Unexplainable Knee Joint or Knee Cap Pain? Try These 3 Exercises

Exercises to give your knees some relief

By Coach E

3 exercises to try for knee joint or knee cap pain

Nagging knee cap pain can really wear you down and mess with your performance. Try these 3 easy exercises to find some knee pain relief.

Knee pain can be tricky to manage because so many muscles cross the joint and issues at either your hip or your ankle can contribute. I’ll give you 3 simple techniques that should help ease pain, but first, let’s learn a little about the anatomy of your knee.

What You Need to Know About Knee Anatomy

Your knee is actually 2 joints: the tibiofemoral joint between your femur (thigh bone) and tibia (shin bone) and your patellofemoral joint formed between your patella (kneecap) and femur.

Your quadriceps muscles come together to form the quadriceps tendon, which surrounds the patella. Your patella helps give your quads mechanical advantage as they work to extend your knee [1].

Your kneecap moves as you move your knee, so for optimal knee performance, your patella needs to be unrestricted and free to do so.

3 Strategies for Knee Cap Pain Relief

The exercises I’ll teach you are great for 3 main reasons.

For one, they all work to bring blood flow to your knee. This is helpful because if there are any damaged tissues in the area, increased blood flow facilitates tissue healing.

Two, these exercises activate all of the major musculature around your knees. This is an important step to interrupting  an unhelpful pain signal.

Sometimes your body can get stuck in a cycle of generating pain signals when a muscle isn’t being used properly, which leads to you using a muscle less, which leads to more pain signals and so on.

It’s a vicious cycle, but you can help interrupt it by consciously firing the muscles surrounding the knee, which tells the neuromuscular system that they are on and working just fine.

And finally, these 3 exercises will help provide physical relief to the tissues by breaking up adhesions and encouraging a full range of motion so that your knee can move and function how it’s supposed to.

Exercise 1: Patellar Active Self-Myofascial Release

In this first exercise, you’ll work on manually releasing the quadriceps muscle around the patella. This should help break down adhesions that can impact how the patella moves and cause kneecap pain.

Knee Cap Exercise 1 - Patellar Active Self-Myofascial Release. In this first exercise, you’ll work on manually releasing the quadriceps muscle around the patella. This should help break down adhesions that can impact how the patella moves and cause knee cap pain.

  • Start by pressing both thumbs into your medial quadricep, about 6 inches above the knee
  • Slide your thumbs down your thigh and around the patella as you actively flex your knee to bring your heel in towards you
  • Repeat, pressing your thumbs in slightly lateral from where you started
  • Continue to work your way laterally, pressing and sliding your thumbs down and over or around the patella as you flex your knee, then repeat the process on the other leg

It’s important that you ACTIVELY flex the knee here. Doing so requires your hamstring muscles running along the back of your thigh to contract. Thanks to a neuromuscular reflex called reciprocal inhibition, active hamstring contraction causes reflexive quadriceps relaxation.

If your quads are relaxed, you’ll be able to dig in deeper and better release soft tissue restrictions.

Exercise 2: Tibial Rotations

This open-chain exercise works to activate the muscles that rotate your tibia. Your tibia doesn’t move as much as your foot does, but it does internally and externally rotate.

If your tibial rotation is limited, it will lead to excess stress on the knee. Utilize this exercise to restore the movement and make sure your knee is functioning optimally.

Knee Cap Pain Exercise 2: Tibial Rotations This open-chain exercise works to activate the muscles that rotate your tibia. Your tibia doesn’t move as much as your foot does, but it does internally and externally rotate. If your tibial rotation is limited, it will lead to excess stress on the knee. Utilize this exercise to restore the movement and make sure your knee is functioning optimally.

  • Sit on the floor and flex your right knee as much as you can
  • Rotate your shin bone (and your foot) internally as much as you can, pausing at the end range, then rotate it externally and pause at end range
  • Complete 5 rotations in either direction, then straighten your leg out a bit at repeat
  • Continue completing the tibial rotations at 4 or 5 different angles of knee flexion, then repeat on the other leg

Exercise 3: Hip Bridge with Push & Pull

This closed-chain exercise activates the quadriceps (knee extenders) and hamstrings (knee flexors). As you perform it, make sure you are maintaining neutral alignment in your spine.

Knee Cap Exercise #3 - Hip Bridge with Push & Pull. This closed-chain exercise activates the quadriceps (knee extenders) and hamstrings (knee flexors). As you perform it, make sure you are maintaining neutral alignment in your spine.

  • Lay on the ground and actively flex your knees as much as you can before planting your feet and lifting your hips up to come into a bridge
  • Activate your quads as if you were going to push your feet away from you (but keep them planted) and hold for 5 seconds
  • Then activate your hamstrings as if you were going to pull your feet in towards you, and hold and breathe for 5 seconds
  • Lower down and relax before repeating 3-6 reps

What Else Can You Do?

I’ve got a few more tips that you should keep in mind.

If your knees are really aching, try alternating between 30 seconds of hot water and 30 seconds of cold water for about 3 minutes on each knee the next time you take a shower.

This should help give you a little pain relief, decrease inflammation, and also facilitate blood flow, which you’ll recall, is important for healing.

If you’ve had ongoing, unexplainable knee pain, its wise to consider what’s going on above and below in the kinetic chain – an issue in your hip or ankle is often the culprit.

If you think this might apply to you, check out some programs I offer. My Lower Limb Control Course focuses on the knees, ankles, and feet and might be a good place to start. Or if you think your hip is to blame, I’ve got a Hip Control Course that can help.

But start by trying these exercises out for your knee cap pain.

These 3 exercises use a variety of stimulus types & methods (manual pressure, isometric activation, isotonic activation, closed chain, open chain….) to help loosen up and activate the muscles surrounding your knee.

They will help restore tissue quality around the knee cap, ensure active stability of your knee, and reduce pain.

However, if there’s a structural problem going on that’s causing your kneecap pain (like a ligamentous laxity), these exercises won’t cut it.

If after trying these exercises you don’t find relief, it’s probably time to seek some in-person help. A physiotherapist should assess your knee and help you move forward.

About the Author

Eric Wong (aka Coach E) is the founder of Precision Movement and has a degree in Kinesiology from the University of Waterloo. He's been a coach since 2005 and spent his early career training combat athletes including multiple UFC fighters and professional boxers. He now dedicates himself to helping active people eliminate pain and improve mobility. He lives in Toronto (Go Leafs Go!) with his wife and two kids and drinks black coffee at work and IPAs at play. Click here to learn more about Eric.

  • Anonymous says:

    Similar to the above commenter, but my medial root meniscus tear was verified by an MRI which also showed arthritis (likely from a severed PCL from 35 years ago and the road marathoning and trail racing took it toll too I’m sure. The first doctor told me to “never run again” which was like telling me not to breathe, so a second opinion got me to a doctor that said “do what you want and can tolerate,” which completely contradicted the first doctor. The second one did have me fitted for an OSSUR brace that has straps that pull the knee into a better position when extended. It seems to be helping a bit, but I’m going to try your techniques to help activate the blood flow to help heal the meniscus and to to further decrease my knee pain. Thanks much for sharing your knowledge!

    • Coach E says:

      Meniscus issues definitely take time but if you can identify symptom-producing movements and activities and work to minimize/avoid them, healing can proceed faster. In your case I’d recommend figuring out what you need to do (whether it be shoes, strengthen certain areas or changing running technique) that minimizes pain.

  • Michael says:

    These exercises intuitively seem excellent for helping a painful knee rehab. I was diagnosed without confirming x-rays or MRI as “probably” having a micro meniscus tear or less likely a slight tear in the popliteus. So, I have been going through PT for about 15 months now and the doctor did some r-rays recently which showed mild arthritis. When I walk or cycle for two hours or less I have little or no problem. Longer bike rides with climbing 3+ hours definitely causes major pain that will usually 90% dissipate with rolling the glutes and IT band. I can literally limp from the car to my living room, roll out on the foam roller and be able to walk normally. I will try these exercises as the first two are different from anything the PT showed me. The third one is very similar to one I am doing already with a band. Thx!

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