The most important thing you can do in order to protect your knee from injury is to strengthen the muscles that support the knee. This way your muscles will be better prepared to adequately support the knee joint or absorb the shock before it causes injury. Another important thing is to increase the flexibility of your muscles. That is why it is recommended to combine strengthening exercises with stretching knee exercises. This way your muscles will be strong, but not too tight, and flexible at the same time.
The main muscle groups that control the knee movement and stability are the quadriceps, which run along the front part of the thigh, and the hamstrings, which run the back of the thigh. The quadriceps has the function of extending the leg, so it is used when standing up, walking uphill or up the stairs and running. The hamstrings are used when bending the knee or pushing against something.
Knee Strengthening Exercises
Warm Up First. Five minutes of light aerobic exercise such as walking or riding a stationary bike to warm up the muscles helps to prevent injury.
Stretching or Strengthening Exercises First?
Muscles tend to be tight after strengthening exercises so stretching after strengthening exercise may be more beneficial than stretching first. However it is largely a matter of personal preference - stretching and strengthening exercises can also each be done on separate days if desired. Some people prefer to do stretches both before and after strengthening exercises. If you have knee problems or pain, consult a physical therapist for an exercise plan customized for your needs. Remember to warm up for 5 minutes to prepare your self for any type of exercise.
Keep Breathing throughout the exercises. Do not hold your breath.
How Often to do Knee Strengthening Exercises
In general, any strengthening exercises should only be done about every second day or three times per week on non-consecutive days to allow healing and to avoid overuse injury.
How Many Repetitions and Sets
If you are a beginner to exercise, start with five repetitions of each exercise - or less if the exercise is difficult. If you do not have post exercise pain, slowly add a couple of repetitions each week until you reach 10 - 15 repetitions. To increase endurance add a second set of 10 -15 repetitions after you can handle one set. When two sets because easy to do, you can add a third.
*NOTE: There are several strengthening exercises to choose from for some muscles. Choose one per exercise session.
Quadriceps Strengthening
Note: Only do one quad strengthening exercise per exercise session with the exception of the quad strengthening contractions, which can be done additionally.
Quad Strengthening Contractions:
Sit in chair. Move forward so that you are sitting at edge of chair. Extend legs, heels to floor. Keep knees straight (or as straight as possible if you have arthritis.) Tighten thigh muscles. Hold for count of 10. Relax for count of 3. Do 10 repetitions. You can do this several times throughout the day. You can build up to 2 or 3 sets of 10 repetitions at a time.
Quad Strengthening Leg lifts:
A simple exercise that will help strengthen the quadriceps consists of lying down and doing straight leg raises. Once you are in a good shape you can move to a more advanced level by doing the same exercise with weights. You don’t need any complicated equipment in order to do this. Just get an old bag, put a book in it and repeat the straight leg exercises. You can gradually add more weight to the bag.
Lie flat on back. Bend left knee at 90-degree angle, keeping foot flat on floor. Keeping the right leg straight, slowly lift it until right foot is the height of the left knee. Hold for a count of 3. Repeat 10 times. Switch sides. Work up to 10 sets of 10 over several weeks.
Safety Tip:
Leg lifts: Lifting both legs at the same time causes excessive stress on your lower back so
only lift one leg at a time; the opposite leg should be kept slightly bent with foot on floor.
Leg lifts: Lifting both legs at the same time causes excessive stress on your lower back so
only lift one leg at a time; the opposite leg should be kept slightly bent with foot on floor.
Quad Strengthening Short-Arc Leg Extensions:
Sit or lie on floor. Place a rolled up towel under your thigh for support. Keep you leg straight and raise your foot about six inches off the floor. Hold for 5 seconds. Slowly lower your foot, bending your knee. Do 10 repetitions. Switch sides.
Quad Strengthening Knee Dips:
Stand with knees slightly flexed. Point your toes straight ahead.
Make sure your kneecaps are also pointed straight ahead.
Lift one leg up and balance on the other leg. Slowly lower yourself up and down ONLY a few inches. Keep the knee of the leg you are balancing on slightly flexed. Your knees must remain pointing straight forward. Do not let them turn inward. Stand straight, do not lean you body to one side. Do 10 dips. Switch sides.
If you feel pain in your knees, start with fewer dips.
Quad Strengthening Partial Squats:
Stand. Keep back straight, knees hip-width apart and pointing straight ahead. Slowly lower and move your buttocks backward as if you were sitting in a chair (don't bend your knees beyond a 90-degree angle, if 90 degrees is too difficult bend even less). Hold position for a count of 5. Do ten squats. Stop if you feel pain in your knees. You may find it useful initially to do these against a wall sliding up and down - you can even progress with a physioball between you and the wall. Another modification is to place a chair underneath you so if your knees are weak you can just sit down.
Safety Tip: Make sure your knees do not extend beyond your toes when doing partial squats. Keeping your weight behind your knees reduces the pressure on the knee joint during the squat. Bending the knees beyond 90 degrees (a right angle) places excessive strain on the knee.
Hamstring Strengthening
Note: Only do one hamstring strengthening exercise on the same day.
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Seated Hamstring Strengthening Contractions:
Sit in chair, with knees bent to 45 degrees and heels on floor (toes lifted up). Don't move heels but pull back on them, digging heels into floor. You will feel tension in you hamstrings. Hold for count of 5 - 10 seconds. Relax for count of 3. Do 10 repetitions.
Lying Hamstring Strengthening Contractions:
Lie on back, knees bent about 45 degrees. Dig heels into floor. You will feel tension in your hamstrings. Hold for count of 5 - 10 seconds. Relax for count of 3. Do 10 repetitions.
Hamstring Strengthening Curls:
Lie on stomach. Place left foot onto the back of the right heel. Slowly pull your right heel toward your buttocks - resisting with the left leg. This contracts the hamstrings. Hold for a count of 10. (Keep pressing your left foot and right heel against each other) Hold for a count of ten and relax for count of 3. Do 10 repetitions.
Walking backwards helps to develop the hamstrings. When walking backwards, your weight is distributed more evenly, resulting in less strain on your knees.
Other Strengthening Exercises for Knee Stability
Sit in chair, put fist between knees, squeeze together knees. If you have a small medicine ball you can use this too. Hold for count of 10. Relax for count of 3. Do 10 repetitions.
Lie on floor on your right side, shoulder and hips aligned. Use your right hand to prop up your head. Place the left hand on floor in front of you to help balance yourself. Bend left leg and bring it to the floor in front of you. Slowly raise your right leg about 10 inches off the floor then, hold for a second, then slowly lower leg to ground. Lift 10 times on each side.
Hip Abductors (Outer Thigh) strengthening:
Lie on floor on your right side, shoulder and hips aligned.
Bend right leg (leg on floor) to 90 degrees.
Slowly raise you left leg about 18 inches, hold for a second, then slowly lower leg.
Do 10 repetitions. Repeat on other side.
Glutes Strengthening Backward leg swing:
Hold onto back of chair for support. Swing leg back at a diagonal until you feel your buttocks tighten. Tense muscles as much as you can and swing leg back a couple more inches. Return leg to floor. Repeat 10 times.
Switch sides. Do 10 repetitions. Repeat on other side.
Stretching Knee Exercises
How Often to StretchIn general, stretching exercises may be done daily but every second day or 3 times per week is enough. Stretching exercises are often prescribed twice per day or more by physical therapists for the treatment of knee pain, the specific exercises recommended depend on the cause of the pain.
How Long to Hold a Stretch
For stretching exercises, the stretch should generally be held for a total of about 60 to 90 seconds. Holding a stretch for 30 seconds only requires 2 or 3 repetitions. Some people prefer to do more repetitions of 5 or 10-second stretches or just one 60-second stretch.
WARM UP before stretching with 5-10 minutes of low-impact aerobics (e.g. walking, stationary bike). Warmed up muscles are more responsive to stretches and less likely to tear.
Stretches should be performed without any bouncing and in a slow & controlled fashion
Calf Muscles Stretch:
To stretch left calf muscle, step back with left leg, forward with right. Bend right knee (keep left leg and back in a straight line as you lean forward) until you feel a gentle stretch in the left calf. Do not roll foot out to side. Keep heel flat, foot forward. Hold 30 seconds. Repeat on other side.
Quad Muscle Stretch:
There a few ways to do this:
To stretch your quadriceps, stand. Bend right knee, grab front of right ankle and bring heel to buttocks with hand. Keep knees together. Do not arch back. Do not let leg go to side. Point knee toward floor. Tighten buttocks and tuck tailbone under to increase stretch.
Hold for 30 seconds. Repeat on other side. bring your heel to the hip with your hand, while keeping the knees together. Hold for 30 seconds.
Hold for 30 seconds. Repeat on other side. bring your heel to the hip with your hand, while keeping the knees together. Hold for 30 seconds.
Hamstring Stretch:
Standing position
Keep one leg on ground; put one foot on chair with leg straight. Bend forward at the hip. Hold for 30 seconds. Repeat on other side. *Do not attempt to touch your toes as this will stretch your back, and the goal of this exercise is to isolate your hamstring muscles in the leg that is being supported by the chair.
Sitting in chair hamstring: Straighten one leg, keeping heel on floor. Lean forward at hips, keeping back straight. Don't try to touch your toes. Hold for 30 seconds. Repeat on other side.
Iliotibial Band Stretch:
Standing position:
Stand up. To stretch the right side, cross right leg behind left leg. Bending from the hip, lean torso to the left - pushing hips to the right. The stretch is felt on the outer right hip and thigh. Keep right leg straight, left knee slightly bent. Hold for 30 seconds. Repeat on other side.
Sitting position:
Sit in chair or on floor. Bring right foot to outside of left leg, bringing knee towards opposite shoulder so that the knee crosses the midline of the body. Hold for 30 seconds. Repeat on other side.
Hip Adductors (Upper Inner Thigh) Stretch:
Standing: Step off to the side with the right leg. Bend left knee slightly (do not extend knee beyond toe) and move your right foot further to right until your feel a stretch in your right inner thigh. Hold stretch for 30 seconds. Repeat on other side.
Sitting position: Sit on floor, spread legs into a V position. Slowly lean forward from your hips, keeping your back straight, until you feel the stretch. Do not bounce. Then lean towards the right, foot then left foot. Hold for 30 seconds.
Hip Abductors (Upper Outer Thigh) Stretch:
Sit on the floor, legs extended in front of you.
Bend right leg and place right foot on floor on outside the left knee.
Twist upper body to right and use left elbow to gently push against outside of right knee until you feel a gentle stretch in the right hips, buttocks, and lower back.
Hold for 30 seconds. Repeat on other side.
Hip flexors (front of hips) Stretch:
Tightness in these muscles can affect the alignment of the knee bones.
Standing Exercise: Step forward with the right leg, bending right knee (to increase the stretch, take a larger step). Do not extend right knee past toes. Keep left knee slightly bent with heel off the ground. Keep back upright. This stretches the front of the hip on the left side. Push the left hip forward to increase the stretch.
Hold for 30 seconds. Repeat on other side.
Gluteal Stretch (back of hips / buttocks):
*Of all the above knee exercises, the quadriceps strengthening contraction is probably the easiest, safest and most important exercise you can do to prevent knee pain and injury. Those who have trouble fitting in exercises into their schedule can always do this exercise while watching television.
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