As pivotal joints in our body, the knees bear the brunt of our movements and activities. This makes them susceptible to wear and tear over time.

Whether you’re dealing with knee pain or aiming to prevent it, adopting a holistic approach to knee health is paramount. In this guide, we’ll delve into the many causes of knee pain and discuss exercise to strengthen knees using safe techniques and exercises specifically designed to strengthen and safeguard your knees from injury.

CAUSE #1: ARTHRITIS & BURSITIS

Osteoarthritis, rheumatoid arthritis, and other types of inflammatory joint diseases can cause chronic knee pain, stiffness, and reduced mobility. Osteoarthritis (OA) is the most common form of arthritis and a significant cause of disability worldwide, with approximately 14% of the adult population living with OA (Public Health Agency of Canada, 2022). 

Though there is no known cure for osteoarthritis, there are plenty of management and prevention techniques that you can incorporate into your life in order to reduce its likelihood and level of impact. Time and time again, studies have proven that exercise is an effective intervention for decreasing pain and improving function in patients with hip and knee osteoarthritis.

Bursitis is a condition characterized by inflammation of the bursae: small sacs filled with fluid that act as cushions between bones, tendons, muscles, and skin, reducing friction in the joints. When bursitis affects the knees, it typically involves inflammation in one or more of the bursae around the joint. The most commonly affected bursa in the knee is the prepatellar bursa, located in front of the kneecap (patella). Another commonly affected bursa is the infrapatellar bursa, situated beneath the patella tendon. 

We urge you to consult your primary care physician to diagnose and set a treatment plan if you suspect you have bursitis. “Physical therapy and range of motion exercises play a role in increasing the strength of the muscles that support the area around the bursa” (National Centre for Biotechnology Information, 2023), and a certified personal trainer can work alongside allied health professionals to improve condition.

CAUSE #2: OVERUSE & MISUSE

Overuse and misuse of the knees can lead to significant pain and discomfort due to the excessive strain placed on the joint and surrounding structures. Engaging in repetitive activities or movements without adequate rest and recovery can result in stress on the knee joint, causing irritation and inflammation. Activities such as excessive running, jumping, or prolonged kneeling can strain the tendons, ligaments, and cartilage in the knee, leading to conditions like tendinitis, bursitis, or even stress fractures. 

Additionally, poor biomechanics, improper footwear, or incorrect body posture during movement can alter the alignment and distribution of weight on the knees, putting undue pressure on specific areas. This can result in imbalances, increased wear and tear, and eventual breakdown of the joint, leading to chronic pain, stiffness, and reduced mobility. Proper conditioning, appropriate rest periods, using correct techniques, and maintaining good posture are essential in preventing overuse-related knee injuries and preserving joint health.

cause #3: injury

Knee injuries encompass a wide spectrum of conditions. Ligament injuries, such as anterior cruciate ligament (ACL) tears, often occur due to sudden twisting motions or abrupt changes in direction, commonly observed in sports like soccer or basketball. Medial collateral ligament (MCL) injuries result from direct impact or force applied to the outer knee and are prevalent in contact sports or accidents. Meniscus tears, involving the cartilage cushioning the knee joint, can result from abrupt twisting or deep squatting motions. Patellar tendonitis, or jumper’s knee, is caused by repetitive jumping or activities that strain the patellar tendon, while patellar dislocation occurs due to sudden twisting or direct impact, leading to the displacement of the kneecap. Fractures can arise from high-impact accidents or trauma to the knee, such as falls or vehicular collisions. Overuse injuries, like runner’s knee (patellofemoral pain syndrome), stem from repetitive stress on the knee joint without adequate rest, commonly seen in runners or cyclists.

CAUSE #4: AGING

Aging significantly impacts the knees, leading to various changes and challenges within the joint. As individuals age, the cartilage, which serves as a cushion between the bones of the knee joint, tends to wear down gradually (osteoarthritis). Additionally, ligaments and tendons may become less flexible and more prone to injury. As the years pass, bone density can decrease, making bones more vulnerable to fractures and weakening the overall structure of the knee. Furthermore, years of use and repetitive movements may contribute to cumulative damage and degeneration, resulting in chronic conditions that impact the knees as individuals advance in age. Proper exercise, weight management, and preventive care can help mitigate some of these age- related changes and preserve knee function for longer periods.

CAUSE #5: OBESITY

Obesity exerts significant stress on the knees, leading to various adverse effects on joint health. The excess weight carried by individuals who are overweight or obese places immense pressure on the knee joints during daily activities such as walking, climbing stairs, or standing. 

This increased load contributes to accelerated wear and tear of the joint cartilage, leading to a higher risk of developing osteoarthritis in the knees. Furthermore, the extra weight can alter the alignment of the knees, causing imbalances and misalignment that can strain ligaments and tendons. Over time, this strain increases the likelihood of injuries such as ligament tears or tendinitis. Managing weight through proper diet and exercise can significantly alleviate the burden on the knees, potentially reducing the risk of developing knee-related issues associated with obesity. For further information on how obesity affects your joints, check out our recent blog post on the topic.

CAUSE #6: KNEE ANATOMY

Before diving into exercises, it’s crucial to comprehend the knee’s structure. The knee comprises bones, ligaments, tendons, and cartilage that work harmoniously. The quadriceps, hamstrings, and calf muscles play significant roles in knee stability and function. Additionally, the patellar tendon and other ligaments provide support and maintain alignment. Strengthening exercises should target these muscle groups while also focusing on flexibility and balance.

EXERCISES FOR KNEE STRENGTHENING

QUADRICEPS

Straight Leg Raises: Lie on your back with your knees bent and your feet flat on the floor. Extend one leg, then raise it to the height of the opposite knee. Hold briefly, then lower it down. Repeat for 15 reps before switching legs. Perform 3 sets.

Wall Sits: Stand against a wall with knees bent at a 90-degree angle. Hold the position for 30-60 seconds, gradually increasing duration. If you’re not able to reach 90 degrees, lower as far as you can while maintaining stability and avoiding knee pain.

HAMSTRINGS

Hamstring Curls: Stand with your feet hip width apart. Shift all of your weight onto one left before squeezing the hamstring of the opposite leg to bring your heel towards your glutes. For an extra challenge, add an ankle weight or pull up against an anchored resistance band. Repeat for 15 reps before switching legs. Perform 3 sets.

Bridge Pose: Lie on your back with your knees bent and your feet flat on the floor. Brace your core and push through the heels to lift your hips off the ground, engaging your hamstrings and glutes. Repeat for 15 reps and perform 3 sets.

CALVES

Calf Raises: Stand tall with a braced core and your feet hip width apart. Rise onto your toes, then lower your heels with control. Repeat 3 rounds of 10-15 reps. To increase the challenge, stand with your toes on the edge of a step.

Seated Calf Raises: Sit on a chair and lift your heels off the ground, then lower them down. Repeat 3 rounds of 10-15 reps.

BALANCE AND STABILITY

Single Leg Stance: Stand on one leg and hold the position for 30 seconds to a minute. Progress by closing your eyes or adding challenges like reaching or tossing a ball.

BOSU Ball or Balance Board: Stand on these tools to for advanced balance and stability, engaging the muscles around the knees.

FLEXIBILITY

Quad Stretch: From a standing position, bend one knee to grab your foot or ankle and pull it towards your glutes. Keep your knees close together and your core braced without arching in the lower back. Place your hand on a support for balance if needed. If you’re unable to reach your foot, place the back of it on top of a bench or step instead. Hold for at least 30 seconds per leg.

Hamstring Stretch: Lay on the floor with your legs out long. Bring one leg up as far as you can while keeping the opposite leg out long, aiming for 90 degrees. Keep a slight bend in the knee of your stretching leg to avoid hyperextension while gently pulling it towards yourself. Use a band or strap for assistance if you can’t reach your leg. Hold for at least 30 seconds per leg.

LOW-IMPACT AEROBIC ACTIVITIES

Swimming, Cycling, and Walking: Engage in activities that are gentle on the knees, promoting cardiovascular health without excessive stress on the joints.

Alternative exercises

Alongside the exercises we’ve covered, consider this series (below) specifically designed to strengthen the knees, as demonstrated by Poul Nielsen.
 

PRECAUTIONS AND TIPS

  • Proper Form: Maintain correct posture and alignment during exercises to prevent unnecessary strain on the knees.
  • Gradual Progression: Start slowly and gradually increase repetitions, sets, or weights to avoid overexertion or injury.
  • Warm-Up and Cool Down: Always warm up before exercising and cool down afterward to prepare and recover the muscles.
  • Consult a Professional: If you have existing knee issues or concerns, consult a physiotherapist or healthcare professional for personalized guidance.

CLOSING COMMENTS

Strong and resilient knees are integral to an active and healthy lifestyle. Regular exercise, focusing on strengthening the muscles around the knees, improving flexibility, and enhancing balance, can significantly contribute to knee health. By incorporating these exercises into your routine while being mindful of precautions, you can protect your knees from injury and maintain their strength for years to come. Remember, a proactive approach to knee care today ensures a more functional and pain-free tomorrow!

If you need further assistance, contact Nielsen Fitness to start your knee-care journey with an experienced personal trainer.