If you have knee pain, it can be difficult to workout. Not only are you unable to do certain exercises, but some movements may cause pain, which makes skipping the gym an easier choice. But that doesn’t have to be the case. Understanding knee pain and learning exercises to strengthen your knees can make a world of difference.
How Knee Pain Develops
Unfortunately, certain people develop primary OA, or osteoarthritis, early in life — around 30 years old — and without cause, explains Yukiko Matsuzaki, DPT, OCS, SCS, physical therapist at NYU Langone’s Sports Performance Center in New York City. For most though, this isn’t the case. “Factors like excess weight, previous joint injuries, poor mechanics from weakness in the hips, and/or poor alignment at the ankle have greater contributions to knee OA,” Matsuzaki says.
Besides the ankles, the knees are the most distal (situated away from the center of the body) joint, and because gravity loads from the top down, the knees absorb a lot of weight. One pound of weight translates to three times the amount of force on the knees, explains Michele Olson, Ph.D., FACSM, CSCS, professor of exercise physiology at Auburn University at Montgomery in Alabama. “So a 5-pound weight gain increases the load on each knee by 15 pounds!”
What’s more, the natural aging process can result in arthritis. “The soft tissues between the articulating bones begin to thin and can experience micro tears due to the decrease in collagen formation as we become older,” Olson says. This can result in pain and the loss of movement.
Why Knees Are So Sensitive?
Compared to the amount of weight they bear, knee joints are actually very small. “The knees have the entire body to support other than the lower leg,” Olson says. “They are also not designed to twist and rotate as are the hip joints, for example. They truly are rather delicate and are the most readily injured body part in athletes.”
Knees are also especially sensitive because of their location between the hip and ankle. If something goes wrong with one of those joints, the knee is first in line to compensate. “Weakness at the pelvis or hips, or poor alignment at the ankle or foot can lead to alternation in the normal movement of the knee, which can then lead to pain or dysfunction,” says Matsuzaki.
What to Avoid if You Have Knee Pain
High-impact activities are pretty off limits for someone experiencing knee pain. Things like plyometric exercises and running on hard surfaces can cause even more discomfort in the knees, as can things like walking up stairs, squatting, or even kneeling, Matsuzaki says. Sticking with lower-impact exercises is the best option.
Exercises to Strengthen Bad Knees
Knee pain shouldn’t be something you just accept. There are exercises you can do to strengthen knees and thus lessen discomfort. Here Olson and Matsuzaki share a few.
1. Seated Straight-Leg Lifts
Sit on the ground, right leg extended, left knee bent with foot flat on the ground next to right knee. Place hands around left shin for support. Slowly lift right leg off the ground 6 to 8 inches. Slowly lower leg. Repeat 8 to 12 times, then switch legs. Perform 3 sets.
“This exercise develops and strengthens the muscles around the knee cap that stabilize the knee and knee cap,” says Olson.
2. Quad Sets
Sit or lie on your back, legs extended out long. Tighten your right thigh muscle while simultaneously pressing the back of your right knee into the ground. Hold 5 seconds, then release. Repeat 8 to 12 times, then switch legs. Perform 3 sets.
“Weakness of the quadricep muscle has been demonstrated in the development and progression of knee OA,”Matsuzaki says. “This exercise helps to activate the quadriceps muscle in an isolated manner, so just the quad is working.”
3. Leg Press
Sit on the leg press machine, feet shoulder width apart, flat on the platform. Choose a light weight. Push through your feet to extend legs fully. Slowly bend knees back to starting position. Do 5 to 7 reps. Perform 3 sets.
“The key here is low resistance and small ranges,” Matsuzaki says. “The leg press targets the glutes, hamstrings, and quads in a controlled fashion, and is a safe intervention for people with knee pain. It is an excellent total-leg-strengthening exercise.”
4. Half Squat Against Wall
Stand with back against wall, feet 6 to 8 inches in front of wall, shoulder width apart. Press back into wall and bend knees to lower a quarter of the way down. Push through heels to slowly stand back up. Do 8 to 12 reps. Perform 3 sets.
“This exercise strengthens quads, hamstrings, and glutes, all of which protect and support the knee joint,” Olson says.
5. Side Leg Raises
Lie on one side, bottom hand under head, legs extended and stacked on top of one another. Pressing top hand into the ground, lift top leg 6 to 8 inches, hold 3 seconds, then lower leg. Repeat 8 to 12 times, then switch legs. Perform 3 sets.
“Here you’re strengthening both the knees and the hips, and the hips help support the knees,” says Olson.
“Some kind of aerobic exercise will help you maintain cardiovascular fitness, as well as help keep your joints moving,” says Matsuzaki. “The elliptical is especially recommended because it reduces weight on your joints while achieving that goal.”