Getting In and Out of the Car With Knee Pain (and the Secret No One Told You)

Watch someone with knee pain get out of a car and you’ll see something fascinating.

They don’t just stand up. They rotate first. They swing both legs out. They put one hand on the doorframe, one on the seat. They push up with their arms more than their legs. They lead with the good side.

They’ve choreographed the whole thing without even realizing it. And if you asked them, they’d say “I’m fine, just a little stiff.” But I see the strategy. It’s the same strategy I see with a dozen other clients because the body only has so many ways to solve this problem.

What makes the car so tricky

Getting in and out of a car involves a combination of movements that are uniquely challenging for a painful knee:

Rotation under load. You have to pivot your body while one foot is planted. The knee doesn’t love rotation, especially under load. It’s designed primarily to bend and straighten. The twisting is managed by ligaments and meniscus, which are often the structures that are already irritated.

Low seat height. Most car seats sit lower than a dining chair. That means your knee starts at a deeper bend, and the muscles have to work harder from that position to get you upright. Sound familiar? This is the exact same problem as the toilet just in a different context.

Why Getting Off the Toilet Shouldn’t Be the Hardest Part of Your Day

Limited space. You can’t adjust your foot position easily. You’re constrained by the doorframe, the steering wheel, the pedals. Your body has to make it work in a tight space with limited options and limited options mean more compensation (and further your knee needs to bend).

The driving-plus-exit double whammy

Here’s what makes the car especially sneaky: it combines two problems.

First, you sit with your knee bent for 20, 30, 60 minutes. You get the stiffness effect. Our bodies crave movement and when we are sitting still the best motion is the next motion. It is important to not constantly keep our body in one position. Have you ever seen some nursing home residents who walk bent as if they were still in a chair? It isn't their fault, they truly have spent too much time in that position and their muscles have trouble stretching back to upright. (I wrote about knee stiffness and synovial joint fluid in detail in my article on knee pain after sitting too long, same mechanism.)

Knee Pain When You’ve Been Sitting Too Long

Then, right when your knee is at its stiffest and least prepared, you ask it to do one of its hardest jobs: rotate, extend, and bear your full weight from a low position. In a tight space. Usually in a hurry because you’re late or you really need that gas station bathroom.

It’s no wonder the car is where people first notice something is wrong.

The workaround you didn’t plan

The compensations people develop for getting in and out of the car are some of the most creative I see. Leading with the opposite leg. Scooting to the edge of the seat before attempting to stand. Grabbing the roof handle or the door frame. Avoiding parking spots where the car door can’t fully open.

These workarounds are smart. They got you through the day. But they’re also signals — your body telling you that the muscles around your knee don’t have the strength or the trust to do this movement the simple way.

What’s actually going on

The car challenge comes down to the same fundamentals that show up everywhere else in these articles: quad and glute strength, the ability to control rotation at the knee, and the confidence to load the leg without bracing through it.

If you’re seeing this pattern in the car AND on the stairs AND getting off the couch AND at the toilet — you don’t have five different problems. You have one problem showing up in five places. The underlying cheat pattern is the same. I break down how to identify yours in my squatting guide.

Knee Pain When Squatting: The Cheat Pattern Fix: give me 10 minutes and I will show you what your knee is trying to tell you

Small changes that help right now

Before you get out: open the door fully. Swing both legs out first, then scoot to the edge of the seat. Plant both feet flat on the ground. Push through your legs, not your arms. Take a breath.

This isn’t a permanent fix, it’s a better strategy for right now. The real solution is building the strength and mobility so none of this requires a strategy at all.

And after a long drive: give yourself ten seconds of standing before you walk. Or better yet, do a few ankle pumps before you even start to get out of the car. You will increase circulation in your legs and help your body to overcome the stiffness faster. Your first few steps shouldn’t be a sprint to the gas station bathroom.

If the “after driving” stiffness is a big piece of your picture, my spring walking plan article has a section on timing your walks for when your knee feels best and post-drive is often a great time for a short warm-up walk.

How to Start a Spring Walking Plan with Chronic Knee Pain

If you’re noticing more and more of these workarounds in your daily life, that’s your body asking for help. In 3 Steps Forward, I share one focused insight each week to help you start taking that next right step.

Want to measure where your knee actually is before you start? The Knee Function Self-Test gives you a score across six real-world movements including balance and sit-to-stand so you know your starting point.

Take the Knee Function Self-Test