Want to strengthen your knees but worried about making your knee joint pain worse?

This blog post provides progressive exercises that help build strength whilst gradually increasing the load tolerance of your knee.

Before You The Start Exercises

STEP 1: Reduce Inflammation
STEP 2: Desensitize The Knee
STEP 3: Knee Joint Decompression

When you are ready – move on to the Strengthening Exercises For Knee Joint Pain.

STEP 1: Reduce Inflammation

Before performing the exercises mentioned on this blog post, it is important to reduce the amount of inflammation in the knee.

Excessive inflammation can make the knee too painful to tolerate the exercises.

Ways To Reduce Inflammation

STEP 2: Desensitization

Massaging the outer portions of the knee joint pain may help to desensitize the area.

Knee Joint Massage

Instructions:

• Sit down on a chair.
• Have your knees bent at 90 degrees.
• Locate the exact area of the knee joint where there is pain.
• Use your finger tips to apply a firm amount of pressure into this region.
• Continue for 1-2 minutes.

STEP 3: Decompression

Performing a decompression technique can help reduce the amount of pressure on the knee joint.

Knee Decompression Technique

Instructions:

• Lie down on your back.
• Instruct someone to hold onto your ankle and slowly provide a pulling force.
• Aim to feel a gentle pulling sensation in the knee.
• Hold this position for 1 minute.
• Perform 3 repetitions.

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Knee Strengthening Exercises

The knee exercises mentioned in this blog post are categorized into different levels, with each level gradually increasing in difficulty.

Progress to the next level once you can perform all of the exercises from the current level without pain or difficulty.

LEVEL 1: Non-Weight Bear Isometric Exercises
LEVEL 2: Resistance Band Exercises
LEVEL 3: Hydrotherapy/Cycling/Walking
LEVEL 4: Body Weight Knee Exercises (Gentle)
LEVEL 5: Heel-Biased Exercises
LEVEL 6: Forefoot-Biased Exercises

(Note: It is important that you do not experience any pain when performing the exercises.)

LEVEL 1: Non-Weight Bear Isometric Exercises

These gentle exercises are performed without placing any body weight on your knee.

Terminal Knee Extension

Instructions:

• Lie down on the floor.
• Place a foam roller (or a rolled towel) underneath your ankle.
• Push your knee downwards as hard as you can comfortably tolerate.
• Aim to feel a firm contraction in muscles at the front of the thigh.
• Hold for 30 seconds.
• Perform 3-5 repetitions.

Terminal Knee Flexion

Instructions:

• Stand up right.
• Hold onto something to help maintain your balance.
• Keep your knees together throughout this exercise.
• Bring your heel closer to the back of the hip by bending your knee as far as possible.
• Aim to feel a contraction in the muscles at the back of the thigh.
• Hold for 30 seconds.
• Perform 3-5 repetitions.

Knee Flexion/Extension (Mid Range)

Instructions:

• Sit down on a chair.
• Cross your ankles.
• Push your ankles against each other.
• Aim to feel a contraction in the muscles at the front of the knee that is pushing forwards and back of the knee that is pulling backwards.
• Hold for 30 seconds.
• Perform 3-5 repetitions.
• Switch legs and repeat.
• Note:
  • You can repeat this exercise at different knee angles.

Tibial Internal Rotation

Instructions:

• Sit down on a chair.
• Have both knees bent at 90 degrees.
• Pivot your shin and foot inwards.
• Place the ball of other foot on the inner front part of the foot.
• Push your feet together as hard as you comfortably can.
• Aim to feel a contraction in the muscles at the back/inner region of the knee.
• Hold for 30 seconds.
• Perform 3-5 repetitions.

LEVEL 2: Resistance Band Exercises

Knee Flexion

Instructions:

• Anchor a resistance band to a stationary object in front of you.
• Tie the other end of the resistance band on your ankle.
• Move away from the anchor point to increase the amount of tension on the band.
• Sit down on a chair that is facing towards the anchor point of the resistance band.
• Bend your knee completely.
• Aim to feel a contraction in the muscles at the back of the thigh.
• Hold for 2-5 seconds.
• Perform 10-20 repetitions.
• Progression:
  • Increase the resistance on the band.
  • Use the Hamstring Curl machine at the gym.

Knee Extension

Instructions:

• Sit down on a chair that is high enough so that your feet are not in contact with the floor.
• Anchor a resistance band on the leg of the chair.
• Loop the other end of the resistance band on your ankle.
• Straighten your knee completely.
• Aim to feel a contraction in the front of the thigh.
• Hold for 2-5 seconds.
• Perform 10-20 repetitions.
• Progression:
  • Increase the resistance on the band.
  • Use the knee extension machine at the gym.

Tibial Internal Rotation

Instructions:

• Sit down on a chair with your hip/knees bent at 90 degrees.
• Keep your knee pointing forwards throughout the exercise.
• Loop a resistance band around the front portion of the foot.
• Tie to other end of the resistance band to a stationary object at ankle height.
• Move away from the anchor point to increase tension on the band.
• Turn your shin bone inwards and pivot your foot inwards.
  • (Internal rotation of the tibia bone.)
• Make sure your foot does not lift off the ground.
• Aim to feel a muscular contraction in the inner/back region of the knee.
• Hold for 2-5 seconds.
• Perform 10-20 repetitions.

Tibial External Rotation

Instructions:

• Sit down with your hip/knees bent at 90 degrees.
• Keep your knee pointing forwards throughout the exercise.
• Loop a resistance band around the front portion of the foot.
• Tie to other end of the resistance band to a stationary object at ankle height.
• Move away from the anchor point to increase tension on the band.
• Turn your shin bone inwards and pivot your foot outwards.
  • (External rotation of the tibia bone.)
• Make sure your foot does not lift off the ground.
• Aim to feel a subtle muscular contraction in the outer/back region of the knee.
• Hold for 2-5 seconds.
• Repeat 10-20 times.

LEVEL 3: General Exercises

Hydrotherapy

When you walk in water, there is less stress on the knees, allowing you to perform more exercises than you would on land.

Consider exercises such as:

Cycling

Cycling on a stationary bike will allow your knee to move through the range whilst being subject to an appropriate amount of resistance.

Walking

For most people, walking is considered a gentle exercise for the knee.

If walking is too challenging and/or painful for the knee, consider the following:

LEVEL 4: Gentle Body Weight Exercises

Single Leg Balance

Instructions:

• Stand up right.
• Hold onto something for balance.
• Raise one leg up.
• Maintain your balance for 30 seconds.
• Progression:
  • Use less hand support

Lean Back Squats

Instructions:

• Hold onto a stationary object that is in front of you.
• Keep your feet in a comfortable position around shoulder-width apart.
• Keep the knees in line with your toes throughout this exercise.
• Lean backwards so that your entire body weight is relying on your arms.
  • Be careful if you have shoulder or arm issues.
• Drive your hips backwards as you squat down as low as possible.
  • Most of your body weight should be leaning on your heels.
• Perform 10-20 repetitions.
• Progression:
  • Squat deeper.
  • Gradually reduce the amount of support being provided by your arms.

Forward Lunge On Step

Instructions:

• Place your foot on top of a step.
• Have both of your hands supported onto a wall that is in front of you.
• For the leg on the step, keep the knee in line with your toes throughout this exercise.
• Lean an appropriate amount of your body weight into the knee that is on the step.
• Allow your knee to move forwards as much as possible.
• Provide as much support from your hands as required.
• Perform 10-20 repetitions.
• Progression:
  • Allow the knee to move more forwards.
  • Lean more of your body weight into the knee that is on the step.
  • Remove the step.
  • Gradually reduce the amount of support being provided by your arms.
  • Hold onto weights.
  • Elevate the heel slightly.

LEVEL 5: Heel-biased Knee Exercises

Sit To Stand

Instructions:

• Sit down on a chair that is at an appropriate height for you.
• Keep your legs shoulder-width apart.
• Keep the knees in line with your toes throughout this exercise.
• Drive your knees outwards.
• Stand up.
• Make sure to push mainly through the heel of the foot.
• Slowly sit down.
• Perform 10-20 repetitions.
• Progression:
  • Hold onto weights.
  • Use a lower chair.
  • Perform the exercise slower.

Step Up

Instructions:

• Place your foot onto a step.
• Hold onto a stationary object for support.
• For the leg on the step, keep the knee in line with your toes throughout this exercise.
• Lean your body weight into your knee.
• Slowly step up.
• Make sure that you are mainly pushing through your heel.
• Try not to push off the other foot that is on the floor.
• Slowly lower yourself back to the starting position.
• Perform 10-20 repetitions.
• Progression:
  • Use less arm support.
  • Use a higher step.
  • Hold onto an appropriate amount of weights.

Wall Sit

Instructions:

• Stand upright with your back facing a wall.
• Have your feet about a foot away from the wall.
• Lean your back against the wall.
• Lean your body weight into your heels.
• Squat down to a depth you are comfortable with.
• Aim to feel a contraction in your thigh muscles.
• Hold this position for 10-30 seconds.
• Progression:
  • Squat to a depth where the knees are bent at 90 degrees.

Bulgarian Split Squat

Instructions:

• Stand in front of a chair.
• Step away from the chair and place one foot on the chair.
• Hold onto something for balance.
• Hinge forwards at the hips so that your torso is leaning forwards.
• Shift your body weight into the front leg.
• Push mainly through your heel of the front leg.
• Lower your body as low as possible.
• Perform 10-20 repetitions.
• Progression:
  • Hold onto an appropriate amount of weight.

LEVEL 6: Forefoot-Biased Exercises

Wall Lean Squat

Instructions:

• Stand up right with your back and heels against the wall.
• Keep the feet approximately shoulder-width apart.
• Keep the knees in line with your feet throughout this exercise.
• Place more of your bodyweight underneath the front part of your foot.
• Slowly bend your knees forwards as you slide your back down the wall.
• Only squat to a depth that you are comfortable with.
• Aim to feel an increased amount of pressure in the knees.
• Hold for 1-5 seconds.
• Perform 10-20 repetitions.

Note: If required – you can off load some of your body weight off your knees by holding onto a nearby table for support.

Supported Sissy Squat

Instructions:

• Stand in front of a wall.
• Place both hands on the wall.
• Lean most of your body weight onto the ball of the feet.
• Whilst allow your knees to move forwards, squat as low as you are comfortable with.
• Perform 10 repetitions.

Staggered Squat

Instructions:

• Place on foot on a step and the other on the floor.
• The side with the foot on the floor is the side that will be targeted.
• Lean an appropriate amount of body weight into the foot that is on the floor.
• Aim to place more pressure on the ball of the foot.
• Perform a squat.
• Bend your knee as much as you are comfortably able to do so.
• Perform 10 repetitions.

Step Down

Instructions:

• Stand on top of a step.
• Hold onto a stationary object for support.
• For the leg that is on the step, keep the knee in line with your toes throughout this exercise.
• Place more of your bodyweight underneath the front part of your foot.
• Slowly reach your other foot down to the floor.
• Aim to feel an increased amount of pressure in the knee that is on the step.
• Return to starting position.
• Perform 10-20 repetitions.
• Progression:
  • Perform the exercise slower.
  • Allow your foot to reach lower.
  • Use less support from the arms.

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Other Areas To Strengthen

In addition to performing the knee exercises mentioned in this blog post, it is also important to strengthen the feet and hips.

Having strong feet and hips will likely help to make these knee exercises even more effective.

For exercises for the feet: Foot Strengthening Exercises.

For exercises for the hips: Gluteus Medius Exercises and Hip Extension Exercises.

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Conclusion

Strengthening the knee is a vital when recovering from knee pain or an injury.

However – it is important to choose the appropriate strengthening exercises that match your current ability. Performing movements that are too advanced may aggravate your knee joint symptoms.

Work through the exercises mentioned in this blog post systematically. Start with the ones that feel comfortable and gradually progress as your strength improves.

Remember – knee exercises should not cause pain while you are performing them. If an exercise is too difficult or painful, move back to an easier variation.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.