Around 1 in 5 Americans struggle with knee pain, and it can be frustrating when the usual RICE (rest, ice, compression, and elevation) treatment doesn’t cut it. The following athletes and fitness professionals have been there, but they didn’t give up—and neither should you. Here are their best strategies for managing chronic knee pain while maintaining an active lifestyle. 

Dr. Jordan Metzl breaks down what “Runner’s Knee” is, how to prevent it, and how to cure it.

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Targeted exercise

James Whiteside, a principal dancer at American Ballet Theater in NYC, spent more than a decade looking for something that would help the chronic pain caused by tendinitis in both knees. Ultimately, what worked was a regimen of exercises like weighted squats, squat jumps, weighted lunges, and weighted quad extensions.

“I love ballet, but it sure does hurt. I’ve found that strengthening my VMO, quads, and glutes has given me more power in my lower body, lessening the tension on my patellar tendons,” he says. “The pain isn’t gone, but it’s much less severe.”

A plant-based diet

Chris Falcon, a personal trainer and corrective exercise specialist, tried everything from physical therapy to acupuncture to relieve the pain just above his right patella. “Some of these methods gave me relief momentarily, but none made it go away,” he says. But after seeing a client get pain relief by cutting gluten from her diet, he decided to research the link between nutrition and pain. “That led me to trying to lower the inflammation within my body,” he says.

“I removed almost all animal-based foods from my diet and replaced them with plant-based superfoods,” says Falcon. He also made healthy fats like avocados, coconut oil, olive oil, and flaxseed part of his daily diet. (Want to go plant-based? Here are 3 How to Treat Tight Quads from Running.) “Before, I had pain in my right knee that prevented me from doing lunges or squatting more than a few reps at a time,” he says. “After embracing the plant-based diet, I lost 37 pounds and I’m able to run 10 miles with no discomfort.”

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Stretching

“I’ve struggled with patellar tendinitis on and off for the past year,” says marathon runner Bekky Zucco. When rest and ice didn’t help the pain subside, she tried a supportive knee strap, which helps relieve her pain while running. “But it doesn’t prevent pain afterwards,” she adds. “What seems to help is extra stretching of the quads and hamstrings, and some light strength-training exercises like leg raises and squats.”

Foam rollers

After playing competitive squash in college, Lucy Arnold dealt with constant pain in her knees. “I’ve had chronic knee pain for a long time, most prominently since I stopped being a college athlete and became a little less active,” she says. Luckily, a few years after she graduated, she met her husband—who happens to be a personal trainer. He helped her strengthen her knees with lateral band walks, squats, and bridges. “He also has me foam rolling, which has been a huge help. I foam roll every night for 20-30 minutes,” she says. 

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ACL surgery plus extended rehab

ACL Surgury
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After tearing his ACL during a pickup basketball game, former college baseball player Josh Watkins had surgery to fix it—but the pain continued for seven years. “I tried running, yoga, massage, and ice with no relief,” he says. When he re-tore his ACL last year, he opted for surgery again—but decided to take the rehab process slower this time.

“I had a full immobile brace for two months,” he says. “My mentality also changed. I know when to stop, and I didn’t push the rehab too fast. Running still hurts, but now I’m cycling 20 miles almost daily with no pain.”

Knee replacement

Kittie Weston-Knauer took up BMX racing in her 40s—and now, at 68, she’s the oldest female competitor in the country. But just a few years ago she could barely get out of bed because her knees were so painful. "I made changes to my riding form to minimize the agonizing pain, but this new form wasn’t efficient for racing,” she says. Realizing her joint pain was holding her back, she decided to get both knees replaced.

“I worked really hard to ensure I recovered,” she says. “About four to six weeks after receiving my knee replacements, I was back on the stationary bike. It hurt, but I was determined to get back to racing. Looking back, I wish I would’ve gotten my replacements much sooner. I’m ecstatic to be back to racing without pain, and I’ll be competing in the 2017 USA BMX Grand Nationals this November.”

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A little bit of everything

Emmy Simpkins, owner of CrossFit Speakeasy in New Jersey, started having knee pain near the end of her college soccer career and ended up having surgery on both knees to repair fractured patellas. “Doctors and physical therapists said both fractures were due to over-development of my quadriceps, weak hamstrings, and a patella tracking issue,” she says. After the surgeries, she spent time in physical therapy strengthening the surrounding muscles to prevent it from happening again. 

“I do cryotherapy, acupuncture, sauna treatments, foam rolling, and static stretching on days that I do not train,” she says. “I feel a combination of all of these things help me in managing my pain. I am squatting more than I have ever squatted. I am running further and faster—and, more importantly, I'm pain-free. I believe surgery might have been avoidable if I had found these recovery and prevention methods beforehand.”

The article ​7 Athletes Reveal How They Manage Chronic Knee Pain—And Still Stay Active Races - Places Prevention.

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Kara Wahlgren is a New Jersey-based freelance writer specializing in health, entertainment, and personal finance.