Lunge Exercises: How to Modify the Lunge if You Have a Knee Injury or Pain

It can be frustrating when knee pain or an old injury interferes with your workouts.  This is especially true when knee pain prevents you from exercising your lower body.  Some people give up and avoid exercising all together. However, there are ways for you to exercise and move without pain.  This article shows you how to modify lunge exercises so you can keep training.

The lunge exercise is a great way to train your lower body muscles from your glutes all the way down to your lower leg.  The lunge is closely linked to everyday walking, running, stair climbing, and balance.  Lunge exercises also help train athletes for changes of direction common in sports.  Just about everyone will benefit from doing some type of lunge exercise.  This article will teach you how to modify lunge exercises so you can have a great workout without pain.

The Basic Mechanics of Lunge Exercises

Lunge exercises involve coordinated movements between your hips, knees, and ankles.  Also, control of your trunk position influences how your lower body joints will move.  The greatest amount of joint movement occurs at your knee.  However, during the lunge the greatest muscular demands are placed on your glutes.  Therefore, performing lunge exercises in a way that increases your glute muscle activation will theoretically reduce the stress on your knee.

muscles during lunge
Lunges are primarily a glute dominant exercise

The lunge is a movement pattern that many people struggle with.  It is a challenge for some people to control the position of their trunk.  We see people leaning or falling to their left of right all the time.  It is important that you maintain a relatively upright and stable trunk throughout the lunge.  Don’t add any weight or resistance until you can master this important part.

Just as important is the position of your knee relative to your hip and ankle.  When your knee is bent during the lunge it should not collapse towards the middle of your body.  Instead, keep your knee in line with an imaginary line from your hips down to your second toe.  Think about pushing your knee out (not your foot) as you move up and down during the lunge.  Learn more about this here.

Lunge Regressions and Progressions

The exercises that follow are part of a simple progression. Start with the basic split squat and go from there.  Many people also benefit from performing other corrective exercises to strengthen their gluteus medius and maximus.  These corrective exercises are based on your physical therapists examination of your strength, mobility, and movement patterns.

Split Squat Exercises

The simplest way to minimize knee stress to your knee during the lunge is to control the depth.  Deeper knee bends increase stress around your knee cap and within your joint.  Deep squats or lunges increase stress to your meniscus, ligaments, and joint surfaces.  Controlling the depth of your lunge is easy to accomplish when you are starting from a static position like in the split squat.  We recommend starting without any weights or resistance.  Instead focus on maintaining balance and control of your trunk.

The split squat also allows you to adjust the position of your feet. A good starting point is to begin with your feet split about 60% of your total height.  This distance places the greatest demands on your hip muscles.  For more challenging variations that require greater knee flexion try the rear-foot elevated split squat.

Reverse Lunge Exercises

The reverse lunge involves a backward step instead of the more traditional forward step.  The reverse lunge loads the hip more than the knee.  Therefore it is a more knee-friendly option than the traditional forward lunge.  This makes it an excellent option for people with arthritis or those with a recent knee surgery.

Lunge exercises
TRX Assisted Lunge

Begin with both feet together holding a suspension trainer in each hand.  This will help maintain your balance during the exercise.  Step back and lunge down into a comfortable depth.  Keep a neutral spine with good upper body posture. Think about pushing up with your glutes and extending through your front hip.  Finish with both feet together. At first it will be easier to perform all repetitions on one side first.  As you gain confidence, alternate steps with each leg.  Perform 2 to 3 sets of 8 to 12 repetitions.

After you are able to perform the assisted exercise with good technique you are ready to progress to a traditional reverse lunge. Another progression is the deficit reverse lunge.  This exercise uses a small step of 4 to 6 inches.  The elevated position will load your hip and glute muscles more.  It will also increase your available knee range of motion.  This increases the training effect to your quadriceps muscle.  But it also adds to the knee joint load.

Forward Lunge Exercises

After mastering the split squat and reverse lunge, you are ready to progress to the forward lunge.  This requires greater balance and control of your trunk.  And if performed poorly, will increase the stress on your knee.  Remember; focus on your technique before getting fancy with weights, bands, balls, or balance devices.

There are an endless number of variations that can be incorporated into the forward lunge.  Some include the use of external loads (dumbbells, kettlebells, and other weights).  Other variations utilize technique modifications to unload or load certain parts of the body.  We will focus on a few of these types of lunge exercises.

Allowing the front of your knee to move past your toes will increases stress to your patellar tendon.  In the early phases of rehabilitation or when pain is severe, this should be avoided.  Instead, in these instances perform the lunge with your knee staying behind your toes.  In most cases, this is your best approach.  However, if you are bothered by chronic patellar tendinitis, (AKA “jumper’s knee”) controlled stress or load to the tendon may be a good idea.  Your physical therapist will help you decide if this is the right approach for you.

Additional Ways to Modify Forward Lunge Exercises

  • Hold a light medicine ball out in front of you to act as a counterbalance. This will make it easier for you to maintain proper trunk position.
  • Add an external load or weight to increase the demands on your hip muscles and ankle. However, adding weight will have less of an impact on your knee joint.
  • Hold a dumbbell in the hand opposite to the side you are lunging with to increase glute activation.
  • Slightly lean your trunk forward to further increase glute muscle activation (instead of keeping a perfectly straight trunk).

Final Thoughts on Lunge Variations

This article outlines some key points about progressing lunge exercises for people with knee pain or injury.  You can achieve great benefits from sticking with the split squat and never progressing to a traditional lunge.  Other people will be able to modify and progress through these exercises.  After mastering the forward lunge, you may want to experiment with lateral or transverse lunges.  These exercises are more challenging and require impeccable form.  The doctors of physical therapy at BSR are experts who can help you move without pain.  If you want a little extra help to get over the hump, contact us and schedule your initial evaluation.




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