Exercises for Knee Pain

Knee pain is something that hundreds upon hundreds of millions of people experience worldwide. It’s so common that the odds are that every adult will experience some form of knee pain at some point in their life.

Why is this? The answer is relatively straightforward: our knees bear the most weight of any joint in the body, with constant pressure, and depending on factors like weight, strength, types of activity, degenerative disease, and more, our knees can take a beating over time.

You can do many exercises to help address and alleviate knee pain. Exercises that strengthen the lower body, from the ankles to the hips, can significantly help the knees improve strength and resilience over time.

Health Report Live offers knowledge and resources to help you better understand and overcome knee pain.

Understanding What Knee Pain Is

Symptoms

As the knee is a very complex joint, the sensations and symptoms one can experience with knee pain are likewise complex.

First, knee pain can have different types of feelings. Knee pain might feel like a dull, droning pain at different knee locations, a sharp pain that only occurs with specific motions, a burning sensation, a tingling, numbness, and more. 

The type of pain one feels in the knee generally indicates the nature of the injury in the knee.

Knee pain can also occur in different locations and stimulates by different motions. Occasionally, knee pain occurs on the side of the knees, while some knee pain occurs in the back of the knees. 

Other knee pain occurs at or beneath the knee cap, and sometimes the entire knee might feel swollen to the touch. 

In one location, sharp stabbing pain might indicate an acute injury like a torn meniscus or ligament. 

In contrast, a dull, lightly pulsing pain when walking might indicate tendonitis or some form of cartilage degeneration such as osteoarthritis.

Causes

Knee pain has several causes; the indirect causes of knee pain are mostly due to activity and lifestyle. In some instances, such as with rheumatoid arthritis, anti-immune diseases can contribute. 

Aging, in general, contributes to the breakdown of joints over time, as the body wears down and produces less blood and other fluids that help cushion the joints.

Being overweight can be a huge factor contributing to knee pain. The knee is an incredible joint that can withstand a high amount of force, but if a person is 25, 50, 100, or more pounds overweight, the knee joints will simply not be able to keep up, no matter how much muscle in the legs someone builds. 

When people live and perform strenuous activities while being overweight, this can significantly affect knee pain.

Certain activities also contribute to knee pain over time. High-impact sports like basketball, volleyball, soccer, and other activities that require constant bending and cutting motions put significant stress on the knees. 

Overuse and not allowing the knees to recover after strenuous activity can reduce knee pain.

Injuries, including small injuries like microscopic tears, contribute to knee pain. A torn ligament, a torn meniscus, or damaged cartilage under the kneecap, for example, can all contribute to significant knee pain and can worsen or complicate without proper treatment.

Too much inactivity can also contribute to knee pain. The body is designed for motion, and if a person is still for too long, this can create stiffness in the joints and decrease fluids moving to the knee.

On the other hand, fluid issues, such as bursitis and gout, can also significantly contribute to knee pain. These issues occur when inflammation causes a buildup of fluid and acid that creates pain in the knee.

Finally, infections or fractures in the bones of the knee themselves can be a significant source of knee pain. 

Not getting enough rest, overactivity, exerting your knees after injury and exacerbating the injury, not operating at a healthy weight, and not having proper treatment or strength training to help protect the knee and diminish impact and shock over time, can all be significant causes of temporary or chronic knee pain.

Prevention

The old saying goes, “An ounce of prevention is worth a pound of cure.” (Although we will be suggesting a few ideas, these are not to be construed as medical advice).

Many knee issues such as degeneration of cartilage, orthopedic issues, inflammation of the tendons or ligaments, lack of strength in the muscles surrounding the knee, and so on are related to lifestyle and activity, much of which are within one’s control.

From a broad level, one of the most effective ways to prevent knee pain is to maintain a healthy weight. Whether you are 50 or 100 pounds overweight, every step you take utilizes your knee joint which causes it to be severely compounded and stressed. 

Even though your leg muscles might get stronger to compensate, your knees are simply not designed to withstand that much extra weight with every step, day after day, month after month, and year after year. 

The single most important step you can take, pun intended, to ensure the health of your knees is to lose weight and keep it off.

Stretching, which we will explore in detail, is another great way to help preserve your needs. As you stretch and lengthen your muscles and tendons, they become more flexible and useful for absorbing shock and helping the body move as it is supposed to. 

Your knees will greatly benefit when the muscles surrounding them are stretched and utilized properly.

A third important step to prevent knee pain is to avoid over-using your knees and to give them significant periods of rest and recovery. 

Your knees are just like any other part of your body: they have their purpose, but they will start to break down if you overuse them.

Fourth, you can prevent knee pain over time by listening to what your body tells you. Pain is your body’s way of letting you know something’s wrong, and it is important to become more intelligent about the particular type of pain you are experiencing to know how to heal. 

Knee pain specifically concentrated right under your knee communicates a different message than if your pain were along the back of your knee. 

Knowing how to diagnose knee pain with the help of a trained physical therapist and potentially utilizing physical therapy is a hugely important step in healing and preventing further knee pain in the future.

Is It Safe to Exercise?

Excercise safety is a complicated question because the answer is not always immediately clear. There are several variables in play.

First, knowing whether it is safe to exercise depends on the nature of your injury and the source of your knee pain

If you have recently been diagnosed with a torn ACL, it is essentially impossible to exercise with jumping and cutting motion, as you will need surgery to repair this injury. 

It could potentially be viable to walk, but depending on the severity of the injury, you would need the help of a medical professional to make a good judgment about what you can and cannot do.

The other factor is the nature of the exercise you want to do. For most knee injuries, it is usually not wise to engage in strenuous activity that puts stress on it, like jumping, bending, and lateral motion. 

However, in many instances, it is safe to do upper body exercises that allow your knee to rest. It is always better to achieve some type of motion after a knee injury simply to help blood flow and keep the body in shape, if possible.

In summary, the answer to this question is that it entirely depends on your injury and the nature of the exercise you want to do. In any situation, self-diagnosis or trying to determine what is best by looking at health websites is not a wise move. 

A trained physician will be able to ask questions and even use equipment that you will not be able to use on your own to determine the nature and extent of your injuries and prescribe a plan for safe exercise.

Can Knee Pain Be Cured by Exercise?

Like the question above, the answer to this question is, “It depends.”

First, the type of pain one experiences determines whether the pain can be “cured.” If one experiences knee pain strictly related to being overweight and no other factors, losing weight will functionally “cure” the pain by placing a normal pressure level on the knee joints.

In some situations, the exercises involved in strengthening the leg muscles around the knee can help “cure” the knee pain. 

If someone is experiencing a cartilage breakdown in one knee due to that leg not being strong and coordinated/balanced, the exercise of strengthening that leg can help reduce shock to the knee as the muscles absorb more shock. 

There is less shock placed upon the cartilage as this happens, allowing for more blood flow and potential healing. 

Sometimes your left leg is weaker, your right leg is stronger, and vice versa. This imbalance can cause knee pain, and it is important to achieve a balance of strength.

However, for many types of knee pain, “curing” will involve much more than just exercise, although exercise will be an important ongoing factor. 

In situations where the knee has bone spurs or rough cartilage causing pain, surgery may be recommended to smooth out the knee’s rough portions.

One can think of knee pain as something that can be “cured” by exercise in the sense that exercise is a great way to manage and reduce knee pain, keep the knee in healthy motion, and maintain a healthy weight that reduces unnecessary pressure on the joints. 

Strengthening and stretching muscles around the knee are crucial practices for helping to ease knee pain and reduce the risk of greater pain in the future.

Warm Up First

In any form of exercise, it is important to start with a warmup routine to get the joints ready to move. Walking, jumping up and down a bit (not intensely), and achieving a small increase in heart rate is a great way to warm up the body.

Different Exercises to Help Relieve Knee Pain

Stretching Exercises

Multiple lower-body muscle stretching exercises can help lengthen the muscles and tendons that connect to your knee and put your knee in a great position for mobility, blood flow, pain relief, and healthy flexibility during exercise.

Heel and Calf Stretch

You can stand at the edge of a step or raised surface with either one or both feet shoulder-width apart in this stretch. Your feet should be halfway off of the edge of the stairs or on a raised surface as a starting position. 

Allow your feet to depress down gently, and hold this position for about 10 seconds. Slowly bring your feet up to a tiptoe position, and hold this position for about 10 seconds. 

Then, relax the feet. Repeat this cycle 2-3 times to stretch and strengthen the calf muscle and heel, which are crucial for healthy knee function.

Quadriceps Stretch

To stretch your quadriceps:

  1. Stand on one leg, and hold onto a wall to support yourself if needed.
  2. With your free hand, grab the ankle of your free leg (these should be on the same side).
  3. Gently pull your leg up into a full bend and hold this position for 8-10 seconds.
  4. Repeat the process with the other leg.
  5. Do this 2-3 times to provide a great stretch to the thigh muscles.

Hamstring Stretch

This stretch works best with another person, but iyou can also it it alone. Lie flat on your back and lift both of your legs. 

If you can reach the back of your thigh, or your hamstrings, gently pull them close to you while keeping them as straight as possible. 

You can also use a rope or stretch band if needed. A stretch band will provide a great stretch for your hamstrings. You can also try to touch your toes from a sitting-up position, helping with back pain and range of motion.

Single Hamstring Stretch

Like the hamstring stretch, the single hamstring stretch involves sitting up but with one leg tucked toward you in a bow-legged position. 

You should stretch out your other leg in front of you. Reach forward and try to touch your toes, or get as close as possible. Hold this position for 8-10 seconds, then repeat with the other leg.

Knee Stretch

To perform the knee stretch, place one knee in front of you and allow your other leg to extend back behind you, keeping your back as straight as possible. Place your hands on your front knee, and move your upper body forward slowly and steadily. Do this for 8-10 seconds, then switch.

Straight-Leg Piriformis Stretch

Lie flat on your back. Lift one leg, bend it at a 90-degree angle, and rotate it to look directly at your inner leg bent in the direction of your left (or right). 

Slowly and gently, place one hand on the knee and one hand on the ankle, and bring your leg as close to your chest as you can get it. 

Taking this stretch slowly and carefully will also work your abdominal muscles.

Ankle Stretch

Sit on a chair. Lift one leg and let it rest in a square position on the other. Your ankle should be hanging over your thigh in this position. 

Rotate your ankle, extend it, and move it in as many ways as possible. Hold it in certain positions, then release it.

Horizontal Straight-Leg Raise With Chair

Sit on a regular chair with your feet decently far in front of you. Holding on to the front of the chair with both hands, lift one leg and extend it as far outward and straight as possible. Hold this for 10 seconds, then repeat with the other leg.

Muscle Stretch

As you stretch your muscles in general, you will feel a greater sense of looseness and flexibility, greatly benefiting your knees.

Leg Stretch

There is plenty of leg stretches you can do, but continue to focus on stretching the quads, hamstrings, and calf muscles, the three biggest muscle groups in the legs.

Strengthening Exercises

Now that you are more familiar with stretching your lower body, here are some knee exercises you can do to get stronger, as strong muscles help to promote strong joints. 

Do these as part of your exercise program for as many reps as you can without burning yourself out.

Half Squat or Wall Squat

Sit against a wall for 30-90 seconds.

Calf Raises

Stand on a step or a raised surface that allows your calves to depress down to a full stretch. Holding onto a rail or wall, attempt to go into a tiptoe position, starting from being as low as possible. Do this 10-15 times, then rest. Repeat 2-3 times.

Hamstring Curl

You will lay on your stomach on a hamstring curl machine while weaving your legs into two protruding pads. Pull the pads toward yourself ten times at a moderate resistance until you have a fully bent knee. 

Alternatively, some hamstring curl machines involve sitting up straight and pushing down on a pad.

Leg Extensions

You can do leg extensions on a machine or a chair as described above. You will sit on a chair-like apparatus with a pad that goes above your ankles on a machine. 

Set the machine to moderate resistance, then slowly extend your legs forward, which will work out your quadriceps. Do this for ten repetitions, then rest for a minute. Do this 2 to 3 more times.

Straight Leg Raises

Lying flat on your back, lift one or both legs simultaneously. Hold your lift in the air for 10 seconds, then slowly bring it back down. Do this ten times. Leg raises are also a great workout for your abdominal muscles.

Side Leg Raises

Lying on your side, supported by your elbow, bring up one of your legs like an opening scissor. Hold for 10 seconds, then bring it back down. Repeat 5-10 times, then flip to the other side and repeat with the other leg.

Prone Leg Raises

Lying on your stomach on the floor, kick your legs upward in a slow-motion swimming-flutter-kick motion. Do this for 30-45 seconds, rest for 1 minute, and repeat two times.

Step-Ups

Using a staircase or raised surface, step up and down from the surface in a left, right, left, or right pattern. Increase the speed to get a better workout, and do this for 30-45 seconds at a time. Rest 1-2 minutes, then repeat two times.

Leg Presses

Leg presses are one of the best workouts for the quadriceps muscles. Using a leg-press machine at a gym, load a moderate amount of weight onto the machine, then press forward, hip-width apart, for ten repetitions, allowing the machine to press so that your thighs come within a foot of your chest. 

You will feel the front of your thighs working hard. You can do this as a single-leg exercise, but make sure to greatly reduce the weight. 

This will also help your hip muscles and glutes, and it’s one of the best knee strengthening exercises you can do. Rest for 1-3 minutes, and repeat two times.

Other Types of Exercise to Reduce Knee Pain

Clamshells

Lie on your side as if you were doing side leg raises. Have your knees slightly bent so that your legs resemble a closed clam. Lift one leg as high as you can to resemble a clam opening its shell, then close the legs. Do this ten times.

Bridging

Lie on your back with your palms on the floor and your knees bent. Using your back muscles and glutes, lift your stomach into the air as much as possible while keeping your hands and feet flat on the floor.

Hip or Leg Abduction

Hip/leg abduction exercises are any motion that makes your legs and hips open like a pair of scissors. These can be done from a standing position, lying on your side, using an abduction machine, etc.

Unweighted Flexion

Lay on your back with both legs pointed upward. Extend your arms outward at your side to maintain balance. 

Make a cycling motion with your feet straight up in the air. Make the range of motion as large as possible, so your “flexion” in your knees goes from almost straight and extended to bent at a 90-degree angle.

Quadruped Hydrant

In quadrupled hydrant exercises, you will kneel on the floor with your hands and your knees, with your back straight and parallel with the floor. Lift your legs individually and extend backward, to the side, making a kneeing motion toward your stomach, and so on.

Sit or Stand

In this simple exercise, you will transition back and forth from a sitting position to a standing position. This exercise will work out your quad and hamstring muscles and is a great overall lower-body exercise.

Quads Exercise With Roll

Lie down flat on the floor, with a foam roller underneath your quads. Use your quads to help propel you (rolling motion) forward and backward.

Leg Cross

Lying down on your back, lift your legs, keeping them fully extended. Allow your feet to cross over each other, then bring them apart, then over each other again with the opposite foot on top.

How to Tell if You Are Exercising Right

Pain During Exercise

If you have pain during exercise, especially if it is a sharp pain, this is your body’s way of communicating that something is wrong. The general strain of exertion is different from acute pain.

Pain After Exercise

If you experience pain after exercise, depending on whether it is acute or dull, this is not as serious but still could mean that you might be exercising incorrectly.

How Often Should You Exercise?

It is best to consult with a physical therapist to answer this question, but in general, a good goal for exercise is 150 minutes per week as a baseline.

What Is the Best Exercise for Knee Pain?

Your quadriceps muscles are the muscles that are most connected to your knee, so any exercises that strengthen the quads as the leg raises will be ideal for knee pain.

What Exercises Should I Avoid With Knee Pain?

You should avoid any exercises that put direct stress on the knee, like squats, deadlifts, or jarring exercises like lunging, running, jumping, etc.

What Else Can Help With Knee Pain?

Massages, ointments and creams, and rest and cold therapy can help with knee pain.

Know When to See Your Doctor

When your knee pain is very sharp, make an appointment to see your doctor immediately.


Photo of author

Stevie Compango, CNSC, CPT

Stevie is Certified Nutrition Specialist and Certified Personal Trainer for the past 10 years. He specializes in mobility and chronic pain management. His methods have helped thousands of clients improve the quality of their life through movement.

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