Guide to Foam Rolling for Knee Pain

March 24, 2023

foam rolling quad muscle to treat knee pain

If you've ever experienced or are currently dealing with knee pain, you know how frustrating it can be. You’re not alone; 25% of US adults suffer from chronic knee pain. It can be caused by injuries, overuse, and chronic health conditions, or a combination of these. But that doesn’t mean you have to endure invasive or costly procedures to treat your discomfort. There's another way.

Foam rolling is an effective way to treat chronic knee pain. By targeting the muscles around the knee, you can reduce pain, inflammation, and stiffness in the knee joint itself. In this article, we'll show specific foam rolling exercises to treat your knee pain. But first, we'll discuss what's causing it and how foam rolling can benefit you.

Benefits of foam rolling for knee pain

Your knee pain could be the result of one or several factors, which we’ll examine in further detail below. But no matter the cause, foam rolling can be an effective treatment for both chronic and acute knee pain.

Foam rolling is a form of self-massage therapy alleviates pain and improves range of motion. When applied to the muscles & tissue around the knee, foam rolling can be beneficial in the following ways:

Reducing muscle tension & tightness: Releases tension & tightness in the quadriceps, hamstrings, and calves. This reduces the pressure on the knee and increases the joint's range of motion (ROM).

Improving circulation: Improves blood flow to the muscles and tissues around the knee joint, promoting healing and reducing pain.

Enhancing recovery: Stimulates recovery after exercise or physical activity, reducing muscle soreness and the future risk of injury.
Increasing range of motion: Increases both active & passive knee mobility by breaking down scar tissue and reducing surrounding muscle tension. A 2020 study suggests that it can improve passive knee ROM by up to 8 degrees.

But before you grab your foam roller or muscle roller stick, it’s important to understand what’s causing your knee pain.

What causes knee pain?

The most common causes of knee pain are diseases, acute injuries, overuse, and general muscular issues. Each causes a different type of pain and thus requires a different course of treatment. Let’s explore each of these types a bit further.

Diseases & Conditions

Autoimmune diseases & conditions are one of most common causes of chronic knee pain. Specifically, these three are the biggest culprits:

Osteoarthritis: A degenerative joint disease that wears down the cartilage in the knee joint, causing pain, stiffness, and swelling.
Rheumatoid arthritis: An autoimmune disease that causes inflammation in the joints, including the knee, damaging the cartilage and surrounding tissues. As the inflammation builds up, patients experience extreme chronic pain and stiffness which worsens with exercise.

Patellofemoral pain syndrome (PFPS): A physiological condition that’s characterized by the kneecap (patella) not moving properly over the thigh bone (femur). It causes knee pain & stiffness even during basic activities like climbing stairs, squatting, or sitting for long periods.

When used properly, foam rolling can be an effective tool to manage knee pain caused by both types of arthritis as well as PFPS.

Acute Injuries

Knee injuries are one of the most common injuries in sports, right up there with shoulder and ankle injuries. It’s not uncommon for a previous injury to cause lingering knee pain. Individuals who run, jump, and change directions constantly are particularly at risk for the following:

Meniscus tears: The meniscus helps cushion and stabilize the knee joint. Even a partial tear can lead to chronic pain and swelling, especially if left untreated.
Ligament injuries: There are four major ligaments in the knee: the ACL, PCL, MCL and LCL. Tearing any one of these ligaments will sideline you for weeks and cause instability in the knee joint until rehabilitated or repaired.

Though a foam rolling won’t be able to repair a torn meniscus or ACL, it will help promote blood & nutrient circulation to the injured area, reducing inflammation and accelerating the overall healing process.

Inflammation

Inflammation is generally the result of injuries or overtraining, and sometimes a combination of the two. And if left untreated, inflammation in and around the knee will

Bursitis: Inflammation of the small fluid-filled sacs (bursae) that cushion the knee joint. Inflamed bursae cause acute pain & stiffness during practically every movement involving the knees, including walking, taking the stairs, and even sitting down.

Tendonitis: Knee tendonitis is one of the most common conditions in physically active individuals, where the tendons that attach muscles to bone become inflamed as a result of overuse or lack of muscle. This is why knee sleeves have become common in almost every kind of gym these days. In the knee, specifically, it can occur in both the patellar tendon or the hamstring tendons, causing chronic pain and stiffness.

Both bursitis and tendonitis are caused by overuse. Muscles attach to tendons and generate the force required for movement. When a muscle becomes tight or weak, it increases strain on the tendon. This added stress results in acute inflammation and tears. Foam rolling helps improve tendonitis by alleviating this muscle tension. It also has pre-habilitative uses, preventing tendonitis before it occurs.

Muscular & Tissue Issues

There are three muscle groups in your leg that control your knees: quadriceps, hamstrings, and the calves. And though often mistaken for a muscle, the iliotibial (IT) band can also cause issues. The IT band is a thick band of tissue on your outer thigh, which facilitates hip movement. Knee pain can be caused by strains, tears, and imbalances in any one of these.

Foam rolling eases tension, treats soreness, and reduces associated pain caused by these muscle & tissue abnormalities.

4 foam rolling techniques to treat your knee pain

Though foam rolling helps reduce general pain and tension in these muscle groups, the biggest benefit comes from targeting trigger points. These points, commonly known as “knots,” are adhesions, where the muscular tissue binds to the myofascial tissue and restricts movement.

By employing active release therapy (ART) with the foam roller, we can free these specific areas of tension. This protocol is typically used by sports massage therapists, but it can be performed with the Rolflex foam roller. It involves applying pressure with the roller to the trigger point while simultaneously engaging both the joint and the muscle. Active joint motion while foam rolling was shown to have a greater effect than passive foam rolling in this 2018 study. ART breaks up adhesions and releases the myofascial tissue from the muscle, enabling it to move freely.

Let’s explore how to perform ART on each of the primary muscle and tissue groups responsible for knee pain.

Quadriceps

The quadriceps are composed of four muscles: the rectus femoris, the vastus lateralis, vastus intermedius, and vastus medialis. We'll target all four of these muscles.

Adjust the handles on the Rolflex so that the arms fit around your thigh. Squeeze the handles to apply pressure and slide the foam roller up and down your quadriceps. Start on the front of your thigh before moving onto the inner and outer thigh. Spend at least 1-2 minutes massaging the entire muscle group.

As you roll, you’ll notice areas that are more tender and sensitive than others; these are the trigger points. Once you’ve massaged the entire thigh, return to the first of these points. Place the roller over the knot and apply pressure to the muscle. While doing that, bend & straighten your knee without moving the roller from that spot. Repeat this for 5-10 repetitions, then move onto the next knot.

If you’re struggling particularly with thigh tension, check out our full foam rolling technique for quadriceps.

Hamstrings

There are three muscles that make up the hamstrings: the semitendinosus, semimembranosus, and biceps femoris. If your hamstring is responsible for your knee pain, such as in the case of hamstring tendonitis, you must foam roll the entire group to effectively treat the pain.

Again, adjust the handles on the Rolflex to fit the arms around your thigh. Squeeze the handles to apply pressure and slide the foam roller up and down your hamstrings. Start on the middle of your back thigh, then move onto the inner and outer thigh. Spend at least 1-2 minutes massaging the entire muscle group.

Again, revisit especially tender areas and perform ART to release the myofascial tissue. Just as with the quadriceps, bend & straighten your leg for maximum effectiveness.

For more information, check out our full guide to foam rolling your hamstrings.

Calves

Your calf is composed of two primary muscles: the gastrocnemius and the soleus. However, it’s common for calf tightness and associated knee pain to occur because of a weak or tight anterior tibialis muscle. This is the muscle located on the front of your shin, and it plays a major role in calf mobility & strength. So before rolling the calf, we’ll start with the front of the shin.

Place the contoured foam roller just to the outside of your tibia. Massage the anterior tibialis for 30 seconds. As you do this, again, make note of trigger points to target afterwards. Perform ART to break up the tension while flexing your foot up into dorsiflexion and down into plantar flexion. Do this for 5-10 reps.

Then, move onto the calf muscles. Spend 30 seconds foam rolling the back of your lower leg, then use ART to release any specific areas of tension. And just as with the front of the leg, flex your foot up & down. Repeat this for 5-10 reps.

Read our full guide: How to Foam Roll Your Calves.

IT Band

It’s important to note that unlike the quads, hamstrings, and calves, the IT band is not a muscle. And because it’s not a muscle, it’s impossible to have a “tight” IT band. What people commonly refer to as a tight IT band is actually the result of muscle tension in your hips and outer thigh. As these muscles tense up, they squeeze the IT band, resulting in the pain. If left untreated, minor discomfort in your outer thigh will lead to iliotibial band syndrome (ITBS) and knee pain.

Removing this tension is not as simple as foam rolling the IT band directly. There are two distinct areas that need to be addressed: tensor fascia latae (TFL) and lateral quad. For the full technique, check out the video below and our full guide to full guide to foam rolling your IT bands.

Foam rolling is an effective method to treat knee pain caused by injuries, overuse, and certain health conditions. So instead of taking a few ibuprofens when you wake up or before every workout, you can treat the pain at the source. Foam rolling reduce inflammation, improves range of motion, and promotes the flow of blood & important nutrients to the muscles, tendons, and ligaments around your knee.

As we’ve discussed here, there are distinct methods that yield positive results. Repeat these foam rolling techniques at least 1-2x per day for 10-14 days. And even after your pain has subsided, you should continue to foam roll. It will help prevent future injuries or reaggravating the same condition.

However, it is important to remember that foam rolling should not be used as a substitute for proper medical treatment. If you are experiencing chronic or severe knee pain, you should seek the advice of a healthcare professional before attempting any self-therapy.

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