How to Keep Up Your Leg Days When You Have a Knee Injury

Knowing when to train or when to take time off to recover is a tough decision for high-level tactical athletes looking to stay fit in a physically challenging job.

Here is an email from an operator trying to work around knee pain that is affecting many activities.

Stew, I have been feeling some pain in my knee for a few weeks, and I am pretty sure it is ITB (iliotibial band) syndrome from the additional running, rucking and swimming with fins I do on top of lifting weights. I am at a pretty high level on all my fitness scores, so my goals are to just maintain what I have. I would rather not stop the combination of cardio and lifting. Any recommendations for healing this nagging pain that’s not yet bad enough for me to call it an injury? Thanks – Trying not to skip leg days 🙂

I get it. Pushing through the pain while trying to avoid a full-blown injury is a delicate balance.

Here’s what I do when I have a nagging injury:

1. If it hurts to run or ruck, stop doing that activity.

2. If it hurts to walk, don’t run or ruck or lift using that joint.

3. If it hurts doing nothing, it is time to rest and see a doctor.

However, if the pain is truly mild and you are nowhere near No. 3 above, consider some of these options when it comes to your training. These changes will feel like you are training while you make some temporary changes.

1. Lifting Weights. Give your knee (ITB) a break by replacing squats, lunges and other knee-bending exercises. You can add more hip-hinge movements like deadlifts, Romanian deadlifts, kettlebell swings, weighted hip thrusts and non-weighted glute bridges. These exercises will let you feel like you are not skipping leg day.

2. Running and Rucking. This one is a delicate one to try. If you reduce some of your distance, run on softer ground (grass, turf, trails, sand) and avoid concrete or asphalt, you may be able to continue with running and rucking. I would make sure you are continuing to stretch and add more foam rolling or massage on the legs (upper and lower, front and back, sides).

3. Swimming with Fins. I would replace swimming with fins. Just do more swimming without fins and mix in some swim buoys so you limit the kicking. ITB has a way of introducing itself to your training when you’re doing a higher volume of running, rucking and swimming, especially when doing all three during the same week for several weeks or months. You can still swim; just focus on freestyle swimming and use your arms more than your legs.

4. Add Another Mobility Day. You should do a mobility day workout at least once a week. In your case, I would recommend a second one later in the week or on the weekend instead of a longer run, ruck or swim. See the classic mobility day workout below and just do that for the day and nothing else.

Repeat 5 times
Bike or elliptical: 5 minutes (no impact cardio)
Stretch or foam roll or massage tool: 5 minutes

Pool Time
Swim: 20 minutes
Tread water: 10 minutes
Dynamic stretches in chest deep water: 10 minutes

This is still a 90-minute workout with transitions so it is not completely like a day off, but you will feel so much better if you place one of these workouts in the middle of the week and on your weekend when nursing these types of aches and pains. This approach does mean no running or rucking on these days. If the pain is bad enough, you may want to replace your leg days with mobility days during the week.

The above are ways to remain active while giving your knee the rest it needs. Obviously, if this is not working for you, consider taking lower-body rest days and only do upper body and non-impact cardio for a few weeks. Go see your physical therapist for advice on running shoes, running stride and exercises that can help with mitigating this common overuse injury.

Stew Smith is a former Navy SEAL and fitness author certified as a Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association. Visit his Fitness eBook store if you’re looking to start a workout program to create a healthy lifestyle. Send your fitness questions to stew@stewsmith.com.

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