Knee pain sucks—and if you struggle with it, you're not alone. (Most runners and OCR athletes do at some point!) Bottom line: Knees are infamously known as the best and worst joint in the body for good reason. The key is to care for your joints by prioritizing cross training, recovery and eating right. With the proper rehab and enough pre-injury intel, you can circumvent inflammation, osteoarthritis and other game-stoppers down the line. In this series, we team up with DUROLANE® to bring you our top tips from MDs and pro trainers to treat your knees like the gold they are. 

Sponsored by our partner, DUROLANE

Suffering with knee pain? There’s almost nothing worse when it comes to dominating OCR at max performance. We get it. Your knee joints power you through miles of tough, unpredictable terrain, lift you up and over unforgivable obstacles, and are a key connection point in your body’s kinetic chain from your feet to your core. 

Here’s the bad news: knee pain, if left untreated, can develop into osteoarthritis over time. Knee OA is one of those conditions that creep in and… well, metaphorically cuts you off at the knees. When you damage your knees from injury or overuse, symptoms of OA are hard to identify because you lack nerve endings in cartilage. Furthermore, cartilage tissue doesn’t repair on its own, leads to pain down the line, and creates the need for non-surgical treatments like hyaluronic acid injections. By the time you feel bone-on-bone crunching, it’s often too late to remedy without surgery and can lead to a total knee replacement.

In short, regular knee rehab is crucial to keep crushing your endurance goals for life. “The thing about joints is that they need to be moved...often,” says Spartan Director of Fitness Sam Stauffer. “When you use your joints, you're getting tons of benefits from synovial fluid that nourish the joint to improve function and range of motion.” 

Related: Your Knee Pain, Decoded: Common Myths About OA in Endurance Athletes

Stauffer recommends starting your day with a simple 5-10 minute mobility warm-up routine that you do ASAP after getting up. “It will also help with blood circulation, giving you that extra boost,” he says. Additionally, a dynamic or mobility-specific warm-up before and after workouts will help support your joint recovery from physical activity to prevent injury. The bottom line: “A little bit of targeted movement daily is key,” he says. Don’t skimp on the warm up and cool down. 

The good news? We've got your back with the most effective recovery moves you should practice regularly to keep your knees in tip-top shape. Plus, why you still need a conscious knee-recovery regimen, even if you're pain free right now. (Remember: you're in this for the long haul and prevention is the name of the game.)

First, More On Where Knee Pain Comes From

Mike D. Ryan, PT, ATC, CES, PES, has worked with athletes and their injuries for 36 years. His clients range from high school endurance athletes to professional football players and Olympic athletes. And intriguingly across the board, he says the two most common factors for knee pain are trauma and overuse. 

Trauma

Acute trauma most often comes from unexpected falls or sprains. “I treat many endurance athletes after they twist their knee running on uneven surfaces or injure a knee ligament landing improperly,” says Ryan. The bummer-drag about trauma? Accidents happen and most of these kinds of injuries are unavoidable. “It’s the nature of the sport: running on uneven and inconsistent surfaces, or running in improper footwear can contribute to the injury.”

Overuse

This is where you have a lot of power as an athlete, according to Ryan. “These kinds of injuries are very much preventable,” he says. Two main factors play into overuse injuries and related pain: volume of work placed on the knee joint and the frequency of stress under which you place the joint. “When it comes to running for endurance athletes, it’s easy to see how the amount of miles (volume) they run can be directly related to knee pain,” says Ryan. “High miles equals higher compression volume on knee-joint surfaces, knee ligaments and the muscles controlling those same knees.” 

Similarly, how often athletes run (frequency) matters. If you go too far, too fast, too often, you can screw yourself into injury and out of making big gains. “This is where cross training is so important,” he says. “Using a distance runner, like a Spartan athlete, for example, adding deep water pool running or cycling is a great way to work on conditioning while reducing the stress on an injured knee.” 

Adding warm ups, cool downs and regular mobility work (as Stauffer suggests) will also help mitigate knee pain and keep you running further, faster and longer. Stauffer sees knee injuries in athletes all of the time. “I know more athletes who are nursing an old injury, working with a new one, or just in constant pain than I do those without,” he says. “A small tweak here or a tight muscle there can lead to a chain reaction that can bubble up into something much more serious. The best thing you can do is pay attention to your body's signals when they start and address them immediately. It takes months of patience and dedicated work to change tissue—start now and you'll be happy you did!”

Related: LINK TO DUROLANE ARTICLE #2

3 Spartan-Approved Knee Exercises You Should Do Daily—And Why

Stauffer recommends these three knee-rehab exercises to all Spartans. Use them each day to promote mobility and stability in your knee joints, and set yourself up for success both on the course and in training. 

1. Spiderman T-Spine Rotation (A.K.A. The World’s Greatest Stretch) 

Start in a high plank position. Bring your right foot to the outside of your right hand. Ground down through your left hand and reach your right hand up toward the ceiling opening your chest out to the right. Sweep your right hand down coming back to center. Repeat on that side 5-10 times and then switch sides. 

WHY SPARTANS NEED IT: “This stretch opens up the hips, stretches the hip adductors and psoas,” says Stauffer. “But with the added t-spine rotation, you get the benefit of the t-spine mobility with little extra effort.” 

2. Lunges (Bodyweight or Weighted)

Start by standing up tall, with both feet flat on the floor and a long, straight spine. Step forward with your right foot and drop your hips until your leg reaches a 90-degree angle. (You can place your hands on your hips or bring them together in front of your chest for added stability.) Ground into your right foot and push into that lunging leg to return to the starting standing position. Repeat 10-15 times on that same leg, or switch off between legs until you total 10-15 reps per leg. 

WHY SPARTANS NEED IT: “It’s a great knee-dominant movement pattern,” says Stauffer, and you recruit many of these same muscles when running uphill or and tackling steeper-grade obstacles. 

3. Deadlifts 

Stand with your mid-foot under a weighted barbell. Bend forward and grip the barbell placing your hands shoulder-width apart. Bend your knees until your shins touch the bar. Lift up through your chest and straighten your lower back. Breathe as you stand up with the weight. Hold for a moment at the top with an engaged core, and locked hips and knees. Then return the weight to the floor by moving your hips backward and bending your legs. Repeat 10-15 times. 

WHY SPARTANS NEED IT: “This strengthens the glutes,” says Stauffer. “When weak or under active, this can put some of the load on the knee joint as other muscles and joints will have to work overtime for what the glutes aren’t doing.” 

The Bottom Line: Make Knee Rehab Your Best Friend

Targeted knee exercises and a solid recovery routine will help you maintain joint health and mitigate injury. Even though some blow outs are just unavoidable, you can (and should!) be mindful of workout volume and frequency—especially as you are easing into a training plan or coming back from an injury (even if you think you’re in the clear). Cross train regularly and don’t miss dynamic warm ups or cool downs. 

Basically, help out your future self, starting now. “A knee with chronic osteoarthritis is not a happy knee, nor is the knee’s owner!” says Ryan. “Repeat that sentence a couple of times. It’s very much worth remembering.”

To learn more, visit DUROLANE.COM.