How to Train Clients With Knee Injuries | Learn: Your Fitness Business Resource

How to Train Clients With Knee Injuries

Training clients with knee injuries can open up a new client base for a personal trainer. But, it's important that you have the proper tools to train someone with knee injuries effectively. Using certain personal training software features can help you train clients with knee injuries.

Thomas Barnett is a writer for and a Professor of Exercise Science at Keiser University. He has over eight years of experience working in rehabilitation, personal training, and strength and conditioning. Additionally, Thomas holds a Master's Degree in Human Performance, a Bachelor's Degree in Exercise Science, is an NSCA Certified Strength and Conditioning Specialist (CSCS), a Certifi...

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UPDATED: Sep 20, 2021

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  • Training someone with knee injuries requires a comprehensive assessment to determine the mechanism of injury and contraindicated exercises.
  • Most clients with knee injuries experience pain on the anterior (front) side of their knee and will need to temporarily remove things like jumping, running, and lunging forward from their training program.
  • Incorporating workout and assessment software can help prioritize your client’s safety while helping them reach their goals with fewer setbacks.

Breaking into training special populations, like training clients with knee injuries, can be a rewarding way for personal trainers to add a new stream of revenue to their fitness businesses.

To train clients with knee injuries, it’s important that you’re not only well-versed in knee injuries, but that you have the tools in place to make your training as effective as possible; that’s where personal training software comes into play.

By taking advantage of the features that personal training software has to offer, you can train clients with knee injuries in a way that works for them, not against them.

To learn more about the personal training software platform, book a demo today.

How to Train Clients With Knee Injuries

To learn how to train clients with knee injuries, it’s imperative that you have a thorough understanding of common knee injuries and why it’s important to follow certain procedures with these clients.

What are common knee injuries?

The knee is an oft-injured joint that absorbs a large percentage of the impact that we experience day to day. Many of the common knee injuries affect the anterior (front) portion of the knee, according to MedLine. Some of these injuries include:

  • Osteoarthritis
  • Patellofemoral Pain Syndrome (Runner’s Knee)
  • Patellar Tendonitis (Jumper’s Knee)
  • Anterior Cruciate Ligament (ACL) Tears
  • Meniscus Tears

These are common injuries that might cause pain somewhere around the patella, whether it be superior, inferior, or deep to the patella. Anterior knee pain is the most common, but there are some other injuries that occur regularly, including medial collateral ligament (MCL) tears.

ACL and MCL tears are more common in athletes, while most other sources of anterior knee pain are common to the general population. It’s important to know the difference between anterior, medial, or lateral knee pain. While each type of pain might impact the same joint, procedures differ when determining how to remain active with a knee injury depending on the type.

Do you need to be certified to train clients with knee injuries?

Becoming a certified personal trainer (CPT) often provides you with a foundational knowledge of the body and how to train most normal clients. Where those certifications lack is providing applicable modifications and procedures when training clients with a knee injury or other condition.

To better prepare yourself to work with clients with knee injuries, there are some desirable certifications, listed below.

  • NASM Corrective Exercise Specialist (CES)
  • ACSM Certified Exercise Physiologist (ACSM-EP)
  • NSCA Special Populations Specialist (CSPS)

The aforementioned certifications will help trainers better prepare for common conditions that will need some accommodation. While a CPT might teach you the fundamentals of flexibility and strength, these certifications can help you learn some knee-friendly exercises to help with knee pain.

Training Clients After a Knee Injury

Working around exercise and knee pain isn’t always easy. Knee pain presents itself with different locations and limitations from person to person. For starters, you typically want to stay within a pain-free range of motion. It always helps to start with adequate warm-ups to prepare the affected knee for exercise.

Some theories suggest that knee pain is driven by other limitations in the kinetic chain, more specifically, the ankle or the hip. In short, if someone is experiencing anterior knee pain, the problem might stem from weakness or stiffness that causes an excessive force on the knee joint instead of a more even distribution of weight between all three joints.

If this were to be the case, your client may need to emphasize stretching of the direct and surrounding joints. Most notably, they would want to stretch the quadriceps, hip flexors, gluteal muscles, and calves (soleus and gastrocnemius).

Depending on the knee injury, you may need to emphasize knee stability exercises or knee strengthening exercises. Some good exercises for starters are terminal knee extensions (TKEs) and bridges. TKEs help to stabilize the anterior portion of the knee while bridges help posteriorly.

TKEs and bridges are just two examples of available knee strengthening exercises at home. If you’re trying to learn how to strengthen knee ligaments, you can perform these exercises while exaggerating the eccentric (lengthening) phase or by performing them isometrically. This basically means you would produce a full contraction and hold that position for 20 to 30 seconds.

There are a considerable number of clients that will exercise with bad knees to lose weight. Virtually anyone can lose weight, but there are some exercises to avoid if you have bad knees, especially if you have anterior knee pain. You’ll want to avoid exercises that require a great deal of shear force on the knee.

Some examples of exercises to avoid with knee injuries include:

  • Forward Lunges
  • Stair-Climbing
  • Pistol Squats
  • Heavy Knee Extensions (Machine-based)
  • Jumping

Over time, these exercises may be able to be implemented back into a training regimen. During the initial stages of recovery, you’ll want to re-establish movement patterns to alleviate some of the stress on the knee joint. Most commonly, this means developing the posterior chain with exercises like Romanian deadlifts (RDLs), good mornings, or bridges.

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Train clients with knee replacements.

Software Tools for Training Clients With a Knee Replacement

When you’re learning how to train someone with a knee injury, you’ll need to be consistent with check-ins for exercise tolerance and progression. If you’re managing a full clientele, this can be a time-consuming task. Thankfully, there are resources that can help manage exercise and knee pain.

Workout Software for Clients With Knee Injuries

Knee injuries can be complex and cover a gamut of potential limitations. Most of your clients won’t have much background in biomechanics and resultantly might not recall exactly which exercises to avoid for knee injuries. If that client wants to fit in a workout on their own time with no real plan, there’s a risk that they might exacerbate their knee injury.

By incorporating’s workout software, you’ll be able to provide your clients with customized and structured workouts for knee injuries of any type. Depending on the severity of their knee injury, you can provide them with accessible workouts with custom-designed volume, intensity, rest intervals, and more.

On top of customized workouts, you and your clients will also benefit from workout analytics. These reports will help simplify and display progression for your clients, maximizing their satisfaction and retention without any additional work for you.

Fitness Assessments for Clients With Knee Injuries

It’s hard to provide your clients with adequate fitness programs if you don’t know what they’re capable of. offers functional fitness assessment software that affords trainers the ability to develop customized fitness assessments that can also be conveniently tracked to monitor progression.

To train clients with knee injuries, you might want to include range of motion assessments, functional mobility screens, balance assessments, and even test their strength. Don’t forget, your clients will likely still want an upper body workout with a knee injury, so you can still include those assessments and performance metrics.

As a trainer, you can even distribute your assessments to clients’ assessments virtually so that they can perform the assessments on their own, if applicable. This way, your client will know when they should be assessed and they can still see if their training program is as effective as it should be. Happy clients are long-term clients which means stable income for you.

Customizable Exercise Library for Clients With a Knee Injury

There are a limited number of hours in a day. This means that you’ll have a limit on how many clients you can see face-to-face each day. That doesn’t have to limit your revenue. To help retain clients, you’ll want top-level resources to assure they will be pursuant to their goals whether you’re present or not.’s customizable exercise library offers clients the luxury of seeing and reading details related to any exercise you include in your training program. For example, if you wanted to include a Romanian deadlift for your injured client, they could quickly see that the movement is hip-driven and doesn’t include a great amount of knee flexion or extension.

On the contrary, if you simply provided them a sheet of paper that included a Romanian deadlift, your client might misinterpret the exercise and perform something along the lines of a squat, further aggravating their injured knee. In essence, an online exercise library is an effective way to assure your client’s understanding for desirable safety and performance outcomes.

Your clients will have access to your exercise library from a custom-branded fitness app 24/7. Improved accessibility and functionality helps to maintain a presence with your clients, even if you aren’t physically there. Accountability is one of the most important roles for personal trainers. Adding features like an exercise library helps eliminate excuses.

Training Clients With a Knee Injury: The Bottom Line

Training clients with a knee injury requires a lot more than just general knowledge. It requires education, empathy, and a host of software tools built with customization and adaptation in mind.

To learn more about how can help you train senior clients, book a demo today.


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