One of the biggest problems clients run into with lunging is anterior knee pain. This is especially prevalent in middle-aged females. Patellofemoral joint pain is a consistent issue on this population. In light of this, I have gone away form forward lunges with programming to avoid irritating the knee joint. Instead, I will routinely use rear foot elevated split squats or a stationary lunge position with modified range of motion centered on the client’s capacity.

In a 2008 article published in the Journal of Orthopedic & Sports Physical Therapy, the authors conclude that the best way to minimize knee pain and stress is to perform the lunge with a long step compared to a short step and without a stride compared to with a stride. Research has shown that patellofemoral joint force and stress is much greater with a short step (front heel and back toe closer together) compared to a long step at higher knee flexion angles. In addition, forces were greater with a stride (stepping forward) compared to being stationary without a stride at lower knee flexion angles.

Therefore, using a stationary lunge (or stationary split squat) with a greater step length and no forward stepping pattern may be the optimal choice to increase strength and reduce knee stress. Check out my video below from one of my recent ‘Functionally Fit’ columns for PFP Magazine.