Many people avoid lower body exercises due to knee pain or discomfort. A Journal of the American Medical Association (JAMA) study found that people with patellofemoral pain — a condition that causes pain behind or around the kneecap — are at a 91 percent risk of experiencing anterior knee pain during a squat. Furthermore, squat exercises can cause tension overload in the knee, especially when the knees are flexed between 60 and 90 degrees. (1)(2)(3)
Ben Patrick, popularly known as the Kneesovertoesguy, is on a mission to debunk myths surrounding knee pain and knee injuries. Patrick is the creator of the ATG (Athletic Truth Group), a training program focused on building strength, conditioning, and athletic ability while bulletproofing the body from injury. On Oct. 22, 2023, fitness content creator Will Tennyson published a video on his YouTube channel wherein Patrick guided Tennyson through a workout comprised of seven exercises to help prevent knee pain. Check it out below:
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Lower Body ATG Standards
Patrick recommends the following seven exercises and standards to treat and prevent knee pain:
1. Backward Walk on the Treadmill
Tennyson opened with a brisk backward walk on a resisted treadmill for 30 seconds to warm up the knees. Walking backward on a switched-off motorized treadmill produces the same results as Patrick’s custom-built resisted treadmill.
2. Low Sled Push & Reverse Sled Pull
Tennyson pushed a sled stacked with 90 pounds, followed by a reverse sled pull. Instead of prescribing rest, Patrick prescribes motion to treat knee pain. “You can take someone who is in pain, and rather than having to avoid working hard, you can use work ethic to get out of pain,” said the Kneesovertoesguy.
[Related: Jogging Vs. Running — What’s the Difference and Why Does it Matter?]
3. Tibia Dorsi Calf Machine
Most people train their calves, but few focus on the front side of their lower legs. Dorsiflexion exercises like tibia machine calf raises can strengthen the support around the ankles, shins, and knees, helping eliminate knee pain. “My vision is that every gym that has a seated calf machine must have the [tibia dorsi machine] right next to it,” Patrick said.
4. Tib Bar
Patrick stated that shins are the first line of defense when performing high-impact exercises like jumping. Performing tibialis exercises can help strengthen lower body joints for better impact management. To build robust tibialis, Patrick recommended performing at least 15 reps of tib bar raises with 20 percent of one’s body weight. For example, 35 pounds is standard for a 175-pound individual.
5. Split Squat Hold
Patrick and Tennyson proceeded to split squat holds. This exercise involves positioning the front foot’s heel under the hips and extending the back leg behind until the knee is a few inches off the floor. They held the split squat for 30 seconds before switching sides.
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6. Cable Reverse Squat
Patrick set a cable pulley at the lowest setting and added ankle strap attachments. He recommends this exercise for lower body strength and explosiveness. Lay supine on the floor with the feet close to the cable pulley. Then, pull the knees to the chest for 20 reps with 50 percent of one’s body weight on the stack.
7. Nordic Curls
Per Patrick, performing five bodyweight Nordic curls can help strengthen the knees, calves, hamstrings, glutes, and lower back. This not only helps prevents knee pain but can improve sports performance.
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References
- Patellofemoral pain syndrome. (n.d.). Retrieved from https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/patellofemoral-pain-syndrome/#:~:text=Patellofemoral%20pain%20syndrome%20is%20a,some%20point%20in%20their%20life.
- Duong V, Oo WM, Ding C, Culvenor AG, Hunter DJ. Evaluation and Treatment of Knee Pain: A Review. JAMA. 2023 Oct 24;330(16):1568-1580. doi: 10.1001/jama.2023.19675. PMID: 37874571.
- Pereira PM, Baptista JS, Conceição F, Duarte J, Ferraz J, Costa JT. Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review. Int J Environ Res Public Health. 2022 Jul 28;19(15):9241. doi: 10.3390/ijerph19159241. PMID: 35954598; PMCID: PMC9367913.
Featured image: @willtenny on Instagram
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