This weeks post ‘Exercises to Strengthen Your Knees’ is a continuation from my previous post entitled 'Knee Pain: Solutions to Common Problems'. In that post we looked at some of the causes of knee pain and I offered some basic advice to help manage the different situations which can present themselves.
Today's post is simply directed at the 'next steps' on this topic - So, I have designed an exercise programme to help remedy knee pain. This programme involves removing muscle tension, improving flexibility and building strength in the legs to help improve the function of your knees, reducing some of your knee discomfort to improve your quality of life.
How the Programme Works
The workout I have designed is broken down into four sections which should be completed in this order:
Specific exercises using a foam roll help release tension in the muscles to help them relax
2. A Warm-Up
To prepare the body for exercise and mobilise the knees... 5 - 10 minutes of cycling or cross training would be ideal
Exercises to stretch the muscles to help develop the range of movement of the joints
4. Strength Exercises
Stronger muscles mean more support of the knees, hips and ankles which help reduce pain. To help you get the most value out of the programme, I will offer an explanation into how each section works to help you fully understand what you should be doing and why.
As a general rule of thumb I would advise aiming to complete this workout 3 - 4 times per week. It goes without saying; if you have very sore knees, some of these exercises may not be suitable for your specific challenges - Please consult your GP before you commence the workout if you have any concerns.
Section 1. Myofascial Release / Foam Rolling
The first step of any workout will always be to fully mobilise the muscles, preparing the body for exercise. A sedentary lifestyle, excessive sitting and a lack of movement can cause the muscles to tighten up. This tightness can cause a restricted range of movement around the joints. Over time, excessive tightness can cause overuse and repeated stress injuries to the joint... This is often the origin of many types of knee pain in the first place.
This particular tension can be remedied with a technique called ‘Myofascial Release’ (a technique which includes the use of a foam roll). Foam rolling manipulates the nervous tissue in the muscle which in turn will help the muscle relax and feel less tense and/or tight. Be warned though; if you have very tight muscles these exercises can cause a sensation of pain and sharpness. Please do not fret, this is perfectly normal and is a similar sensation to having a sports massage.
Tense tight muscles and nerves tend to 'over stimulate' very easily. Manipulating them can initially be tender or even painful. Ideally, the exercise should be held until the discomfort subsides. Word of warning; the joints themselves should never be rolled and certainly NOT the spine for your own safety. Keep your focus on the meaty part of the muscles and you should feel an immediate benefit afterward foam rolling.
Foam Rolling Lateral Quads (Outside of Upper Thighs)
- Lay face down with the foam roll pressed into the front of one of your thighs
- Turn the body so the pressure focuses on the outside of your upper thigh
- Search for tender spots just above the knee to the top of the thigh (by the hip bone)
Foam Rolling Calf Muscles
- Sit on your backside and place the foam roll under one of your calf muscles
- Place the other leg on top of the shin of the leg you wish to foam roll
- Gently apply a downward pressure from the top leg
- Using the arms for support, roll the leg looking for tender spots from over the ankle to the meaty part of the calf below the knee
Foam Rolling Hamstrings (Back of the Lower Leg)
- Sit on the floor in the same position as when you did your calf muscles
- Place the foam roll on the upper rear thigh
- Use the hands and arms to stabilise yourself and roll the thickest part of the muscle from above the knee right up to the base of the buttock area
Section 2: The Warm-Up
A warm-up will serve you on many levels - For example; to help you feel more 'in the mood'/focused for exercise now your body is warmed up, but also, low impact cardio will massively help take care of your knees too.
Inside your joints you have a ‘sack’ which covers the joint. This sack or 'membrane' (as it's officially called) is incredibly clever. When your knees start moving, the membrane secretes fluid into the joint to lubricate it and keep the joint healthy... Imagine a self-oiling engine and you get the idea. Movement in the knees is essential to keep this ‘synovial fluid’ in the knees to continue to protect the joints.
Ideally, we want to mobilise the muscles and joints WITHOUT stressing the joints. Cycle, swim or use a cross-trainer on a medium intensity for 10 minutes or more to fully warm the body up.
Section 3: Stretching
Stretching is important because it's the only effective way to lengthen the muscles. This is crucial to a rehabilitation programme as an improved level of flexibility massively reduces the stress on the joints. Flexible muscles will leave you with a greater range of movement around the joints which means you will move more freely, feel looser with less pain and be able to physically do more.
Quad Stretch (Front of the Thighs)
I'm going to show you this stretch with a towel - If your knees aren't painful on this stretch, feel free to hold the ankle instead
- Wrap a towel around your ankle
- Stand upright and lengthen the body upward
- Hold the towel in the hand of the leg you are stretching and aim to pull upward behind you
- You should feel the stretch in the front of the upper thigh
- Hold for a minimum of 60 seconds
Hamstrings (Back of the Upper Thighs)
- Sit on a chair or an exercise ball
- Lengthen one leg out straight in front of you
- Sitting tall with a straight back, ease the chest forward
- You should feel the stretch in the back of the upper thigh
- Hold for a minimum of 60 seconds
- Stand on the edge of a step
- With the ball on your foot on the edge of the step, gently drop your ankle downward off the step
- Keep the other foot flat to support your balance
- Hold for a minimum of 60 seconds
Adductor Muscles (Inner Thighs)
- Sit on the floor with the soles of your shoes touching
- Maintain a straight back
- Using the muscles in the legs, gently lower your knees toward the floor
- Hold for a minimum of 60 seconds
Section 3: Strength Exercises
Increasing muscle strength means two things for painful knees; improved stability and being able to absorb impact and/or weight bear with confidence. This means being more efficient at walking, running, playing sport and load bearing impact exercises.
Interestingly enough, not all the following exercises work the knees directly. Some of the exercises work the muscles around the hip joint. This is because both ends of the thigh bone (femur) are directly connected to both the knee and hip joint. If the hip is weak, it affects the positioning of the knee... Poor positioning can weaken the joint - Strong hips equals strong knees.
The type of workout you need to do for your knees to develop strength depends on lots of variables. How strong and stable your knees are, history of injury, pain being present and physical ability are all relevant.
With this in mind, if any of the exercises feel painful or uncomfortable, you should seek medical advice before continuing.
Half Squats 3 x 10
Target Area: Front of thighs & buttock muscles
- Stand with feet at hip distance apart
- Turn your feet out slightly
- Maintaining a strong, straight (neutral) spine... Ease your backside downward and backward
- Keep your body weight toward the heels of your feet
- Bend your knees to 45 degrees
Single Leg Step Squat 3 x 10
Target Area: Front of the thigh and buttock muscles
- Stand upright with one foot on the edge of a step
- Drop your hip backward and downward to encourage a 'sitting' movement
- Bend the hip joint and knee into a squat to drop the opposite side foot toward the floor
- Pause before your foot touches the floor or step below
Hamstring Curls 3 x 10 (each leg)
Target Area: Back of the thigh muscles
- Lay face down on the floor
- Place the lower shin of one leg on top of the lower leg
- Apply a little downward pressure from the top leg to provide resistance
- Keeping the hips down, curl the leg up against the resistance of the other
- Aim to bend the knee to at least 90 degrees
- Pause and squeeze the back of the leg while bent
- Slowly release and lengthen the knee while maintaining pressure from the top leg
Calf Raises 3 x 15
Target Area: Back of the lower legs
- Stand on the edge of a step on the balls of the feet
- Maintain good posture and straight knees
- Allow your ankles to bend until you feel a stretch in the calf muscles
- Stand tall on to your tip toes and aim to contract and squeeze the calf muscles
- Slowly drop the ankles into the stretch and repeat
Straight Leg Raises 3 x 10 (each leg)
Target Area: Front of the thigh and hip muscles
- Sit on the floor and stretch one leg out in front of you
- Support yourself from behind with your arms and hands
- Maintaining a straight knee, turn the ankle outward about 10 degrees
- Lift the leg as high as you can slowly without allowing the knee to bend
- Pause at the top of the movement then control the leg slowly down
Side Leg Raises 2 x 10 (each leg)
Target Area: Buttock & Hip Muscles
- Lay on your side ensuring your posture is dead straight and support your head with your arm
- Gently rotate the knee inward so your foot and knee face downward slightly. This will ensure you target the correct muscles
- Maintaining a straight knee, lift the leg directly upward (imagine you are lifting the ankle to the ceiling)
- Pause at the top and control the movement on the way down
Prone Hip Extensions 3 x 10 (each leg)
Target Area: Buttock and back of the thigh muscles
- Lay flat on your front, bend one knee to 90 degrees and flex the ankle to stretch the calf
- Support your head with your hands if need be
- Keep the hips pushed gently into the floor to ensure they don't lift
- Slowly and under control, push the heel of your foot upward
- Squeeze your buttock muscles at the top of the movement
Floor Bridge 3 x 10
Target Area: Buttock, lower back and back of the thigh muscles
- Lay on your back with your arms rested to your side
- Bend your knees to 90 degrees and keep your body weight on the heel of your feet
- Push upward through the hips
- Squeeze your buttocks, lower back and back of the thigh muscles
- Lower gently and repeat
Post Workout Tips
At the end of your workout, it may be advisable to repeat the warm-up stretches you completed earlier to help remove any tension created from the workout. Please remember to drink plenty of water to re-hydrate if you found this workout physically tiring.
Regarding the outcome of this programme; if you stay consistent you should feel stronger within about 4 - 6 weeks. If you have further queries, please leave a comment below and I will be happy to help.
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As always, thanks again for reading and for your time. I hope you enjoy this workout and that most importantly, if you have sore or weak knees, that it's able to help you start feeling stronger, more able and a little more confident.