Quick Exercise Overview
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Your knees are an incredible feat of engineering. They’re a powerful set of weight-bearing joints tasked with handling about 80% of your bodyweight, and up to 1.5 times every time you take a step. That’s on level ground, not to mention jogging, running, and navigating varying terrain. No wonder the knee joint is one of the most common sites for aches and degenerative(wear and tear) conditions. In fact, recent estimates show Knee Osteoarthritis as one of the leading causes of chronic pain and disability, affecting about 5%(734 million) of people worldwide.
This is why keeping your knees in the best shape possible is a great step towards optimised health and well-being. Strength training for muscles around your knees is a classic approach to build their capacity and enhance function and structural integrity. This article will look at some of the most effective exercises to strengthen and build efficiency in your knees. We’ll lay the foundation with a quick look at how your knees are set up, then dive into these moves in terms of what they’re good for and how you can do them safely and effectively.
Inside Your Knees: What’s going on under the skin?
Understanding how each exercise works requires a basic knowledge on the key muscle groups responsible for driving movement and stability in the knee joint. It serves the basis for understanding key things like good exercise form, which is critical for success. Let’s take a quick look.
Quadriceps(Quads)
The largest and most powerful muscle group, located above the knee on the front part of the thigh. It’s actually a group of 4 muscles, which originate from the lower parts of the pelvis and thigh bone, and insert into the upper parts of the Tibia. They are key drivers of knee joint extension, and stabilise the jont by working together with other muscle groups.
Hamstrings
This is a smaller group of muscles located at the back of your thigh. They originate from the lower part of the pelvic bone and insert on the upper parts of the Tibia and its smaller counterpart, the Fibula. They’re responsible for bending the knee joint(flexion), and work together with quadriceps to ensure knee joint stability during a variety of movements.
Gluteals(Glutes):
A group of muscles located at the back and sides of the pelvis. They’re primarily responsible for driving hip joint movements and controlling the pelvis. However, they also play a remote role in knee joint stability and efficiency. More specifically, they help prevent the thigh bone from being drawn inwards, which promotes proper load-bearing in the knee joint.
Adductors
These are muscles located on the inside parts of your thighs. They are mainly responsible for pulling the femur inwards to facilitate Adduction(inward movement) of the thigh. They also help with providing a counter force to keep the thigh bone in optimal positions during a variety of physical tasks.
7 Most Effective Exercises of the knee joint
Now let’s move on to some of the best exercises to strengthen your knees and keep them in the best shape possible. The good thing is that the most effective moves don’t require equipment and lots of space. You can easily get off to a great start with proper exercise form and loading strategy.
Caution: Please don’t jump into these exercises without professional assessment and advice if you’re recovering from or battling co-existing conditions. Book an appointment with one of our physiotherapists here for advice, or possible assessment.
Squat
The Squat is a powerful move for building multiple muscle groups in your lower body. Your Quadriceps and Gluts are the major players of the movement here, responsible for driving and controlling knee extension and hip joint extension respectively during all phases of the movement. Hamstrings play a secondary role, mainly as stabilisers of the knee joint.
How to do it
Starting position
- Stand up, feet at shoulder width wide. Keep your back straight, with your chest slightly drawn outwards.
The Movement
- With control, lower your body, as if you’re sitting down on a chair/bench. Your thigh should be parallel to the floor at the bottom position.
- Arm movements: Raise your arms to shoulder level as you’re lowering to the bottom position.
- Return to the starting position.
- Repeat the movement for another rep.
- Initially, aim for 4 sets of 12-15 repetitions.
Progression
Once you’re comfortable with the exercise form and easily hit 4 sets of 122-25 reps without much effort, it’s time to upgrade the load.
- Use an external weight(barbell/Dumbbells) you can handle for a maximum of 8-10 reps per set. Later on, adjust to higher loads you can handle for a maximum of 4-5 reps. This approach allows progressive overload, which is key for sustained strength gains.
If external weights prove hard to come by, you can easily adjust the difficulty level by altering the stance/position of the squat. The Bulgarian Split Squat is a perfect example. It’s essentially a form of single leg squat that allows you to zone in on one leg.
Safety
- Keep your knees safe. Make sure your knees dont bend beyond tour toes to avoid excessive loading in the knee joint.
- See a physiotherapist if you feel pain or crackling sensations in your knees when performing the exercise.
Bulgarian Split Squat
- Stand in front of a bench, chair, or any raised platform to knee level.
- Bend one leg and rest its foot on the raised platform at the back.
- Shift the lead leg forward to create some space to move into.
- Lower your body down until the lead thigh is parallel to the floor.
- With control, return to the starting position.
- Initial exercise volume should be the same as the basic squat. Adjust accordingly as you get proficient at varying difficulty levels.
Notes
- Keep your torso straight throughout the movement. Do not curl your back during the lowering and descending phases of the movement.
Safety
Don’t jump into squats before consulting your physiotherapist if you have a preexisting joint problem. You may need to start with lighter variations depending on your condition and other factors.
Lunge
The Lunge offers a more dynamic option with almost all the benefits that come with the classic squat. Again, your Quads and Glutes are key drivers of the movement, powering knee flexion and hip extension. Hamstrings work together with Quads to control the knee joint during movement. Adductors and Glutes help with controlling the thigh and pelvis to keep things aligned.
How to do it
Starting Position
- Stand up, chest slightly drawn outwards.
The Movement
- Take a long step forward with one leg, and lower your body to a squat position upon landing on the floor. At the bottom position, you should have your lead thigh parallel to the floor. The rear knee should be bent at around 90 degrees at the bottom position.
- Return to the starting position.
- Repeat the movement with the other leg.
- Initially aim for 10-15 reps for each leg, 3-4 sets.
- Once you are comfortable with the movement and volume, it’s time to upgrade the load.
Progression
Hold a dumbbell in each hand. Aim for a load that allows you to go for 8-10 reps without breaking exercise form. Adjust gradually as you get better till you can handle loads that allow a fewer number of repetitions(1-5 reps) per set. Alternatively, you can use a Barbell, placed across your shoulders.
Safety
- Avoid curling your back throughout the movement.
- If it proves too difficult or painful, switch to the partial lunge: Instead of going all the way down, only drop to around 40-50% of the movement then gradually work your way up to the ideal range of movement.
Nordic Curl
Recent studies consistently show the Nordic Hamstring Curl as one of the most effective exercises for building strength and efficiency in your Hamstrings. In fact, it’s a staple exercise in Hamstring rehabilitation and injury prevention programs in professional sports. Additionally, your glutes and core muscles work really hard to keep your pelvis and torso aligned. This translates to more gains beyond the Hamstrings.
How to do it
Starting Position
- You’ll need assistance from one person or a stable anchor to keep your legs fixed behind to get this done.
- Kneel down on a comfortable platform with your partner firmly holding your legs at the back for support.
- Keep your pelvis, thighs and torso aligned in a straight line at this point.
The Movement
- With control, lower your body down to floor level.
- Slightly push off the floor to return to the starting position.
- If this proves too difficult, begin with a partial curl(about 50% into the movement range).
- Aim for 8-10 reps, 3-4 sets.
Progression
Once you get comfortable, upgrade the load with extra weight i.e holding a weight plate/dumbbell on your chest. However, if this proves too difficult to execute, switch to the following lighter versions:
- Go partial range: Only go for 40-50% of the lowering range before returning to the starting position. You can do this actively, or set up a raised platform like a bench in front to allow you some rest before reversing the movement.
- If you can’t reverse the motion once you hit the bottom position, simply rest and use your arms to roll back to the starting position. The descending phase is enough for a start before you upgrade to full range.
Notes
- Avoid curling your Torso to the floor, movement should be limited to the knee joints.
Safety
- Don’t force it if this is too heavy or painful on your knees. Switch to the options below for more comfort.
Romanian Deadlift
This is another highly effective move for your Hamstrings. Comparative research studies consistently show it a heavy recruiter of your Hamstrings against a wide range of other popular workouts. Your Hamstrings and Glutes drive the movement by actively controlling the hip joint during the lowering phase, and driving its extension during the ascending phase. Your Quadriceps and core muscles also work to keep your legs and spine stable throughout the movement.
How to do it
Starting Position
- Stand tall and hold a light Dumbbell in each hand. Place the dumbbells just in front of your thighs, with palms facing backwards. Alternatively, you can use a light barbell.
- Bend your knees slightly, and lock/stiffen them to avoid any movement throughout the range.
- Keep your back straight and slightly draw your chest outwards.
The Movement
- With control, lower your chest down until it’s parallel to the floor. The dumbbells should be at ankle level at this point, with both arms stretched downwards.
- Return to the starting position.
- Repeat for another rep. Aim for 10-15 reps, 3-4 sets.
Progression
Once you get comfortable with the right form, upgrade the load to enhance strength gains:
- More dumbbells weight: Aim for heavier weights with lower repetitions. Initially concentrate on weights you can handle for 8-10 reps, same number for sets. Later on, upgrade to heavier loads with a target of 1-5 reps.
Safety:
- Protect your spine: Don’t curl your back throughout the movement. Poor form can easily cause back injuries.
- Proper form is crucial: Use very light loads at first to nail proper exercise form.
Single-leg Glute Bridge
This exercise is one of the most effective ways of recruiting your Gluts and Hamstrings in a single thrust. This makes it a great addition to the routine for building sheer strength and dynamic control during loaded movements which involve your hip and knee joints.
How to do it
Starting Position
- Lie down on your back. One leg should be bent with the foot flat on the floor while its counterpart is stretched out in front on the floor. Arms should be placed down on the floor straight by the sides.
The Movement
- Raise your waist and stretched leg to get into an inclined plank position.
- Hold for 1-2 seconds.
- Return to the starting position.
- Repeat for another rep. Aim for 12-15 reps, 3-4 sets.
- Repeat the sequence on the other leg.
Progression
Once you get comfortable and highly proficient with the exercise, switch to a folded arm single leg bridge:
- Simply fold your arms across the chest to reduce overall support. This imposes a higher load on your Glutes and Hamstrings to complete the movement.
Safety
Swith to the double-legged version if this proves pianful or too heavy to execute. In stead of raising one leg, push off the floor with two feet to get into the bridge position.
Step Ups
This is a great dynamic exercise to get your Quads, Glutes and Hamstrings work in unison. The Quads handle most of the load to facilitate knee extension, while Glutes and Hamstrings handle hip extension and facilitate stability and proper movement. It also helps with building balance due to the narrow base of support offered by the single leg stance.
How to do it
The Movement
- Stand up, facing a raised platform i.e 6 inch standard step, aerobic step.
- Place one foot on top of the platform.
The Movement
- With control, raise the rear foot onto the platform, and return to the starting position.
- Repeat the movement.
Note:
- Avoid pushing off the floor with the rear foot during the ascending phase. Don’t put weight on the moving foot once you’re on top of the platform with both feet. The stationary leg should be doing all the work throughout the movement.
Safety
- It’s best to perform the exercise close to wall or stable object, just in case you lose your balance.
- Pay attention to your body, any significant pain in the knee joint signals too much exercise intensity.
Sumo Squat
This is a classic squat variation, which aims at shifting some of the load to your Adductors. In fact, it’s one of the most effective ways of recruiting your Adductor muscles without the need for special equipment or tools. The wide stance with partially rotated legs alters the femur’s movement angle, which comes with a greater need for Adductor muscle force output.
How to do it
Starting position
- Get into a wide stance, feet a couple of inches outside shoulder width. There is no optimal distance, just make sure you’re wide but still comfortable and stable enough to move your upper body
- Rotate your feet outwards at about 45 degrees.
The Movement
- Lower your body down to a squat position(thighs parallel to the floor).
- Return to the starting position.
- Repeat for another rep, aim for 10-15 reps of 3-4 sets.
Progression
- Hold a dumbbell/weight plate on your chest to upgrade the load.
Safety
- Keep your torso straight: avoid curling forward to keep things optimally aligned and safe.
- Start out light: Begin with bodyweight-only training and get proficient and comfortable with the movement before upgrading the load.
When to see a Physiotherapist
Sometimes, your knees may give you important clues on their health during exercise or just regular physical activity. Spotting them early often makes the difference between effective, timely care and chronic problems. See a physiotherapist if you exepreinece one or more of these signs:
- Persistent pain during exercise or any other weight-bearing activity.
- Crackling sounds when bending the knee.
- Any form of swelling.
- Numbness or tingling sensations.
- A feeling of instability in weight-bearing positions i.e standing, walking.
Seelking care early on can be a gamechanger when there’s a legitimate condition lurking underneath the skin:
A few months ago, a middle-aged man walked into our clinic with a limp on the right leg. He complained of mild pain in the front part of the knee joint after prolonged standing and extended periods of walking.
Our biomechanical tests showed that his knee cap was tracking out of its natural path whenever he was walking or just bending the knee. The key reason was weakness in the Quad muscle responsible for keeping the knee cap on track. Not only that, weakness in his Glutes left his knees drawn inwards, which facilitated faulty movement and irritation of the knee cap.
We focused on improving his knee mechanics to correct the deficits and designed an exercise program, incorporating strength traning exercises targeting dysfunctional muscle groups. Modified variants of the Squat, lunges, Hip Thrusts, and step exercises were a huge part of the success story.
By the third week, the limp was almost gone while the pain had completely disappared. At this point we upgraded the exercise intensity and aimed at completely addressing imbalances and giving him a practical home program to work with. A few weeks later, he was discharge: without the pesky pain and limp.
Looking to get your knees healthier, and stronger?
Whether you’re simply looking to keep your knees healthy or recovering from an injury/condition, we’ve got you covered. At Healthy Movements Physiotherapy, we specialize in helping people like you with evidence-based treatment methods to get you moving better. Our musculoskeletal physiotherapists will conduct a thorough assessment, formulate a plan that works for you, and help you see it through. We will choose the right exercises for you, and make the necessary tweaks to ensure you have a sustainable solution for optimal knee health. Book a session today, hit the “appointment button” on the top right corner and get started.
Frequently Asked Questions
Exercise is therapeutic for most knee problems like Osteoarthritis. However, this needs to be treated with caution. You need to consult professionals for a proper assessment to know which exercises you need, and how much of load and volume of each you’ll need for tangible benefits.
There’s no one-size-fits-all solution here. While some exercises like Squats and Lunges register higher muscle activation levels than other popular leg muscle exercises, the best option depends on a range of factors beyond muscle activation.
Substantial gains can be seen with as litle as 2 sessions per week. However, there are no hard-set standards for everyone as strengthening goals differ. For beginners, 2-3 sessions may be enough, provided that a proper loading strategy is in place.
It really depends on the context. In cases where there is a degenerative condition like Osteoarthritis involved, exercises can play an important role in slowing down or halting disease progression, which eliminates the need for surgery. Additionally, stronger and efficient knees mean lower risk of issues like tendinopathies, arthritis, and injuries. This translates to lower risk of surgery.
