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Knee Pain When Kneeling: What Physical Therapists Recommend to Feel Better

Learn how movement and physical therapy helps treat knee pain when kneeling and get recommended exercises from physical therapists.

Published Date: Dec 18, 2023
man-working-on-garden-flexing-his-knees

Maybe you’ve heard the joke, “Doctor, it hurts when I do this,” and the doctor replies, “Then don’t do that.” That may seem like reasonable advice if your knee starts hurting when you’re kneeling on it, but if you want to remain active and avoid pain as you get older then avoidance is not always the answer.

Caitlin Shaw, PT, DPT, a physical therapist at Hinge Health
Prolonged avoidance of a particular movement exacerbates stiffness and pain and can lead to other problems.

Most of the time, you can alleviate knee pain that happens when you kneel with strengthening, stretching, physical therapy, and simple modifications, as many Hinge Health members have. 

“I’m doing repair work on my deck — lots of bending and kneeling. I’d usually have a lot of problems, but that’s gone away since doing these exercises,” one member told us. Another reported, “Today, I was able to chase my toddler around and get up from the floor more easily! I was even able to get into a kneeling position with less pain.”

With the right plan, you can learn how to kneel without pain. “Your body has the ability to build 

muscle strength and mobility to maintain this movement with less symptoms,” says Dr. Shaw.

Here, learn more about what causes knee pain when kneeling and how to minimize symptoms — especially with exercises from our Hinge Health physical therapists.

Our Hinge Health Experts

Caitlin Shaw, PT, DPT
Physical Therapist
Dr. Shaw is a Hinge Health physical therapist and board-certified sports clinical specialist.
Dylan Peterson, PT, DPT
Physical Therapist and Clinical Reviewer
Dr. Peterson is a Hinge Health physical therapist who focuses on developing clinical exercise therapy programs and member education.
Jonathan Lee, MD, MBA
Orthopedic Surgeon and Medical Reviewer
Dr. Lee is a board-certified orthopedic surgeon and an Associate Medical Director at Hinge Health.

Why Do My Knees Hurt When I Kneel?

Many factors can contribute to pain when kneeling. Here are some common conditions that can cause knee pain when kneeling.

Bursitis. Bursa are tiny, fluid-filled sacs in joints that act like pillows to reduce friction and cushion bones, tendons, and muscles. Knee bursitis occurs when the sacs in the knee joint become inflamed and swollen, making them more sensitive to pressure.

Osteoarthritis. As you age, the smooth, spongy cartilage that cushions your joints changes, which can cause pain, aching, and stiffness. Knee arthritis can also make kneeling uncomfortable or painful. Other types of arthritis, like rheumatoid arthritis, can also contribute to knee pain when you kneel.

Patellar tendinitis. The patellar tendon attaches the kneecap to the top of the tibia, or shin bone. When the tendon becomes inflamed, your knee may feel more irritated or painful when you're in a kneeling position.

Meniscus tear. The menisci between the bones of your knees are crescent-shaped wedges of cartilage that act as shock absorbers. Tears can happen from an injury or gradually over time, associated with arthritis. Along with pain (often on the sides of the knees), stiffness, and swelling, you might also feel a catching or locking when you straighten your knee.

Lifestyle factors. While they may not be the primary cause of knee pain when kneeling, some lifestyle factors may contribute to your discomfort. Such factors include: 

  • Weak muscles. Weak or imbalanced leg muscles can contribute to knee pain for many reasons. Strong muscles support tracking of the kneecap, stability in the knee joint, and smooth and controlled movement.

  • Less flexibility. Tight muscles in your lower body can make certain positions, like kneeling, more uncomfortable and may affect knee function.

  • Stress. Stress can exacerbate any pain you experience. “There’s scientific evidence showing that stress levels, especially chronic stress levels, can impact the way our body experiences pain,” says Dr. Shaw.

  • Lack of sleep. Poor sleep or not enough sleep can make you more sensitive to pain.

  • Weight. Weighing more than is healthy for your size puts more pressure on your knees, making them more susceptible to conditions like osteoarthritis.

When to See a Doctor

While exercise can help with many of these knee pain causes, some symptoms require immediate attention. If you’re experiencing any loss of function in your legs (like it’s giving out), significant swelling, radiating pain, a lack of improvement, or further worsening of your symptoms, you should talk to a doctor or physical therapist.

Knee Pain When Kneeling: A Hinge Health Perspective

Kneeling is a basic, functional move that involves bending and flexing our knees in a normal range of motion. We do it every day when cleaning, playing with kids, picking something up off the floor, or tying our shoes. Most of the time, we’re able to do these things without pain. But when a sharp pain or even a dull ache strikes as you’re kneeling, you may avoid that movement and compensate in other ways.

And while it’s normal to be more hesitant to put your knees in a position that may cause discomfort, decreasing activity and avoiding certain positions can actually make the pain worse. Muscles become weaker and tighter when you don’t move them as much or restrict range of motion, so, as a result, certain activities can become harder and you lose more function over time. 

That’s why movement is often the fastest way to healing. As our Hinge Health care team says, movement is medicine. The reason: You want your knees (and all the structures that support them) to remain flexible and mobile to prevent the muscle tightness that can lead to more pain when kneeling. In order to do that, you need to engage in exercises that support your healing and strengthen the muscles, tendons, and ligaments that keep your knees flexible.

Treatment Options for Knee Pain When Kneeling

Treatment may vary depending on the factors that contribute to your knee pain when kneeling, but these general strategies can help no matter what issues are playing a role.

Do exercise therapy. Movement pumps nourishing blood, oxygen, and nutrients to your knee joints and cartilage to enhance recovery and keep them as healthy as possible. It also increases the strength and flexibility of the structures in and around your knees.

Get stronger. The exercises below will strengthen the muscles around your knees, which can help to minimize pain.

Stretch regularly. Improving your range of motion and flexibility can help reduce stress on the knee.

Maintain a healthy weight for you. A healthy weight is different for everyone but maintaining a body weight that works for you can help reduce extra pressure on your knees. Research shows that losing just one pound lowers the amount of pressure on your knee joint by four pounds.

Stick with, but modify, your usual activities. Don’t give up on activities you enjoy. If you like to garden, for instance, but are having trouble kneeling over your flower bed, you can make slight changes, like gardening for less time or taking more frequent breaks or squatting instead of kneeling. (You could even raise your garden beds six to 12 inches as a longer-term adjustment.) Finding ways to maintain activities you love — while you’re doing the work to strengthen your knees — can help keep you motivated to get better.

Use some padding. A pillow, knee pads, or a rolled up towel or yoga mat can make for a great cushion for your knees when kneeling for longer periods of time. Whether you’re gardening or giving your kids a bath, you can make minor adjustments that will make being on your knees more comfortable. 

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Exercises to Help Knee Pain When Kneeling

These exercises build strength to support the knee joint when bending and kneeling and

improve flexibility, so you have the range of motion to get into and maintain a kneeling position without pain. Another bonus: These exercises also increase blood flow to the area to support joint health.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Shift Positions

If you’re doing an activity like gardening, playing with kids or grandkids, or a home repair project that requires a lot of kneeling, you can avoid discomfort by changing positions frequently. “Staying in one position is not ideal because you are keeping the muscles and tissues around your knee in a static hold of either a stretch or contraction,” says Dr. Shaw. 

Instead, switch from kneeling on both knees to kneeling on just one and then switching sides. Shift to a position on your hands and knees to redistribute your weight. Extend one leg out to the side for a short break. If you can, stand up and stretch for a minute. “Our muscles and joints are designed to be in motion, so stretching and moving out of sustained positioning allows for blood flow and mobilization of our tissues to establish healthy joints,” Dr. Shaw says.

Aim to move a little every five to 10 minutes to prevent soreness, stiffness, and pain when you’re kneeling for an extended period of time.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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References

  1. Bilodeau, K. (2021, September 1). Take control of your knee pain. Harvard Health. https://www.health.harvard.edu/pain/take-control-of-your-knee-pain 

  2. Bursitis: Overview. (2018, July 26). InformedHealth.org: Institute for Quality and Efficiency in Health Care. https://www.ncbi.nlm.nih.gov/books/NBK525773/ 

  3. Osteoarthritis of the Knee. (2021, September 8). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21750-osteoarthritis-knee 

  4. Deshpande, B. R., Katz, J. N., Solomon, D. H., Yelin, E. H., Hunter, D. J., Messier, S. P., Suter, L. G., & Losina, E. (2016). Number of Persons With Symptomatic Knee Osteoarthritis in the US: Impact of Race and Ethnicity, Age, Sex, and Obesity. Arthritis Care & Research, 68(12), 1743–1750. doi:10.1002/acr.22897

  5. Patellar Tendinitis. (2022, February 22). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/patellar-tendinitis/symptoms-causes/syc-20376113 

  6. Alaia, M. J., & Wilkerson, R. (2021, March). Meniscus Tears. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/meniscus-tears/