Intermediate Knee
Strengthening Exercises
By Chloe Wilson, BSc(Hons) Physiotherapy
Knee strengthening exercises will help nearly all cases of knee pain and can even prevent knee problems from developing and recurring.
Here we will look at intermediate level strengthening exercises for the knee and leg muscles.
I have grouped these knee strengthening exercises by muscle group: quads, hamstrings, buttocks, kneecap, calves and balance. Pick the ones you find best for you.
If you haven’t already tried the beginners strengthening exercises, I suggest you start there. Once they are feeling easy, come back to these ones. Then, when you have mastered these ones, you can move on to the advanced knee strengthening exercises.
Quads Knee Strengthening
These are the muscles at the front of the thigh that straighten the
knee. Weak quads leads to increased pressure through the knee and knee
cap. Knee strengthening exercises for the quads is one of the most effective ways to
reduce knee pain.
1) Wall Squats
Purpose: A great twist on traditional squats. Strengthens the quads but protects the knees. One of my all-time favourite knee strengthening exercises
Starting position: Stand with your back against the wall, feet apart, toes pointing forwards
Action: Slowly slide down the wall a few inches bending your knees. Hold for 3-5 seconds and return to starting position.
Repetition: Repeat 10-25 times, 2x daily
Progression: 1) Increase the depth of the dip 2) Hold the bent knee position for longer (aiming for 10secs)
Note: As you squat, don’t let your knees come too far in or out - Keep your knee in line with your second toe so you can always see your big toe past the inside of your knee
2) Step Ups
Purpose: This is a great quads knee strengthening exercise that also helps reduce knee pain with stairs
Starting Position: Stand facing the bottom of the stairs or a single step. Hold onto the wall/rail for support if required
Action: Step up onto the first stair leading with the leg you want to strengthen. Without turning round, step both feet back down leading with the good leg
Repetition: Repeat 10-30 times, 2x daily
Progression: 1) Don’t hold onto anything 2) Keep the leg to be worked up on the step and just move the other leg up and down
Note: If you don’t have any steps at home, be creative e.g. telephone directory
3) Step Downs
Purpose: Strengthen the quadriceps, improve balance, improve knee stability
Starting Position: Stand sideways on top of a step. Hold the wall/rail for support
Action: Slowly lower your good leg down to the floor and then bring it back up (keeping your other foot up on the step throughout)
Repetition: Repeat 5-20x, 2x daily
Progression: Stand facing forwards and step down instead of sideways, lightly touching the good leg to the floor
Note: 1) You are aiming to do this in a slow, controlled fashion
2) Don’t let the knee twist inwards, keep it in line with your second toe so you can always see your big toe
Hamstring & Glutes Strengthening
These are the muscles on the back of the thigh and the buttock muscles and they often work together. Most people with knee pain have weak glutes, but they are often ignored.
Having weak glutes and hamstrings increases the forces going through the knee. Along with the quads, knee strengthening exercises for the glutes and hamstrings are one of the best ways to reduce pain.
1) The Clam: Stage 2
Purpose: Strengthen the buttock muscles (glutes) to help support the knee and prevent excessive weight going through the inner side of the knee. Another one of my favourite knee strengthening exercises
When to do: Almost always appropriate – most people have weak glutes. Make sure you can do The Clam Stage 1 first
Starting position: Lie on your side with your hip and knees bent approx 90°, feet together. Lift your feet up about 30cms off the bed, knees still resting on the bed/floor
Action: Keeping your feet together, lift the top knee up as high as you can. Hold for 3 seconds and slowly lower
Repetition: Repeat 10-25x on each side, 2x daily
Note: Do not let your top hip roll backwards
2) Bridging: Stage 2
Purpose: Strengthen the hamstrings whilst also working the quads and buttock muscles. Make sure you can do Bridging: stage 1 first
Starting Position: Lie on your back with both knees bent about 90° and your feet on the floor/bed
Action: Clench your buttocks and lift your bottom off the bed as high as you can without arching your back. Then lift one leg up. Hold for 3-5 seconds and slowly lower
Repetitions: Repeat 10-25 times, 1-2x daily
Note: 1) Keep your back straight – don’t let it arch as you lift up, it should be your bottom doing the work
2) Don’t hold your breath – keep breathing normally
3) Don’t let your hips drop during the exercise – keep them up as high as you can
Kneecap Strengthening
Muscle weakness can lead to patella maltracking, where the kneecap doesn’t move properly, which is a common cause of knee pain. Targeted knee strengthening exercises for the muscles that control how the kneecap moves can make a big difference.
1) Kneecap Clenches
Purpose: Strengthen the muscles on the inside of your knee that are responsible for how the kneecap moves. Also increases knee stability
Starting Position: Sit in a chair, feet hip width apart with a soft football in between your knees.
Action: Clench your buttocks, clench your knees and gently squeeze the ball with your knees. Hold for 3-5 secs and relax
Repetition: Repeat 10-20x, 2x daily
Tips: 1) Feel for the VMO muscle tightening with your fingers
2) When you squeeze the ball, make sure the squeezing movement comes from your knees, not your hips
Calf Strengthening Exercises
The calf muscles are at the back of the leg, below the knee. They help support the knee and co-ordinate knee and ankle movement.
1) Solo Heel Raises
Purpose: Strengthen the calf muscles to help support the knee
Starting position: Stand on one leg holding onto something solid e.g. table or wall for balance.
Action: Push up onto your tiptoes so your heel is up off the ground as high as you can. Hold for 3-5 secs and slowly lower
Repetition: Repeat 10-30 times, 2x daily
Target: When you can do 30 repetitions on a single leg, that is a good sign you have good strength in your calf muscles
Balance Exercises
The knee plays a vital role in ensuring good balance and proprioception. This is often affected when there is knee pain and doesn’t always improve after an injury, even once the pain goes away. This leads to an increased risk of further injury in the future.
As a quick test to see whether you would benefit from balance exercises try standing on one leg with your eyes closed. If you can’t do it for one minute, you’ve got some work to do!
1) One Leg Standing: Stage 2
Purpose: Improve balance and proprioception. This exercise helps your body learn the subtle adjustments needed for good balance
Starting position: Standing. Place a small rolled up towel underneath the arch of your foot so you are on an uneven surface (toes and heel off the floor)
Action: Lift up your good leg and stand on one leg for as long as you can
Repetition: Spend 5 minutes doing this 2x daily
Progression: 1) Reach one arm out in different directions
2) Close your eyes
3) Throw and catch a ball
4) Slowly bend and straighten your knee a small amount
Getting the Best Results
Knee strengthening exercises should be challenging, but not painful. The more you do them, the stronger your muscles become and the easier the exercises are. It is important to work at the right level to get the best results without damaging your knee.
If exercises are too easy, they won’t make much difference, if you work muscles too hard, they may cause pain. See our Top tips on getting knee strengthening exercises right section for more info.
You will probably need to do knee strengthening exercises at least four times a week for a month before you notice much of an improvement in your knee pain so stick with it!
If these exercises feel too difficult at the moment, try some beginners strengthening exercises for a few weeks and once your knee is a bit stronger, revisit this section to help you. You may want to mix and match basic and intermediate knee strengthening exercises. Be creative and keep exercising if you want to beat your knee pain!
Once you have mastered these strengthening exercises, CONGRATULATIONS! You are ready to move on to advanced knee strengthening exercises.
Page Last Updated: 27/9/18
Next Review Due: 27/9/20
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