Many people with knee pain or knee problems have difficulty working out and finding ways to get physical activity. Sometimes it is hard to find workouts that don’t cause pain and that are sustainable.  Many people think that just because they have knee pain that they can’t workout or that they shouldn’t workout but that is not true.  It is important for all people to get physical activity and the health benefits of working out are important for many health conditions.  

So, what can you do to help improve bad knees (and what should you avoid)?

First of all, whether you have knee problems or not, all of us should be mindful during any workout that — knees stay in line with toes, not wavering in or out of alignment during an exercise. This includes when doing step exercises and when performing squats. The worst exercises for knee joints for people with bad knees include full-arc knee extension including using the machine at the gym, full-deep lunges, deep squats, and Hurdler’s stretches, because these exercises place excessive strain on the knee joints and can increase pain and cause injury. These exercises are especially harmful when not performed properly, which can also increase risk of injury. 

The best exercises that you can do to help improve strength, flexibility, and to improve knee function include partial squats, step-ups, side lying leg lifts, inner-thigh leg lifts, calf-raises, straight leg raises, short-arc leg extensions and hamstring stretching (focusing on perfect form, to the point of no pain, and with no extra resistance until injury is resolved).  These are the best exercises to target a variety of lower extremity musculature that can help to improve knee function and decrease knee pain.

Partial Squats are performed by standing about a foot away from the front of a chair with your feet about hip width apart and your toes pointed forward.  Then, initiating the movement with and bending at the hips, slowly lower yourself down to the chair. You want to make sure you keep your abs tight to improve core stability and make sure that your knees stay in line with your toes and behind the toes to decrease strain on the knees. 

Step-Ups can be performed using an aerobic step bench or stairs in your home. You can step up onto the step with the right foot; tap your left foot on the top of the step and then lower back down. Repeat again on same foot or bring the right foot down and step up with the left, alternating sides for each repetition. As you step up, remember to keep your knee in line directly over your foot.     

Side-Lying Leg Lifts can be performed with or without ankle weights while you lie on your side. You will keep the foot of your top leg flexed as you raise that leg keeping your body straight.  Slowly lift your top leg toward the ceiling until it is over your hip (or as close as is comfortable) and then slowly lower your leg back down to hover over the other leg until starting another repetition. 

Side-Lying Inner-Thigh Leg Lifts can be performed using ankle weights while you lie on your side. With the knee of the top leg slightly bent, you will want to cross your top leg over your bottom leg so that it is out of the way. From this position, then you will lift your bottom leg up towards the ceiling.  Lift your leg about 3 to 5 inches (or as high as is comfortable) and then lower. 

Calf Raises can be performed near a wall or a chair for balance. You will stand with your feet about hip width apart and toes straight ahead. You will slowly lift your heels off of the floor, rising up on your toes, hold for 1-2 seconds and then slowly lower back down. 

Straight-Leg Raises can be performed by lying on your back or sitting with your back against the wall (requires more flexibility) and with one leg straight and the other leg bent, raise your straight leg up towards the ceiling about 12 inches off the floor, hold for 1-2 seconds and then lower. 

Hamstring Stretches can be performed while lying on your back. You can loop a towel or rope around your foot and pull your leg as far as comfortable towards your chest while keeping a slight bend in the knee.  Keep your back pressed against the floor throughout the stretch making sure not to arch your back.  Hold time may vary per person but the goals should be to hold between 30-60 seconds as tolerated for corrective stretching. If you can’t tolerate that long of a hold at first, you can begin with shorter stretch durations.  Repeat 2-4 times per leg depending on how long you hold the stretch.  (be sure to do long duration corrective stretches only after you have completed all other physical activity, never before)

Written by L Augustyn, Physical Therapist

FB Note: This is a great example of the importance of listening to your body to both prevent injuries altogether, and to avoid worsening them. There's a big difference between the good kind of pain and the bad, and the latter is one that you should never push through. Knee rehabilitation is always going to vary depending on the injury or issue at hand, so be sure to talk to your doctor or PT specifically about your issues before you start into any exercise regime, especially if you are working with an injury.