Fix Your Knee Pain
Daryl C. Rich, D.C., C.S.C.S.
[Core] Chiropractic and Wellness
CoreRoanoke.com

Knee pain is one of the most common issues we see in our clinic. While knee pain can be debilitating, it does not have to stop your busy life. Knee pain is not just a function of your age, it is not just caused by being overweight, and it is not something you just have to live with. The good news is that targeted exercises focusing on stability, breathing, and proper movement patterns combined with some acupuncture can make a large improvement in reducing pain and increasing your mobility.

Understanding Basic Knee Anatomy
Your knee is a complex hinge joint connecting the thigh bone (femur) to the shin bone (tibia), with the kneecap (patella) in front. It includes important cartilage for smooth gliding, ligaments for stability, menisci as shock absorbers, and surrounding muscles (quadriceps, hamstrings, and glutes) that control movement. When the muscles and stabilizers around the knee, hip, and core work together properly, the joint stays aligned and functions without pain.

Important Note on Arthritis Seen on X-Ray
Many patients become concerned when they see some of the anatomy above go through typical changes throughout life. We have commonly called this “arthritis” or degenerative changes on an X-ray. However, research consistently shows that the severity of arthritis visible on imaging is often a poor predictor of actual pain levels. Many people with significant radiographic arthritis have little to no pain, while others with mild changes experience a lot. The key to reducing knee pain is improving movement quality, muscle balance, stability, and neuromuscular control rather than focusing only on the structural changes seen on films. Our exercises and care target these functional factors for real, sustainable relief.

5 Exercises You Can Do at Home
Here are a few easy exercises that you can do today to begin your knee rehab program. Perform these gently and consistently. Stop if pain increases. Start with 1–2 sets and focus on good form and breathing. If you need more help with these exercises or other knee issues ask us for personalization.

1. Supine 90/90 Breathing
Lie on your back with hips and knees bent at ~90 degrees (feet supported on a wall or bench). Inhale deeply into your belly, not your chest. Exhale fully, activating your deep core (including the transverse abdominis and pelvic floor) while maintaining a neutral spine. Hold the braced position briefly on exhales.
Reps: 10–15 breaths, 2–3 times daily.

Why it helps: This foundational drill teaches intra-abdominal pressure and pelvic stability, crucial for stabilization of the core, hips, and pelvis that provide protection of the knees during movement.

2. 3-Month Prone Position with Head and Limb Lift
Lie face down (prone), chin slightly tucked. Gently lift your head, one or both arms, and opposite leg a few inches off the ground while keeping your spine neutral (avoid excessive arching). Alternate sides.
Reps: 8–12 per side.

Why it helps: Activates the posterior chain (glutes, back) and promotes spinal alignment, addressing common compensations that stress the knees.

3. 4.5-Month Side-Lying Hip Abduction
Lie on your side with the bottom leg bent to 90 degrees. The downside elbow is also bent to 90 degrees without the hand touching the ground. Engage your core, then slowly lift the top leg without letting your pelvis tip. Lower with control to the starting position.
Reps: 10–15 per side.

Why it helps: Strengthens the glute medius and lateral hip stabilizers while coordinating lower extremity movement during core stabilization. This helps to improve knee tracking and reduce valgus stress on the joint.

4. Bear Crawl Hold (Quadruped Rock Back)
Start on all fours with feet, knees, and hands on the ground. Drop your lower ribs to stack your hips, ribs, and shoulders in one line. Now, lift your knees off of the ground keeping your torso in the straight line and not rounding your back. Hold or slowly rock your hips back while keeping your ribs and pelvis in line.
Duration: 20–45 seconds.

Why it helps: Improves coordination, core engagement, and joint centration—great for overall lower body stability supporting the knees.

5. Czech Get-Up
Setup & Ascending Positions
Begin by lying flat on your back on the floor with your legs extended. Hold a kettlebell (start with a light weight, such as 10–20 lbs for beginners, or no weight at all to learn the pattern) in one hand. Press the kettlebell straight overhead with your arm locked and stable. Your eyes should stay focused on the kettlebell throughout the entire movement for better control and shoulder stability. Keep your core gently braced and your opposite arm available to help push or stabilize as needed in the early stages. Breathe steadily and maintain a neutral spine.

Side-Lying Position: Roll or transition smoothly onto your side while maintaining control of the kettlebell. Your body should form a stable side position with good alignment.

Low Oblique Sit to High Oblique Sit: From side-lying, sit up into a low oblique sitting position (partial sit with support), then progress upward into a higher oblique sit. Keep your core engaged and avoid collapsing through the spine.

Tripod Position: Move into a tripod stance—one hand (or the non-kettlebell side), one knee, and the opposite foot or leg positioned for balance. The kettlebell remains pressed overhead.

Tall Kneeling Position: Rise from the tripod into a tall kneeling position on both knees, maintaining an upright torso and stable shoulders/hips.

Standing Position: From tall kneeling, stand fully upright with good posture, kettlebell still locked overhead.

Deep Squat at the Top (Optional Functional Finish): Once standing, drop controlled into a deep squat position, then return to full standing. This adds a functional lower body component.

Descending Phase (Return to Floor)
Reverse the entire sequence with control:
• From standing, move into a deep squat.
• Return to tall kneeling.
• Tripod position.
• High oblique sit → low oblique sit.
• Side-lying.
• 6-month position.
• Back to the 3-month supine position.
• Lower the kettlebell safely and relax flat on the floor.

Key Coaching Cues & Tips
• Move slowly and deliberately—the exercise is about control and stability, not speed.
• Keep your core braced and breathe naturally (avoid holding your breath).
• Watch the kettlebell the whole time to maintain shoulder stability.
• Perform at least 2-3 repetitions. Increase weight as you feel comfortable.
• It will feel challenging and “fluid” after a few practice reps without weight.
• Common mistake to avoid: Letting the low back arch or losing control of the kettlebell.

Acupuncture for Knee Pain Relief
Acupuncture is a valuable complementary therapy that can provide significant relief for many patients experiencing knee pain. By inserting thin, sterile needles at specific points along the body’s meridians, acupuncture helps stimulate the nervous system, promote blood flow, and trigger the release of natural pain-relieving chemicals such as endorphins and serotonin. For knee issues—whether from osteoarthritis, overuse, or injury—this targeted stimulation can reduce inflammation, relax tight surrounding muscles, and improve joint mobility.

Additional Educational Tidbits & Tip
• To decrease inflammation in the knee joint try an Omega-3 oil like fish or flax oil combined with Turmeric. This is a powerful antioxidant combination that can reduce pain, swelling, and improve recovery after working out.
• Consistency Beats Intensity: Short daily sessions yield better results than occasional long workouts.