What’s The Best Knee Pain Exercise? 4 Kinds Of Exercise For Knee Pain

Why Typical Physical Therapy Exercises For Knee Pain Don't Always Work

If you've had physical therapy for knee pain, you may have had exercises something like this:

1. Clamshells
2. Bridges
3. Straight Leg Raises
4. Side Leg Raises
5. Fire Hydrants

(If you don't know what these are, they're briefly demonstrated at the beginning of the video)

Now, there's nothing wrong with those exercises necessarily, but here's the thing:

You're laying down for the first four exercises, and you're on all 4's for the second exercise.

None of them are standing up!

But when do MOST people have knee pain?

Most People Get Knee Pain When Standing Up

Some examples include:

• Walking
• Running
• Jumping
• Going up and down stairs
• Going up and down Hills
• Getting up from the floor

So it just makes sense that at least some of your knee pain exercises should be done standing up.

4 Kinds Of Knee Pain Exercise

In general you can classify knee pain exercises into 4 different categories: 

1. Aerobic Exercise
2. Stretching Exercise
3. Functional Strengthening Exercise
4. Balance Exercise

Aerobic Exercise For Knee Pain

Aerobic exercise is one of the BEST types of exercise for knee pain, and especially knee arthritis.

When you do aerobic exercises like walking, your joint surfaces gently compress and distract releasing synovial fluid from your knee cartilage.

Additionally you get increased circulation and blood flow to the knee which brings the nutrients and oxygen necessary for tissue maintenance and repair.

Examples of aerobic exercise for knee pain include:

• Walking
• Running
• Swimming
• Exercise Bike
• Elliptical Trainer

The specific type of aerobic exercise you choose doesn't matter all that much.  In general, you should choose aerobic exercises that you enjoy and that you can do without increasing your pain.

Obviously, use common sense. If you have knee arthritis, you may want to avoid higher impact exercises like running.  Or, if your pain limits how long you can walk you may want to complement walking short distances with exercise biking.

What's The Best Exercise Bike For Knee Pain?

I often get asked by patients with knee pain what the best exercise bike for knee pain is.

Largely, it doesn't matter.  As long as you're moving and getting exercise, that's the most important part.

Riding an exercise bike is especially good for arthritic knees.

If you also happen to have back pain, a recumbent bike that has a backrest is good to get back support.

If you're in the market for an exercise bike though, I'd recommend a hybrid exercise bike / elliptical trainer like the one below so that you can get some variety in your workout.

Stretching Exercise For Knee Pain

Many of the stretching exercises for knee pain actually don't have a lot to do with stretching the knees at all. Your hips and ankles are actually bigger drivers of knee pain in a lot of cases.

4 Stretching Exercises For Knee Pain

1. Calf stretches
2. Piriformis stretches
3. Quadriceps stretches
4. Hamstring exercises

Calf Stretches For Knee Pain

You need to be able to move your bodyweight forward over your feet when walking.  If you can't do this, your body can find other ways around your foot by pronating, or flattening, but this cause your knee to twist inward which can cause pain on the inside of the knee or pain on the outside of the knee.

However, most people do calf stretches wrong!

If you allow your foot to pronate while you're stretching, you're actually playing in to the problem.

Click here to learn how to do calf stretches correctly

Piriformis Stretches

Your piriformis is 1 of 6 hip external rotator muscles that sits behind the hip joint. Usually weakness of the hip external rotators is more more related to knee pain than stiffness of these muscles.

However, the stretch often called the "piriformis stretch" where you cross your ankle over the opposite knee actually externally rotates the hip as well as stretches the inner thigh muscles (adductors).

Stiffness the adductor muscles can cause the knee to turn inward while walking or running, so stretching your leg in the direction of external rotation can help keep this from happening.

Click here for steps to do the "piriformis stretch"

Quadriceps Stretches

Your quad muscles are the muscle that extends your knee.  They're called quadriceps because there are 4 muscles that attach into a single tendon (quad = four, -cep = head).

When they're too stiff or tight, they can create increased compression on the kneecap, particularly when going down stairs.

However, it's rare that you bend your knee to absolute end-range, so it's more common that the rectus femoris - the quad muscle that crosses both your hip and knee - is the trouble maker when it comes to knee pain.

Your rectus femoris is both a knee extensor and a hip flexor muscle.  That means it straightens your knee but also lifts your hip toward your chest.

Learn how to stretch your quadriceps.

Hamstring Stretches

Your hamstrings are the muscles that bend your knee.

People commonly complain about "tight hamstrings" but hamstring stiffness isn't as big of a cause of back or knee pain as most people think.

Like the rectus femoris, the hamstring muscles also cross both the hip and the knee, but on the back side of the leg.

The hamstrings are hip extensors and knee flexors (opposite of the rectus femoris).

When you walk, you're extending your knee fully, but your hip isn't even close to it's end-range position.  That means that if you can't fully straighten your knee, it's probably NOT due to stiff hamstrings, but rather a stiff knee joint capsule or knee arthritis.

The more common problem with hamstring stiffness when it comes to knee pain is the imbalance between the inner hamstrings (semitendinosis and semimembranosis)  vs. the outer hamstring (biceps femoris).

If your inner hamstrings are stiffer than your out hamstrings, it can cause your knee to twist inward when walking.

Click here to learn how to stretch your inner hamstrings

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Functional Strengthening Exercise

This kind of knee exercise strengthens not just the muscles around the knee, but the entire lower body.  Most importantly, these exercises mimic functional movement patterns that you'd do in everyday life.

Some examples might include:

• Squatting
• Lunging
• Getting up from a chair
• Step ups

Unlike the exercises mentioned at the beginning of this post, these exercises are done in standing with weight on your feet, which is the time when most people get knee pain.

Squats For Knee Pain

Squats are a great exercise for knee pain. They help strengthen your quads and your glutes.

However, doing squats wrong can actually make knee pain worse.

Watch the video below to learn how to do squats correctly.

Lunges For Knee Pain

Squats are another great strengthening exercise for knee pain.

Lunges have a unique advantage over squats in that you exercise one leg at a time so that you can't use your strong leg to compensate for the weak leg.

Again though, doing lunges with improper technique can actually cause knee pain.

Watch the video below to learn how to do lunges correctly.

Balance Exercise For Knee Pain

Every time you take a step when walking or running, you essentially have to balance your body over one leg.

Therefore, standing on one leg is a good way to help your body learn to meet the demands that you'll encounter in everyday life.  (Warning: If you have balance difficulty, hold onto a wall, counter, couch, or other sturdy piece of sturdy furniture so that you don't fall.)

As balancing on one leg gets easier, single leg squats or mini-squats are another good to exercise work on balance and particularly to go up and down stairs.

Why Doing Knee Pain Exercises From YouTube Doesn't Always Work

There are so many knee pain exercises on YouTube that it can be overwhelming.

You have to verify that the source you're watching actually knows what they're talking about.

However, even if you're watching a YouTube channel with good information (such as our YouTube Channel 😀) there's SO MUCH information available, that it's difficult to know which exercises apply specifically to your knee pain...

Or which ones might make it worse. 😕

Even if you CAN find the right exercises that apply to your knee pain, you'll spend so much time and energy searching, that it probably would have been quicker, easier, and more time efficient to just spend a little bit of money to hire an expert to point you in the right direction.

By working with an expert, you'll also have: 

• The peace of mind that you're doing the right exercises
• The assurance that you're doing the exercises correctly
• The accountability to make sure you follow through and actually do the exercises consistently enough to get the results you want.

Need Help For Knee Pain?

Request an appointment with one of our specialists

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