HYROX Knee Pain: What's Causing It and What to Do About It (Part 1)
- Hannah Breal, PT, DPT
- 24 hours ago
- 4 min read
About the Author: Hannah Breal, PT, DPT is the co-owner of Made 2 Move Physical Therapy in Charleston and Charlotte. She helps athletes and active adults rebuild strength, mobility, and confidence so they can move pain-free for life.
Made 2 Move Physical Therapy – Charleston | Daniel Island | Mount Pleasant | Charlotte
If you're training for HYROX but your knees are killing you, this is for you.
HYROX is all the rage these days. It's the new fitness thing, and honestly, I can see why!
It's pretty accessible (no high skill required), it involves a lot of different movements, it's a great workout, aaand you get some pretty sick professional pictures.
Knee pain is one of the most common complaints we've seen so far in HYROX athletes.
and really, it makes a lot of sense.
Running.
Sleds.
Wall Balls.
Lunges.
Broad Jumps.
Your knees are working super hard through all of it.
BUT before you go around saying "HYROX is bad for your knees" (please do NOT spread that myth), let me be clear:
It's not bad for your knees. It does require you to have strong and prepared knees.
It's like any other sport or workout it's going to place demand on your body (that's the whole point)
that demand can help us adapt and get stronger, faster, and healthier.
BUT
If that demand exceeds your capacity to recover and adapt to it, you might experience pain or injuries.
but again: having pain doesn't mean you are permanently injured. it doesn't mean you need to give up on being active or stop training for your goals.
It means we need to change something so you can overcome that injury and get back to doing what you love and maybe even hit a PR!
Why HYROX Athletes Get Knee Pain
Typically, HYROX athletes with knee pain fall into 1 of 4 categories:
They do a race without being fully trained or prepared for it
They go from barely training/running to training 5-6x a week overnight without a ramp up phase
Their training doesn't prepare them enough for the specific knee demands
They have a previous injury that shows up in intense training seasons
The Two Things That Make It Worse
But here's where it really starts to get bad:
Way too many people try to ignore it, push through pain with training, and hope it goes away on its own (spoiler alert: it doesn't)
OR
They completely stop training, rest, and wait it out (and then the problem is worse when they go back into it)
Neither one fully solves the problem. Don't do either of those things.
What We Did Instead: Malina's Story
We actually need to find something in the middle, like we did with our client Malina.
Her knee pain got a lot worse with running, and if you know anything about HYROX it's a lot of running. (a lot more than you think, I promise. it's an endurance event)
She had a race on the calendar that she really didn't want to sit out, so after an assessment, we restructured her training, addressed what was actually causing the pain, dialed in her running plan, and added knee-specific exercises.
A month later, she did HYROX DC without any knee pain.
In Part 2 next week, I'll go through specifically what worked for her and how to start solving the most common HYROX related knee injuries.
The Most Common Knee Structures Involved in HYROX Injuries
BUT before we do that here are the most common knee structures involved with HYROX-related knee injuries:
1. Patellofemoral Pain - Quad and Kneecap
Achy, nagging pain around or behind your kneecap (in the front of your knee)
gets worse with squatting (ahem, wall balls), lunges, running, stairs, and sometimes sitting for longer periods of time.
So you can imagine how your knee might feel doing all those movements in HYROX...
2. Quad/Patellar Tendinopathy - the Tendon Itself
Localized pain right at above or below your kneecap. It usually feels better once you get moving, but WORSE the next day, especially after too much load. Tendons are quite picky, like goldilocks.
3. IT Band - Outside of the Knee
Especially common with running. Feels tight and localized, will get worse with turns and hills, and might come on during your runs.
A lot of people think foam rolling is the solution - but this IT band pain is usually already a compression issue, so compressing it more... doesn't work.
The Common Thread
Most of these injuries are treated with the same principle: load management.
It's the exercise selection and individual assessment that makes the difference in solving it.
Just resting, icing, stretching, or pushing through the pain makes all of it worse.
Sometimes we DO need to dial things back temporarily or train with some pain but that's not the actual SOLUTION. That's just one step.
You need something that keeps you training AND actually fixes the problem.
That's what we'll talk about in part two next week,
see ya then!
Dealing with knee pain and training for HYROX in the Charleston area? Our physical therapy team at Made 2 Move works one-on-one with HYROX athletes and active adults in Daniel Island, Mount Pleasant, and Downtown Charleston. We'll help you figure out what's actually going on and keep you training toward your race. See how we work with athletes or hear from our patients who've competed pain-free.
If You’re in Charleston, Daniel Island, Charlotte, or Mount Pleasant…
At Made 2 Move Physical Therapy, we help active adults and athletes and recreational athletes get out of pain and keep doing what they love.
We have three convenient locations:
Our team of DPTs can help you move, play, and live without limitations.
👉 Learn more about physical therapy for runners
Want to understand your body better, move with confidence, and stay active for life?
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Written by Hannah Breal, PT, DPT, Co-Owner of Made 2 Move Physical Therapy, helping Charleston and Charlotte move pain-free for life.
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