The Exercises and Stretches for Knee Pain That Physical Therapists Swear By

If you’re one of the 25% of adults who develops knee pain at some point in your life, there is one big myth out there you don’t want to fall for, says Hinge Health physical therapist Keesha Vaughn, PT, DPT, OCS. “People often hear that their knee is like a car part that can get ‘worn down’ with too much use. In fact, the opposite is true: Exercise can build tolerance and actually protect the joint.” Said another way, exercise for knee pain is one of the best ways to keep your knees healthy and strong. 

This attitude is called movement optimism. This means treating exercise, daily activities, and hobbies as a primary solution for joint pain rather than something to be avoided for fear of making it worse.

Research supports the idea that motion is lotion for the joints. Take running, for example, which is often falsely blamed for being bad for the knees. One analysis of 115,000 people found that recreational runners are actually less likely to develop knee osteoarthritis than sedentary people (3.5% vs. 10.2 %). Therapeutic exercise is often recommended as a first-line treatment for conditions such as osteoarthritis, with multiple randomized controlled trials showing that strengthening brings about significant improvements in pain levels.

The key to using exercise as your primary treatment for knee pain is to find the “sweet spot,” or the right dose. “Your body can adapt to different forces and stresses,” says Dr. Vaughn. “The key is to do it in a slow, systematic way and gradually build up.”

Here, learn more about why NOT exercising is one of the worst things you can do for your knees. Then, try some of our physical therapists’ favorite knee exercises to build strong, resilient knees for life.

The Big Myths About Knee Pain and Exercise

If you’ve been in pain for some time, it’s natural to want to avoid any activity you feel might make it worse. Here are common questions and comments Dr. Vaughn hears, and how she helps people cultivate optimism in the healing power of exercise.

I heard the cartilage in my knee gets worn down with age. Won’t exercise make it wear down even faster? 

You may be experiencing changes in knee cartilage due to inactivity, says Dr. Vaughn. Since articular cartilage does not have a blood supply, the cartilage cells benefit from the movement associated with activity and exercise, allowing nutrient-rich fluid to find its way to the spaces between the cells.   This is one reason why exercise is helpful for osteoarthritis of the knee and why doctors often recommend a supervised regimen and a home exercise routine to help with the wearing of cartilage. 

But my knee felt worse after I took a long walk. So shouldn’t I stop walking? 

This could mean you did too much too soon (or upped your dose of exercise too fast), says Dr. Vaughn. For example, maybe you felt good after walking half a mile, so added another mile the next day. That might have been too much — and your body told you that through knee swelling and stiffness. It’s fine to listen to your body and scale back when you notice those symptoms. But the right dose of exercise will allow you to nudge into that pain and build strength and tolerance. Ask yourself what variables you can modify so you find the amount of walking you can tolerate and still feel good. For example, can you increase one-quarter mile at a time or vary your pace (maybe try brisk walking instead of running) rather than stop altogether? 

But how can I get rid of the knee pain? Then I’ll be willing to exercise! 

“This is a conversation I have a lot. ‘What is the thing that is going to fix my pain?’” says Dr. Vaughn. “If you’re here, it’s possible you feel like you’ve tried everything: Icing, bracing, wrapping, resting, elevating. Using these tools is fine, but start thinking of them as a means to return to exercise, which is the real remedy for knee pain. People often think the goal is to cure the pain — that it has to be gone in order to exercise. Instead, think of the cure as exercise, and these aids are helping you get back to exercising comfortably.”

Knee Pain: Common Causes

Knee pain that prevents exercise can be due to a lot of different factors, such as: 

• Osteoarthritis (OA): Cartilage that cushions the bones and changes over time. This is normal. In some cases, these changes contribute to swelling, stiffness, and aching. But interventions such as physical therapy, medications, and lifestyle modifications have proven to be highly effective in managing OA.

• Meniscus tears: Menisci are strong, fibrous discs that act as shock absorbers for the knee. Like cartilage, it’s normal for them to change with age, and these changes sometimes contribute to meniscus injuries during activities like contact sports or other accidents. Many people walk around with a torn meniscus and have no idea — it’s often not a big deal. Sometimes, though, meniscus tears can cause pain during everyday activities that involve bending the knees, such as climbing stairs. Many doctors will first prescribe physical therapy for a meniscus injury to see if symptoms improve without other interventions.

• Bursitis: Some activities can cause inflammation of the bursa — the fluid-filled sacs that protect the knee cap and other areas of the knee. This can lead to swelling that can restrict the range of motion. Gentle activity can help bursitis, though you may want to switch to lower-impact options that don’t irritate the knee. Ice, elevating the leg, and NSAIDs to reduce swelling can also help. 

• Tendinitis or overuse injuries: Generally speaking, the human body likes variety in movement. Repetitive activities can sometimes irritate structures like the patellar tendon, leading to microtears and inflammation that cause tenderness just below the kneecap. Strengthening the quadricep (front thigh) muscles can also help strengthen the patellar tendon and relieve pain. 

Physical Therapists’ Favorite Knee Pain Exercises

The following exercises are among the top movements recommended by Hinge Health physical therapists to prevent and relieve knee pain because they strengthen and stretch key muscles. “Many people come to physical therapy with the idea that they either have weak muscles or stiffness, when they oftentimes actually need to work on both,” says Dr. Vaughn. 

These exercises strengthen the quads (which straighten the knee), the hamstrings (which help bend the knee), and the glutes and hips (which help stabilize the knee). They also help with balance by helping to stabilize the knee and improve important functional activities like walking over uneven surfaces. All the moves above can be modified so you can achieve the gradual progression that builds the knee’s tolerance to stress without aggravating pain.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to Add Simple Knee Exercises to Your Daily Routine

Dr. Vaughn recommends working these moves into your day as much as possible. “You don’t have to make a big show of it. If you want to make this a 30-minute thing you do in the morning, that’s fine. But many people start to fall off after a couple of weeks,” says Dr. Vaughn. If that sounds like you, here’s how to trick yourself into doing these knee-friendly moves all day long:

• Every time you stand up from the couch, do five sit-to-stands. It takes 30 seconds! Do this whenever you get out of your car as well. 

• When you brush your teeth, stand on one leg and balance. (See single-leg stand, above.) Put one hand on the sink if you need help.  

• When you’re still lying in bed in the morning, do a set of 10 bridges or straight leg raises. Then stretch for 30 seconds.

• While doing dishes, stand on one leg or do the standing side leg raises.

PT Tip: Don’t Forget Knee-Friendly Cardio

If you’re looking for some different ways to ease back into exercise or switch up your routine, walking is low-impact and tends to be approachable, says Dr. Vaugh. Plus, just 10 to 15 minutes of brisk walking per day brings a ton of health benefits. One new study that followed millions of people found that just 11 minutes of walking per day can reduce your risk of chronic illness and premature death. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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