According to the American Osteopathic Association, about one-third of Americans have knee pain. Along with the day-to-day discomfort, that can really put a damper on your sex life. Here’s the good news: Knee injuries and sensitivities don’t have to put the kibosh on sexual intimacy—in fact, having sex could be beneficial for your condition. “During intercourse, it may actually be helpful to move your knee through its range of motion, and the rush of endorphins could help you manage your pain,” says Maiken Jacobs, orthopedic patient educator and certified occupational therapist for NewYork-Presbyterian/Columbia.
If you’ve been avoiding sex because of pain or fear of aggravating your knee further, follow these recommendations from doctors and physical therapists so your sex life has more ooh and less ouch.
Take a bath.
“Take a warm Epsom salt bath before you’re intimate,” says Jacobs. The heat may help proactively ease your pain. And, what’s more, a relaxing bath is a great way to unwind and get in the mood—so light a few candles and make it a sensual ritual. Better yet, shower or bathe with your partner and make the experience part of the main event. (Here’s another surprising health benefit of taking a bath, from Prevention Premium.)
Use pillows strategically.
Extra props never hurt anyone. “Use pillows to cushion the body and to alleviate any stress on the knees,” says Jacobs. Place pillows underneath your knees, back, or stomach to help get in a sustainable, comfortable position (or one of these that practically guarantee an orgasm). Once you find one, try not to readjust too much.
“Strengthening your quads and hamstrings can help stabilize and protect the knees,” says Claudette Lajam, MD, and assistant professor of orthopedic surgery at NYU Langone Medical Center. If you work out regularly, your muscles will be able to support your knees better during a multitude of everyday activities, including sex. Squats, step-ups, and straight-leg raises are helpful exercises for people with knee pain, because these movements help to strengthen the muscles around the joint. (Got 10 minutes? Then you’ve got time to lose the weight for good with Prevention’s new 10-minute workouts and 10-minute meals. Get Fit in 10: Slim and Strong for Life now!)
Find the right position.
Keep your legs extended. If bending your knees is painful, avoid extreme knee flexion—which can aggravate an injured knee or an inflamed knee. “Stay in a position with the leg extended, with no external pressure on the knees,” says Jeffrey A. Geller, MD, professor of orthopedic surgery, and Chief of the Division of Hip & Knee Reconstruction at NewYork-Presbyterian/Columbia University Medical Center. Avoid positions with prolonged crouching, squatting, or kneeling, adds Jacobs. To keep the legs straight, stick with missionary position or try a spooning position on your side. If it doesn’t hurt to stand for an extended period of time, one partner can bend over the side of the bed with the knees softly bent.
Have morning sex.
“If you always have sex in the evening, try being intimate in the morning instead,” says Lajam. Throughout the day, your knee pain can become increasingly worse. To lessen your pain during intercourse, simply try having sex earlier in the day.
Keep anti-inflammatories on hand. If you know it’s date night, take a Tylenol in advance, so that you’re ready to go and comfortable moving, advises Lajam. Try timing your pain meds so that they take effect while you’re having sex.
Avoid putting direct pressure on the knees.
If you’ve had a knee replacement, try not to kneel or put weight on your knees. “The kneecap repurposing is made of plastic and is not made to have direct pressure on it,” says Lajam. While it won’t hurt you to put pressure on a reconstructed kneecap, it may wear out the plastic. If you haven’t had a knee replacement, it still might be a good idea to stay off your knees to avoid the extra pressure.