The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee: the anterior cruciate ligament stops the femur from sliding backward on the tibia (or vice versa, the tibia sliding forward on the femur). The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur) and the medial and lateral collateral ligaments stop the femur from sliding side to side. There are also two C-shaped pieces of cartilage called the medial and lateral menisci that act as shock absorbers between the femur and tibia. And finally numerous fluid-filled sacs (or bursae) help the knee move smoothly.

Unfortunately the knee is also one of the joints most likely to give us grief at some stage in our lives, either through injury (tearing a cartilage or ligament) or general wear and tear leading to arthritis. In 2017 there were some 106,334 knee replacement procedures carried out in England, Wales and Northern Ireland, whilst in the US this number increases to in excess of 250,000. 

Strengthening the muscles that support the knee can help prevent the need for surgery, or in the event of an operation still being needed, help bring about a successful outcome to the operation. You don’t need to worry that working out will cause more knee damage or pain either. As long as your doctor says it’s OK for you to exercise, the best thing you can do to relieve pain is strengthen the muscles and keep them flexible. 

Traditionally, treatment for the knee focused on strengthening the quadriceps muscle (the muscles at the front of the thigh), but recent research shows that strengthening the core, hip abductors, and glutes—in addition to stretching and strengthening the quads and hamstrings —is actually much more effective at easing knee pain than just strengthening the quads.

If you haven’t exercised for a while you will need to start slowly and build up over time but the following exercises are a great place to start. 

  1. Leg Raises. Start with a simple strengthening exercise for your quads, which puts little to no strain on the knee. Lie on your back on your mat. Bend one knee and place your foot flat on the floor. Keeping the other leg straight, raise it to the height of the opposite knee. Repeat 10-15 times for three sets. Repeat with other leg.
  2. Leg Slides.  Exercises the quads, hamstrings and glutes. Lie on your back with your feet off the mat. Your knees should be bent, a hip width apart ith your feet flat on the floor. If you are lying on a carpet you will need a piece of cardboard or something that will slide easily over the carpet. Raise the toes of your left foot so only your heel is in contact with the ground (or on the cardboard), Slide your left foot away from you being careful to keep your knee in line with your hip. When your leg is straight return it to the starting position. Repeat 10-15 times for 3 sets. Repeat with other leg.
  3. Single Leg Kicks. A great exercise to strengthen the hamstrings and buttocks. Lie on your front with your legs straight in parallel so that your tops of your feet are in contact with the ground, inner thighs engaged. Bend your elbows, making a fist with one hand and clasping it in the other and raise your chest. Keep your spine long, and focus forwards and slightly up. Slowly bring your left heel towards your left buttock with the toe softly pointed. Pulse twice before returning your foot to the ground. Do 3 x sets of 15. Repeat with other leg.
  4. Calf Raises. Stand facing the back of a sturdy chair. Hold the back of the chair with both hands. Slowly raise the heels as high as you can, then lower. Do three sets of 10-15. When this becomes easy you can increase the difficulty by lifting one foot slightly off the ground, and raising and lowering your heels on just one leg.
  5. Side Leg Raises. Works the abductor muscles, the glutes and the core. Lie on one side with your legs stacked one on top of the other. Bend the bottom leg at the knee for support. Ensure that your hips are perpendicular to the floor and your chest and hips remain pointing forwards and not downwards. If you need a little extra support you can place your top hand on the ground in front of you otherwise rest your top hand on your top thigh (this means you need more core control). Raise the top leg to about 45 degrees. Hold for 5 seconds, lower and relax briefly, then repeat 10 times for 2 sets. Switch sides and start over. 
  6. Side Clam. Great for the glutes and hip flexors. Lie on your side with your legs stacked and knees bent. Rest your head on your bottom arm or prop your head on your hand. Your hips should be perpendicular to the floor and your chest pointing straight ahead. Making sure that you don’t rock backwards open your top knee, keeping your feet together. The movement should come from your hip joint. Return the knee to the starting position. Repeat 10 times for 2 sets. Switch sides and start over again.

Think about doing some Pilates on a regular basis as this will enable you to work on all the key muscles without compromising your knee joint. Join a local Pilates class or take an online course from the comfort of your own home.

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