10 Minute Tip 15: Knee Pain During Bench Press | Why & How to Address It
Knee pain when bench pressing is not common but something that can inhibit your progress with the bench press. There are a few reasons why your knees may hurt when you bench press and there are ways to address it without giving up the bench press entirely.
Unlike squat and deadlift, the knees remain bent in a static position during the bench press. Though this greatly reduces the likelihood of having knee pain while benching, it can still happen. Even if the knee angle isn’t changing while performing the bench press, we’re still driving our legs and maintaining tension in the musculature surrounding the knees which remain in a flexed position.
In this episode of the PRS Podcast, we discuss how your position while benching could potentially contribute to knee pain and ways to modify your position to address your symptoms.
The main factors that contribute to knee pain during bench press include:
Foot placement
Height of bench
Angle of the shin and hip relative to the knee
Leg drive
Listen to the full episode on the PRS Podcast to learn why you’re having knee pain while bench pressing and how to address it.
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Dr. Rori Alter, PT, PRSCC, SSC: [00:00:01] Welcome to the Progressive Rehab & Strength.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:00:04] Podcast, we're your hosts, Physical Therapists, strength coaches, and PRS Clinical Coaches, Dr. Alyssa Haveson.
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:10] And Dr. Rori Alter, join us on our journey of barbell strength training and rehabilitation. Welcome back to the Progressive Rehab & Strength Podcast. I'm your host, Dr. Rori Alter, clinical coach here at Progressive Rehab & Strength, with my lovely co-host Dr. Alyssa Haveson, also a clinical coach here at Progressive Rehab & Strength. And in this ten-minute tip Tuesday, we are talking about addressing knee pain in the bench press. So what I'm going to do for this ten-minute tip is start my lovely ten-minute timer, if you guys can see that if you're watching on YouTube. Here we go. Start. So why does your knee hurt in the bench press? Well, it's a little different than the squat and the deadlift because we don't have a change in the knee angle during the bench press. So we plant our feet on the ground, lie down on the bench, or vice versa. Some people lie down on the bench and then plant their feet on the floor, and then that is pretty much the position that your knee stays in throughout the entire lift. So there's no change in the knee angle while you're lifting, which means that there's no change in muscle length during the movement. And we have an isometric contraction of all the leg musculature in the bench press. So the thing that seems to irritate the knee in the bench press is the leg drive, so pushing your legs into the ground, even though there's no change in the knee angle, we are getting isometric hip and knee extension, so the musculature around the knee can cause some pain in the knee joint, particularly the patellofemoral joint if you are having some pain in that area. And also, we're looking at how what the knee angle is. So where your foot placement is. So it's not just leg drive. It's where you're placing your feet, which dictates the depth or degree of angle at the knee. So if your feet are more forward, you have a more open knee angle. And if you pull your feet back behind you, you get a deeper knee angle. So those are some things we can look at that can contribute to some discomfort in the knee, in the bench press, and your knee out position. So the angle of your thighs in the bench press as well. So the more you abduct or externally rotate your hip, the further out your knees are. There's more pull laterally from the lateral musculature at the knee and more pull from the inner thigh muscles on the knee. So the last thing is that the quad muscle can pull across the knee and cause some compression at the patellofemoral joint. So if you're getting this like anterior or anterolateral knee pain in the bench press, Alyssa, what can we do about it?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:03:09] Yeah. So before we give up on leg drive altogether, we want to make some adjustments to the feet, so see if there's a comfortable position where you're still able to drive your legs without knee pain or with reduced knee pain. So we'll first change that knee angle and open it up a little bit. So moving the feet forward or away further away from your shoulders so that your knee isn't quite as bent in your position on the bench. But also, you know, there isn't one right answer here. So you can try like if you have a narrower stance or foot placement.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:49] Yeah, I call it stance. I often tell people to adopt their squat stance on the bench press.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:03:57] Yeah. So if you use a narrower foot placement with your toes pointing straight forward, you still feel discomfort once you move your feet forward, widen your feet, turn your toes out, or vice versa. Depending on where you're comfortable or if you're still having symptoms with the changes you've already made. I always say to make one change at a time and make a small change. So you're not necessarily going to start by moving your feet 12 inches forward, but see how close you can stay to your preferred position and then find where you can be comfortable. So make some adjustments to your foot placement, and then if there's still discomfort, we might need to let up on leg drive and not necessarily eliminate it, but not drive the legs quite as hard while you still have these symptoms.
Dr. Rori Alter, PT, PRSCC, SSC: [00:04:54] Yeah. The other thing and going back to leg drive, I think what happens sometimes, especially when we're talking about the pull of the quad or specifically the rectus femoris, which is one of the four quadricep muscles, that is the only quadricep muscle that crosses the hip and the knee. So when the further back your feet are, the more stretched that muscle is across the hip. So you get a little bit more hip extension when you bring your feet back more or when depending on the height of the bench. So if you're a really short person, your legs are short, that can put a big stretch at the hip, which can lengthen that quadricep muscle a little bit more across the front of the knee. So also, you know, if the bench is high, even if you're like a moderately tall person, like normal, a typical side using terrible words here. But, you know, you might still get good leg drive if you decrease the angle at the hip. So what we can do in that situation is we can, if you're in flat shoes, you can bench press in a heeled shoe because that can just reduce the stress at the hip a little bit, that it decreases the stress at the knee, or you can change the bench.
Dr. Rori Alter, PT, PRSCC, SSC: [00:06:15] So, we have two different benches in our gym: one is short, and one is taller. So, you know, when I was having knee pain when I was benching, I would use the shorter bench and get a better shorter bench and heels. So, I used the shorter bench and heels, whereas previously, I used the higher bench with flat shoes but then developed some knee pain. So I switched to a heel and lower bench, which made a big difference for me. And I was still able you'll still be able to get leg drive without putting so much pressure at the knee, so we can also, instead of a heel, if you don't have that, you can put your feet on plates, on blocks or whatnot. But if we're not getting any relief with a change in footwear or change in foot position, change in hip position, and change in the amount of leg drive that we're putting into the bench press, what are some other things that we can do temporarily so that we can keep bunching without hurting our knee or without being irritated by our knee while we're benching?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:07:15] Yeah. So, you know, this is similar to what we do for back pain, too. I would say you can put your feet up on the bench, assuming that that position is not more uncomfortable because of the position it puts the knees in. But if it's taking stress off of the anterior hip, it might potentially start to reduce symptoms in that position. And if simply laying flat is a problem for the knee, then we look at an incline bench press and just change that position altogether.