Help! My Front Knee Hurts in a Front Split
Help! My Front Knee Hurts in a Front Split
Stretching should never hurt - so if you’re experiencing acute pain or an intense stretch in your knee when doing splits, you’re smart to look for a solution! There are several things that can lead to the sensation of pain in the underside of our knee (especially if your knee has a tendency to hyperextend). These three (below) are the most common causes I run into with my students. Thankfully, all of these can be easily modified for during your training session, and conditioned to “fix” over time to keep your knees safe and strong!
Obligatory Disclaimer: This is not medical advice, I’m not a medical professional. These are the most common causes of knee pain I’ve experienced with my students when teaching, but every body is different! If these fixes don’t work for you, I strongly suggest trying to make an appointment with a physical therapist to get a proper evaluation of what could be causing your pain.
Possible Cause #1: Tight Hamstrings
Because your hamstrings run along the underside of your knee, sometimes feeling knee pain is simply due to an intense stretch in the hamstrings near where they attach to the shin bones near the underside/inside/outside of the knee.
Recommended Blog Post: Why are My Hamstrings Tight? (and How to Fix Them) - this post has a great visual overview of hamstring anatomy if you want a reminder of where they actually are in your body (and how this impacts how you should be stretching them)
Long Term Fix: If tight hamstrings are the culprit, working on both your passive and active hamstring flexibility can help - specifically working in your “pre pain” range of motion to strengthen your hamstrings while they’re lengthened, but not yet at the point where you’re feeling knee pain. High pyramid good mornings are a great active hamstring flexibility strengthener that are easy to regulate how deeply you lean into the stretch.
Short Term Fix: In the meantime, consider slightly bending the front knee in your front split, which lessens the hamstring stretch (although if you have tight hammies, you might still feel a stretch even with the knee bent, that’s OK!) and might alleviate the discomfort. Alternatively, you could bend the front knee a lot and instead work on your “zig zag split” (split variation #2 from Split Variations if You Can’t Do a Flat Split) which takes the hamstring stretch away completely and instead lets you focus more on the back-leg hip flexor stretch - which, frankly, is generally the tighter muscle that holds people back in their splits anyway.
Possible Cause #2: Weak/Unengaged Hamstrings
If your hamstrings are weak and unengaged, when you straighten your front leg in a split, the downward pressure of your knee can put a strain on the knee ligaments (which aren’t meant to stretch!), pushing the knee towards hyperextension, and lead to pain. A good test would be to see if you feel the same discomfort/pain under your knee in a one-legged seated pike stretch. In a seated pike, you can get the same amount of hamstring stretch as in your front split, but the floor is supporting the knee joint. If the pain isn’t present in a regular ol’ pike stretch, then it’s a good sign you need to learn to use your muscles to support your knee when the knee is in the air (like in a split, or half split hamstring stretch). If the pain is still present, then it might be muscular (see #1 above) or nerve-related (see #3 below)
Long Term Fix: Strengthen your hamstrings at their end range of motion and learn to engage them (slightly contract) in your front split. This is especially important for folks who have hypermobile knees and knees that like to hyperextend!
Short Term Fix(es): Slightly bend your front knee - holding a microbend requires your hamstrings to contract (which also works as a strengthening exercise!) and takes pressure off of the knee ligaments. You can also lightly engage your quads on the front leg, trying to pull your knee cap “up” your thigh toward your hip. So this would be an isometric contraction with muscles on both sides of your hip joint contracting (quads and hamstrings), but with the hamstrings engaging just a bit more to maintain the knee bend.
Alternatively (or additionally), you can physically support the front knee by putting something like a yoga block, pillow(s), or a folded blanket under the knee to take weight out of the knee joint.
Possible Cause #3: Sciatic Nerve Tension
Feeling an intense “stretch” in the back of the knee doesn’t automatically indicate nerve tension, but anecdotally it does seem to be a common culprit for my students who feel their “hamstring stretch” strongest right in the back of their knee.
Normally, nerves slide back and forth through our soft tissue like a piece of yarn being pulled back and forth through a straw. Sometimes something presses on the nerve (ex. a tight muscle) or inhibits it from doing it’s normal sliding motion - like pressing a finger firmly on the straw, preventing the string to easily slide through. This causes nerve “tension” - the nerve is stuck trying to stretch (which nerves aren’t meant to do!) because it can no longer slide. Sometimes when we feel intense sensations in the back of our legs, undersides of our feet, or low back when doing hamstring stretches, it’s actually due to the sciatic nerve being pulled with too much tension. This blog pos goes into more detail on how to “test” if the sensation you’re feeling is likely due to nerve tension and not just muscle tension.
Long Term Fix: Work on your active hamstring (and hip flexor!) flexibility at your end range of motion in hamstring stretches so your muscles learn to engage and facilitate healthier neurodynamics. Do a mix of drills that strengthen your hamstrings in a lengthened position (like those High Pyramid Good Mornings I mentioned earlier!) as well as ones that strengthen your hip flexors while your hamstrings are in a lengthened position (like straddle leg lifts).
Short Term Fix: Add a sciatic nerve glide (and potentially a sciatic nerve tensioner) exercise to your warm-up to help get that pesky nerve back to sliding back-and-forth through your soft tissue like it’s supposed to. Additionally, you can try to minimize the nerve tension any time you are doing your front splits by making sure you are pointing your toes, keeping your torso lifted (avoid leaning forwards) and keeping a flat back and neck (avoiding rounding your back) - all of which help put your sciatic nerve on a bit more slack.
I hope one (or multiple) of the above suggestions help with your knee pain. But if not, as I said in the disclaimer, it’s probably worth seeing a medical professional like your doctor or a physical therapist - knee pain isn’t something you ever want to push through because knee injuries are no fun (some of which, like ligament damage, can only be potentially “fixed” with surgery). So learn to use your muscles to protect your knees in your stretches, and when in doubt see a pro - your knees will thank you!
