Physical Therapy Exercises for Knee Pain

Physical therapy is often an essential part of your overall healthcare plan. While your primary care physician or orthopedic specialist provides diagnosis and medical advice, you will spend far more time with your PT as your knee heals. They may also help you avoid long-term medications for pain relief and surgery. Proper PT can even treat sciatica.

Health Report Live reviewed the most up-to-date and authoritative sources to provide meaningful information about physical therapy and knee pain.

Anatomy of the Knee

The knee is where the bones of your lower leg and top leg meet. The largest joint in your body, the knee, allows you to walk, sit, or squat.

Three bones make up the knee:

  • The Tibia is the bone in front or between the lower leg and the shin bone.
  • The Patella is the thick, triangular bone at the top of your kneecap.
  • Femur – The upper leg bone or the thighbone.

Cartilage covers the ends of the bones. This elastic, slick material absorbs shock so bones can glide against one another as they move.

There are two crescent-shaped cartilage pads between the femur and tibia bones. These pads help reduce friction and distribute the body’s weight over the joint.

  • The lateral meniscus is on the outside of your knee.
  • The medial meniscus is on the inside of your knee.

The joint capsule that holds the bones together comprises two layers: an outer membrane of connective tissue and an inner membrane known as the synovium. Fluid secreted from this membrane lubricates the joint.

The tendon and ligaments that support the outer capsule at both ends of the bones are:

  • The quadriceps tendon attaches the quadriceps to the patella.
  • The MCL or Medial collateral ligament provides stability to the inner knee.
  • The ACL, or Anterior Cruciate ligament, is located in the middle knee. It prevents forward movement of the Tibia.
  • The middle of the knee is the PCL or Posterior Cruciate ligament. It prevents the knee from moving backward.

Two groups of muscles support the knee. These two groups are:

  • Hamstrings are the muscles that run from your hip to your knee in the back of your thigh.
  • Quadriceps–Four muscle groups in front of your thigh that run from your hip to your knee. They bring your knees straight from a bent position. Toning your hip muscles often helps to alleviate knee pain.

Strengthening abdominal muscles is also beneficial when you have knee pain.

What Type of Knee Pain Do You Have?

Sometimes, your knees crackle or creak when you bend them. These sounds, known as ‘crepitus,’ can be alarming but not necessarily a sign of a problem unless your knee hurts simultaneously with this sound. That could indicate a severe injury such as a tear in the meniscus or a fractured kneecap.

The combination of pain and sounds can also indicate osteoarthritis. You should consult your doctor to determine the cause of your unusual sounds and painful sensations. 

You can also experience other forms of pain such as knee pain with a ‘crunch,’ when running, climbing stairs, in the morning, sudden and severe pain, and pain with bending and kneeling.

When an Injury Causes Knee Pain

Pain is an indication that something is wrong. Acute pain quickly appears and disappears when there is no cause. Chronic pain can last for six months or more and may not resolve until one treats the injury or illness.

The most common knee injuries are:

  • Knee Fracture
  • Knee Dislocation
  • Knee Ligament Injury
  • Meniscus Tear
  • Knee Tendon Tear

Location of Knee Pain Symptoms

Pain at the Knee Outside

Although there are many causes of pain on the outside of the knees, the most common is Iliotibial Band Syndrome, also known as IT band syndrome. According to Cedars-Sinai Medical Center medical researchers, anyone can get iliotibial syndrome, but it is quite common among distance runners.

Pain on the Inside of the Knee

The medial or inner knee refers to the area closest to the other. This area can be affected by a variety of injuries or conditions. These include:

  • Injury
  • Trauma
  • Bursitis
  • Sprain or tear
  • Torn meniscus
  • Knee osteoarthritis
  • Medial plica syndrome
  • Rheumatoid Arthritis

Pain on the Inside of the Knee

  • Cartilage tear: The meniscus, which provides cushioning for the knees, and the chondral, which provides a smooth coating for bones, are two common areas that can be injured.
  • Knee sprain – The Posterior Cruciate Ligament, which runs in a cross-shape at the rear end of the joint, can be a culprit.
  • Hyperextension – is a condition where the knee joint bends backward. Baker’s cyst – is the most common cause of rear knee pain.
  • Hamstring issues – is a condition where small tears cause inflammation and pain.
  • Calf strain: The soleus and gastrocnemius (calf muscles) can become tired, strained, or torn and cause posterior knee pain.

What to Expect from Physical Therapy for Knee Pain

Your physical therapist will ask questions about your knee pain and what caused it. To get a better understanding of your pain, your therapist may also perform an examination. The following may be included in the examination:

  • Palpation – The PT will feel the structures around the knee with their hands.
  • Assessment of your gait – Your therapist will evaluate your walking ability during this portion of the exam.
  • A range of motion assessment – This assessment can help a therapist understand how far you can bend and straighten your knees.
  • Evaluation of balance
  • Your strength is measured–Your PT will measure your strength to determine if your leg muscles are weakening.
  • Assessment of swelling – the therapist will examine the knee for swelling.

Physical Therapy Knee Exercises for Strong and Healthy Knees

PT Treatment for Knee Pain

A study published by the Journal of Orthopedic & Sports Physical Therapy (JOSPT) compared the effectiveness of exercise therapy, nonsteroidal, anti-inflammatory drugs (NSAIDs), and opioids for knee osteoarthritis pain. 

While close to each other in efficacy, physical therapy knee exercises were most effective in the treatment of knee pain.

Exercise and knee pain

The best exercises for knee pain are:

  • Straight Leg Raise – Lay on your back and keep your knees bent. Keep your foot flat on a table. Keep your straight leg straight by tightening the knee and elevating it to the same height as your bent knee. Your quads and hip flexors will be working. Engage your abdominal muscles while keeping your pelvis straight.
  • Bridge – With your knees bent and feet about shoulder-width apart, lie on your back. Lift your hips as high and squeeze your glutes. Then lift your toes off the ground and place weight on your heels. This will increase your work on your glutes and hamstrings. Just to tap, lower your hips.
  • Ball/Wall Squats – A stability ball is placed between your lower back and a wall. Keep your hip bones distance apart and step forward a few feet. To bring your thighs nearly parallel to the ground, bend at your hips. 

You should keep your back straight and your knees in line with your ankles. To bring your back to the starting position, squeeze your glutes. This will target your glutes and quads!

  • Step-ups – Start with a 6″ step, then add a sturdy box to increase the height. Place both your feet on the box. Keep your pelvis level and step back with one leg. Next, tap your toes on the ground. Then, straighten your leg by stepping up. 

Keep your knee aligned with your second toe. This exercise is great for the vastus medialis muscle, which helps with patellar stability. Do 15-20 step-ups and then switch legs.

  • Lateral Walks – Using a band around your ankles, squat slightly, place weight toward your heels, and keep your knees above your ankles—step to the side with a focus on your outer hip. Maintaining constant tension on the band, step to the right ten times, then switch to the left.

Is It Safe for Me to Exercise?

Exercise should be part of your daily life, even if you have osteoarthritis in the knees. It is important to be able to identify the correct exercises and how to do them. For adults suffering from knee pain, long-term exercise is generally safe.

Exercises that stimulate knee strengthening will ensure you can return to your normal activities as soon as possible. As always, following your physical therapist’s suggestions, for warmup stretches, repetitions, and form are essential.

No-No’s for Your Knee

You should stop exercising if you have any of these symptoms.

  • Swelling increased
  • ·Sharp, stabbing, or constant pain
  • Pain that makes you numb or unable to walk properly
  • Redden joints that feel warm or redden to the touch
  • Pain that persists for more than two hours after exercising or worsens at bedtime

Physical Therapy Exercises to Reduce Knee Pain

Warm Up First

Strengthening exercises

  • Half Squat
  • Calf Raises
  • Hamstring Curl
  • Leg Extensions
  • Prone Straight Leg Raises/Straight Leg Raises
  • Side Leg Raises
  • Ball/Wall Squats
  • Step-Ups
  • Leg Presses
  • The Bridge/Bridging
  • Clamshells
  • Hip Abduction
  • Quadruped Hydrant
  • Lateral Walks

Other types of exercise for knee pain

Some other types you PT may approve of are:

  • Lateral Pendulum (Warmup)
  • Forward Pendulums (Warmup)

Standing Quad Stretch

  • Basic Hamstring Stretch
  • IT Band Stretch
  • Supine Hamstring Stretch
  • Downward Dog Calf Stretch
  • Straight Leg Raises
  • Prone Straight Leg Raises
  • Quad Sets
  • Floor Quad Extensions
  • Floor Lateral Leg Raises
  • Squats
  • Back Lunges
  • Donkey Kicks
  • Roundhouse Kicks

Knee-Friendly Cardio

You do not want to make your pain worse by doing the wrong type of exercise. However, many conditions can be improved with exercise. The best exercises for cardio exercises include:

  • Swimming – Swimming is one of the best choices if you have knee pain. The water keeps your body buoyant, taking the impact off the rest of your body while allowing you to get a great cardio workout and strengthen the muscles that support the knee.
  • Upper Body Ergometer–this is just like a bicycle for your arms. You sit in front of it and cycle the pedals with your hands to get your heart rate up. This puts no pressure on the knees, so this is a good choice if you have a severe injury or you’re recovering from surgery.
  • Treadmill – A treadmill is a great option if you can walk comfortably. The moving belt provides a cushion that concrete sidewalks cannot provide.
  • The Rowing Machine – Another option is to try the rowing machine because it works the quads as well as the hamstrings and helps build strong knees. However, the movement can be repetitive and may cause knee pain. Start slow and keep it going for a few seconds to get a feel for how your body reacts.

Benefits of Working with a Physical Therapist to Resolve Your Knee Pain

Supervision & Safety

You will feel less anxious working with an expert, and you will feel more confident if you exercise under the guidance of a physical therapist. You can visit your local physical therapy office, which will make it easy for you to get back in shape.

Specialized Care

You may notice that your physical therapist has the title of DPT. That means they have earned a Doctor of Physical Therapy Degree. An MPT holds a master’s in physical therapy, while a DPT is a doctorate in physical therapy. Most are members of the American Physical Therapy Association.

A physical therapist, also known as PT, is a licensed healthcare practitioner who has completed a graduate program that helps patients to reduce pain and improve mobility. In the US, the entry-level professional degree for physical therapy is now the Doctor of Physical Therapy (DPT).

The ability to help clients with pain is one of the many benefits offered by physical therapists. About 46% of people visit physical therapists to relieve their back pain, and physical therapists often work as spine and back specialists. 

This type of care is more effective than just getting in shape with your usual routines. Physical therapy can also be used to treat other conditions.

Creative Solutions

Even if your fitness hobby is intense, you may not know how to incorporate physical therapy into your daily life. Physical therapists are experts in this area. They can help you regain your normal activity, even if it is modified to address any permanent or long-term physical conditions. 

This can make a huge difference in your overall fitness and your emotional well-being.

How Can I Rehab My Knee at Home?

Some of the best knee exercises you can do at home are:

Straight-Leg Lift

Place one leg bent on your back and the other straight on your stomach. Slowly lift your straight leg until it is just a foot above the floor. Keep it there for three to five seconds. Slowly lower your knee to the ground. Switch sides.

Two reps with rest between are recommended.

Single-Leg Dip

Place one leg bent on your back and the other straight on your stomach. Slowly lift your straight leg until it is about one foot above the floor. Keep it there for three to five seconds. Slowly lower your knee to the ground. Switch sides.

Two reps with rest between are recommended.

Hamstring Curls

For balance, hold on to the backrest of a chair. Your weight should be supported by your other leg. The heel of the other foot should be lifted towards your buttocks. For 3 to 5 seconds, hold the position. Slowly lower your leg. Continue this process and switch sides.

Two reps with rest between are recommended.

Knee Stabilization Series

To balance, hold on to the backrest of a chair. Lift one leg slightly. Place your weight on the supporting leg. Move your leg in the following direction: Tighten your thigh muscles with your lifted leg. For 3 to 5 seconds, hold the position. Slowly return to the beginning and continue. To begin the next exercise, rotate your body 90 degrees.

Two reps with rest between are recommended.

Can knee pain be cured by exercise?

Often, knee pain can be cured through a proper exercise program.

What else can help with knee pain?

No one wants to hear this, but weight loss is one of the most significant mitigating factors in knee injury recovery.

The Bottom Line

There are many approaches and specialties from which to choose to relieve knee pain. You will notice a significant improvement in your recovery if you work with a qualified, professional physical therapist. 

A physical therapist can help you move forward with your recovery and give you the confidence to return to normal, or at least to begin to return to it.

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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