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How would you modify a hip flexor stretch for someone with knee pain?

Increase knee bending

No modifications

Push knee into hyperextension

Stabilize pelvis and keep pain-free ROM with adjusted hip/knee angle

The main idea here is to protect the knee while still lengthening the hip flexors. When someone has knee pain, the stretch should focus on the hip joint and keep the knee at a pain-free position. Stabilizing the pelvis helps prevent compensations like an excessive low-back or pelvic tilt that can transfer strain to the knee. Keeping the range of motion within what feels pain-free and adjusting the hip/knee angles lets you load the hip flexors (such as the psoas and iliacus) without stressing the knee joint.

Increasing knee bending would push more load into the knee and likely worsen pain. Pushing the knee into hyperextension can irritate the knee cap and ligaments. Not modifying at all ignores the knee issue and risks aggravating symptoms. By stabilizing the pelvis, maintaining pain-free ROM, and choosing an appropriate hip/knee angle, you effectively stretch the hip flexors while keeping the knee safe.

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