for me at this point in my life, maybe before but not right now.

Every injury has a different way of affecting your body and each injury also has a unique pain. Neck, shoulder, elbow and wrist injuries suck as well. Case in point, there is no such thing as a good injury, they all suck. If you are experiencing knee pain then you have 2 options:

Rest and not train at all

Do exercises that don’t hurt you and train around the pain

I would go with the second option because I do not want to lose strength or muscle by being away from the gym for too long. I would rather work on other areas while the knee(s) heal up. I don’t care how injured I am, 99% of the time there is a muscle that you can train. There was a short period of my life where my lower back, knees, rotator cuff and elbows were injured and all I did was neck training for a whole summer with certain bodyweight exercises that didn’t bother my injuries. Don’t find excuses, find ways to still make your training exciting while rehabbing the injured area. Injuries can be blessings in disguise because you can work on a certain body part(s) that have been lagging too. 99% of the time, there will something lagging strength or size wise that you can bring up.

Here are 5 tips that you can do still train your lower body even with knee pain.

(Please consult a physician before doing any of these exercises. Everybody is different and you may not be able to do some of these exercises with your knee pain. I am speaking through my experience and current training.)


Squats are the king of exercises in my opinion. I can honestly say that I have built more muscle with squats than I have with Deadlifts. They are both great exercises, but I find that when I squat I just build more muscle all over. In Mid March 2015 before the injury I weighed 205 at about 13% and then I got the ACL injury which resulted in me not squatting for a month. What happened to my body?

Well, I lost a shitload of size in my lower body while my upper body was hanging in there. I have never measured my thighs but they looked like they lost a good 2 inches, not only that but I lost 8 pounds too and I would have probably lost more weight if I didn’t start squatting as soon as possible. I went from 205lb to 197lb in a month and my legs actually started to look like I never squatted in my life! Fast forward a month after the injury happened, I was (and still am) seeing a physiotherapist and he let me do box squats for high reps (8-12) about 1-3x per week.

I didn’t want to go too heavy on the first day squatting again so I only back squatted 225×10 and it felt good so I’ll gradually increase from session to session. Surprisingly, after only one session of Box Squats, I am already back at 202 (probably due to the fact that muscle memory kicked in and it has only been a month). I have also done a lot of low rep work in the past such as 3×3, 5×5 and stuff of that nature but I am actually enjoying the 3-5sets of 10reps. I find my legs grow the most when I do 8-12 reps too so while my knee is trying to heal I can use the rep range to keep and possibly put on some more muscle mass and try to get stronger in this rep range. The box squat is more of a hip dominant exercise than the traditional high bar squat.

There is a bit more of a forward lean and it still works the quads a lot, but it brings more of the glutes, hamstrings and the posterior chain more into play. So far I have been able to do them pretty much pain free and it feels good. If you are experiencing knee pain then I highly recommend that you try box squats. If you have really bad knee pain then you might want to put the box higher and the better your knees feel the lower you can put the box. Eventually you can go on to free squats with no box or stick with box squats, the choice is yours. I am probably going to stick with high rep box squats for the next few months until my knee feels better. Running still kills and I have to do very controlled movements in order to not aggravate my left knee, it sucks but that’s life.

I also want to add in that if you are experiencing knee pain then it is very important that you add in some single leg work like Bulgarian split squats and single leg hip thrusts. I wrote a few articles on single leg training and they are basically going to help deliver results that the bilateral work can’t do alone such as improved balance, coordination, stability in the knee, increase volume+frequency, less lower back compression, helps imbalances and the list goes on. If you are having knee pain and you still want to do unilateral squat variations then you should try bulgarian split squats with a forward lean. These are basically like box squats but with dumbells and one leg. Once again, the forward lean takes some of the pressure off of the knee and works more of the posterior chain. The quads are still worked, but to a lesser degree. Always remember that the more upright you are, the more the quads come into play. Thats why front squats work the quads more than back squats.

2) RDL Variations (Regular RDL, Sumo RDL, Dumbell RDL, Split Stance and Single leg variations)

Romanian Deadlifts in my opinion are the best hamstring builders. This exercise came in second place for me when it came to lower body mass (first place was the back squat). The glutes, lower back and upper back also get a good workout as well. These are good for knee health because strong hamstrings can help protect the knees and quite frankly if you only do Squats then you might run into issues if you don’t do any hip extension work.

Just because you are having knee pain it doesn’t mean that you can’t set goals for yourself, maybe you can’t squat super heavy right now but you can still try to hit PR’s in RDL’s as long as its something that you can do pain free and if it won’t slow down the knee recovery process then I am all for it.

Everybody is different, but I personally find that my hamstrings grow best when I do my RDL’s in the 8-12 rep range and that they get stronger when I do my RDL’s in the 3-6 range. I must also mention that if your goal is aesthetics then it helps to get a good slow stretch in the hamstrings during the eccentric part of the lift. The RDL is an exercise that most people do with a barbel but who’s to say that you can’t also do DB RDL’s? I would personally recommend doing both because the DB RDL’s will hit your hamstrings in a unique way, try them out and let me know what you think down below.

I always say that I think that a good goal to eventually work up to would be to do RDL 2x your bodyweight for a set of 10, if you could eventually work up to that kind of weight with good form then you will have very impressive hamstrings. This means that if you weigh 200lb then your goal should be to eventually RDL 405lb x 10, its very possible and I have seen drug-free lifters do this on a consistent basis. I think that this is a good goal to have because what else is your goal supposed to be for your lower body training when you are experiencing knee pain if you can’t do any form of squatting?


RDL’s may be my favorite lift for the posterior chain, but there are others that are very effective and also aren’t as hard on the CNS either.

Hip Thrusts (Barbell or with bands)

Back extensions (45 or horizontal)

Glute Ham Raises

Pull through with a cable or band

These will hit your lower back, glutes and hamstrings well without stressing your knees too much.

I must also mention that Hip Thrusts can also be a solid main lift just like the RDL so if your glutes are really lagging and you can’t train your quads hard then give hip thrusts a try. I personally found through my experience that the glutes respond to a variety of rep ranges but for growth I find that my glutes respond well to 15-30 reps.

As for the GHR, if you don’t have a glute ham raise machine at your gym then you can easily hook your feet under a lat pull down and if you thighs are too big for the seat then you can put a bench next to the pull down machine so that your thighs could get more comfortable.

4) Leg Curl variations (Lying with machine, seated curl, dumbbell between legs or band curls.

So you think that just because you did some RDL’s that your hamstring training is all covered? Wrong. The RDL is a hip extension exercise and it trains that function of the hamstrings, but if you want overall development then its important to throw in a knee flexion exercise like a lying hamstring curl so that you can really focus on isolating those hammies without the glutes or lower back taking over. In other words, lying hamstring curls allow you to really isolate those hamstrings without any distractions.

I personally like to do higher reps on any isolation exercise whether it be neck curls or even calf raises. I was never big on doing under 8 reps on isolation work but that’s just me. I find that for hypertrophy purposes my hamstrings grow well when working in the 15-30 rep range on ham curls and I also find that I get a better squeeze and contraction when I use a heavy band. One of the key points in hamstring curls is that you want to eliminate momentum as much as possible and you want to get a nice, slow and controlled stretch on ever eccentric rep while getting a nice squeeze at the top of every rep.

“Don’t count every rep, make every rep count”

Ham curls can also be used to pre-exhaust your hamstrings before hamstring work but they can also be used for pump work at the end of a lower body day.

5) Calf work

Most people have terrible calves and say things like “I have high insertions and shitty genetics”. That may be true, but that should be a reason to hit them harder or hit them at all. I can’t forget to mention that form an aesthetic point of view, people will judge your lower body by your calf development because its the only muscle group that is revealed when someone is wearing shorts (there are some exceptions).

I have a buddy of mine who used to squat 500lb for reps and his thighs measured 26 inches which is huge, but people called him out on having chicken legs because his calves were 15 inches. This situation gets funnier because I know someone who only does pistol squats and glute ham raises for his lower body and he has 23 inch thighs with 19 inch calves and people say that he has jacked legs. Whats the moral of the story?

If you have small calves then your legs will forever look small but if you have mediocre thighs but big calves then your legs will appear bigger, so train those calves!

I have an e-book coming out called Colossal Calves (101 Tips for bigger calves) where I explain everything you need to know about getting bigger calves. I don’t care if you have very high calf insertions, my book will help you out. It should be dropping before Jan 1st 2016 so stay tuned!


Injuries suck, but most of us have to go through them. Its a hard pill to swallow, but crying and complaining about your injuries won’t do much for you. Train whats trainable, make progress with whatever you can while rehabbing and keep moving forward. Over your training career you will have some years that flow by smoother than others so just remember that.

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