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I know this question is the perfect setup for innuendo-laden comments, but it is a serious question, so please limit responses accordingly.

There are at least a few activities where my natural inclination may be to kneel (e.g. sitting on the floor to play with my nieces/nephews, rotating tires on my car, working on appliances).

It seems like children can sit on their knees all day long. However, any time I have seen anyone over the age of 20 get up from kneeling to talk/play with children on the floor (myself included), they say "I'm not as young as I used to be" implying some degree of stiffness/knee pain.

Short of knee pads, is there an exercise or activity that can done to significantly improve the ability to kneel for extended periods of time without pain? Or, is this really just an unnatural position for humans that requires additional padding?

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Honestly, there's not much in terms of exercises to "build up" the knee in any way for kneeling, as the damage done is largely from the static position (most people, when kneeling, stay there for quite some time), weight directly on the joint (many people kneel with with kneeling weight entirely on their kneecap), and strain getting up. What you need to do:

  1. Maintain an active position - Shift positions as often as you can so that the blood keeps flowing and you shift the strain. This is where having better leg fitness can pay off.
  2. Distribute your weight - Try to evenly place your weight between your two legs, and on the kneeling leg, use your entire lower leg from foot to knee. As with Step 1, shift when possible, both between the legs and along the kneeling leg, to maintain blood blow and distribute strain.
  3. Practice proper technique when getting up - I am not an expert here, but I have found that the ideal way, if you can do it, is to simply go straight up with your feet winding up with weight evenly distributed, one foot in front of the other. That takes some muscular strength and coordination, though, so your next best bet is to shift your bodyweight largely onto the non-kneeling leg (if you've been kneeling on one leg, shift one so that the sole of your foot is down and use that leg), centering your torso over that leg, and lean forward as you rise up, knee bent, optionally using your hands on either side of that supporting leg to keep your balance, and then straightening up at around the halfway point. Either way, a good training to build up the knee and leg strength (and to emphasize technique) is the "drop-knee lunge" which can either be done as a standard lunge where the trailing leg is bent so that the knee just touches the ground, then pushing back into position, or can be done from a standing split position by going straight down and straight up.
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