The 18 Best Exercises for Knee Pain, According to a Physical Therapist

When you have achy, sore knees, working out is probably the last thing you want to do. But generally speaking, exercising bad knees can actually help them feel better.

"While you might not feel like exercising when you have knee pain, moving your knee can promote circulation and blood flow," Melissa Prestipino, DPT, clinical director of an outpatient clinic in Sparta, New Jersey, tells LIVESTRONG.com. Yep, strength training for knee pain is key.

The best exercises for knee pain have two important things in common: They strengthen the muscles that surround your knee, and put little-to-no impact on the joint.

Focusing on moves that bolster the surrounding muscles — specifically, the quads — will make sure your knee gets the support it needs and that it doesn't take on too much strain itself when you exercise or go about your daily movements.

"Strengthening your quadriceps after knee injury can help to promote increased joint stability and help to improve joint function and even decrease knee pain," she says. It's common to be prescribed quad exercises after knee injury, but anyone with problem knees should be doing them, too.

Other than the quads, the hamstrings, glutes and other small muscles in the hips and upper leg all play a role in keeping your knees happy.

To help you get started, here are the 18 best exercises for sore knees from Prestipino to add to your workout routine.

Warning

If you're experiencing knee pain, the number-one thing to watch for is increased discomfort during exercise. In general, if you're doing a workout for bad knees, your pain level shouldn't increase by more than 2 points on a scale from 1 to 10 during or after any given exercise.

If you feel any pain while strength training for bad knees — either during or immediately after exercise — it's best to cut that move from your routine or do a different variation so that it no longer causes pain, says Adam Rivadeneyra, MD, a sports medicine specialist with the Hoag Orthopedic Institute in Irvine, California.

If any exercise causes swelling or pain that lasts for more than two days, talk to a physical therapist or a physician with experience in sports medicine or orthopedics. It’s never a bad idea to play it safe and talk to a specialist if your knee issues are nagging or ongoing.

Move 1: Straight-Leg Raise

"Straight leg raises help to strengthen your quadriceps muscles, which are the main muscles supporting the knee joint," Prestipino says. "The quadriceps muscles' action is to flex your hip and to extend your knee."

You use your quads doing most everyday activities, like walking, squatting and even simply standing. In general, doing any quad exercise for knees can really help ease the pain.

Tips:

• Keep your quads contracted throughout the entire movement. This helps maintain the knee in an extended position so that you get the most muscle-strengthening benefits out of the move.

Modifications:

• If you have a difficult time lifting your leg against gravity, use a stretch/yoga strap to help assist the motion.

Move 2: Standing Hamstrings Curl

The hamstring muscles do just the opposite of the quads: They help to extend your hip and to flex your knee.

"Increasing hamstring strength can help to promote increased stability around your knee joint, which can help you avoid injury and limit pain," she says.

Tips:

• Keep your core engaged the entire time so that your spine stays neutral. That means your lower back doesn’t arch, and your pelvis stays stationary the entire time.

Modifications:

• You can also perform the hamstring curl in a side-lying or prone (on your stomach) position.

Move 3: Clamshell

Clamshells are great for strengthening your glute medius and glute minimus, also known as the "side butt" muscles.

"When your glutes are weak, your thigh tends to rotate inward," Prestipino says. "This is an abnormal position that puts a lot of stress on the knee, increasing the risk of injuries. Strengthening your glutes normalizes hip and thigh position, reduces the loading force on the knee joint and prevents the knees from caving in on each other when landing."

Tips:

• Keep your core engaged and tuck your tailbone to make sure your lower back doesn't end up over-arched in this position.

Modifications:

• To make this more challenging, loop a mini resistance band above your knees.

Move 4: Wall Sit

Wall sits, also known as wall squats, build strength and endurance in your glutes, calves, quads and even your abdominals, she says. All those muscles play a role in keeping the knees stable and strong.

Plus, because this is an isometric exercise in which you hold a single position, it tends to be comfortable on even the crankiest of knees.

Tips:

• Keep your toes, knees and hips pointed forward.

Modifications:

• To make the move easier or reduce pressure on your knees, don’t lower down as far.
• Place a stability ball in between your back and the wall.

Move 5: Seated Heel Slide

The focus here is the hamstring muscles. "Strengthening the posterior muscles of the lower extremities helps to balance out the anterior quad muscles, which can better help protect the knee from injury, such as ACL tears," Prestipino says.

The sliding movement also helps to increase circulation in the knee, she adds, which might help with inflammatory conditions like arthritis in the knees.

Tips:

• Don’t sit too far back in the chair, as it will limit how far you can slide your foot against the floor.
• Avoid sliding your foot too far backward, as this can put increased tension on the knee.

Modifications:

• Reduce the range of motion if the full range aggravates your knee.
• You can also do this lying on your back instead if that feels more comfortable for you.

Move 6: Bridge With Ball

"Adding the ball to the glute bridges recruits your hip adductors [inner thigh muscles] and your hip extensors [glutes and hamstrings], mainly your gluteal muscles," she says. Stabilizing and strengthening these areas helps to protect your knees.

Tips:

• Avoid hyperextending your spine in the bridge position. Instead, only lift your glutes until your low back is flat, stopping before it arches.

Modifications:

• Skip the bridge motion and do ball squeezes isometrically instead.
• You can also use a pillow if you don't have a ball.

Move 7: Standing Terminal Knee Extension With Resistance Band

Another great quad exercise for painful knees, this exercise helps to increase quadriceps muscle strength, which ultimately supports the knee and helps decrease pain.

Tips:

• “Avoid hyperextending the knee when pulling it into the extended position,” she says.
• Don't let you hips rock or your heels raise off the floor.

Modifications:

• If this is too challenging, ditch the resistance band and instead, focus on tightening the quad isometrically.

Move 8: Reverse Lunge

Reverse lunges are great knee pain exercises because they strengthen both your quadriceps and glutes. If you have knee pain, reverse lunges are better than forward lunges because they put less forward stress on the knee. Most people also find it easier to maintain stability in the front leg doing reverse lunges vs. forward lunges.

"Keep both feet pointed straight ahead and keep the front foot planted firmly so the heel is down on the ground," Prestipino says. Keep your back straight and neck in a comfortable, neutral position looking straight ahead.

Tips:

• “Keep both feet pointed straight ahead and keep the front foot planted firmly so the heel is down on the ground,” she says.
• Keep your back straight and neck in a comfortable, neutral position looking straight ahead.
• If you need to, hold onto a counter or railing for support.

Modifications:

• If a full range of motion feels uncomfortable, don't bend as deeply. Stop before the point where you start to feel discomfort.
• Keep the back leg straight and only bend the front knee.

Move 9: Hip Adduction With Ball

The goal here is to strengthen your hip adductor muscles. "By keeping the hip muscles strong, it prevents improper positioning of the knees, which avoids necessary strain," Prestipino says.

Tips:

• Avoid placing your feet too close to your butt, as this can cause unnecessary strain on the knees. Your feet should be far enough away that you can’t touch them if you extend your arms, but close enough that you can just tap them with your fingertips if you reach and shift slightly to one side.

Modifications:

• Instead of bending your knees, extend your legs straight and perform the same exercise.

Move 10: Supine Heel Slide

This is another one that helps strengthen those hammies and promotes blood flow in the knees.

Tips:

• Avoid sliding your feet too far backward, which will place unnecessary strain on the knees, she says.

Modifications:

• Shorten the range of motion and stop when you start to feel pressure.

Move 11: Quad Set

"Quad sets help to isometrically strengthen your quadricep muscle," Prestipino says. "The quad muscles are needed in sitting, standing, squatting and running. Strengthening your quads helps to support the knee joint, helping to decrease pain."

Tips:

• Keep your quad muscles completely engaged during the full count.

Modifications:

• "Use a thicker towel to lessen the range of motion between the knee and the bed/floor," she says.

Move 12: Lateral Lunge

Side lunges strengthen lots of muscles in your lower body, including your glutes, hamstrings, quads and inner thigh muscles. They even work your core.

"The side-to-side move puts less strain on the cruciate ligaments — part of your knees known to experience pain," Prestipino says.

Tips:

• Step out with your moving foot as wide as possible, and keep both feet completely flat on the ground, toes pointed straight forward, Prestipino says.
• Make sure your moving knee is over your foot, not caving in toward the midline of your body or bowing out to the outside.

Modifications:

• Don't bend the knee as deeply.
• "Instead of stepping into a lunge, you can use a paper plate or a slider to move away from the body," she says.

Move 13: Side-Lying Hip Abduction

This move focuses on strengthening the muscles of the outer thigh and hip, which will help to keep the knees in a more neutral position, Prestipino says.

Tips:

• Keep your hips stacked and avoid lifting the top leg above a 45-degree angle.

Modifications:

• Lie on your back, legs extended. Slide the leg away from the body in a "snow angel" motion.

Move 14: Short Arc Quads

Unlike some other more traditional quad-strengthening moves, this exercise gets the job done without putting any weight on the knee joint, Prestipino says.

Tips:

• Avoid lifting your leg off the bolster, towel or foam roller — that will get into the hip joint instead of focusing on the muscles surrounding your knee joint.

Modifications:

• Use a smaller bolster or fold a pillow or towel under the knees to reduce the range of motion of the leg, she says.

Move 15: Standing Hip Abduction With Resistance Band

This move targets your hip abductor muscles. "There is a big relationship between hip strength and knee position," Prestipino says. "By strengthening your hips, it can help avoid poor positioning of your knees and reduce strain."

Tips:

• Keep your core engaged throughout the entire exercise to avoid straining your lower back.

Modifications:

• If the band puts some side-to-side stress on your knee, try looping the band higher up your leg.
• Ditch the resistance band and do the movement without any added resistance.

Move 16: Standing Hip Adduction With Resistance Band

This move complements the previous one, this time strengthening your hip adductor muscles, or the glute muscles on the outside of the hip.

Tips:

• You can also use a mini band to do this move. Simply loop it around both ankles.

Modifications:

• Hold onto a bar or countertop for support, and lift the leg out to the side, using the stationary leg as your anchor.
• If the band puts some side-to-side stress on your knee, try looping the band higher up your leg.
• Ditch the resistance band and do the movement without any added resistance.

Move 17: Standing Hip Flexion With Resistance Band

This move helps to strengthen the hip flexors, which are the muscles in the front of the hips that connect the pelvis and the leg. Strengthening these muscles can help promote proper positioning of the hips and knees.

Tips:

• This one can also be done with a looped mini band around your ankles.

Modifications:

• If the band puts some side-to-side stress on your knee, try looping the band higher up your leg.
• Ditch the resistance band and do the movement without any added resistance.

Move 18: Standing Hip Extension With Resistance Band

The glutes and hamstrings are the main hip extensor muscles, connecting the hips and the legs at the back of the body. You use these muscles when you extend your leg behind you.

Tips:

• You can do this exercise with a mini band, too.

Modifications:

• If the band puts some stress on your knee, try looping the band higher up your leg.
• Ditch the resistance band and do the movement without any added resistance.

How to Exercise With Bad Knees

That said, if you get the green light from your doctor or physical therapist to start working out again, you can focus on exercises for bad knees.

Choosing low-impact forms of exercise can help reduce the forces of your own body weight and gravity on your knee joints, Prestipino says. Using softer surfaces, such as cushioned flooring can also help to decrease unnecessary stressors on your knee.

When selecting lower-body exercises, "closed-chain" ones in which your feet are firmly planted on the floor keep your knee in a more stable position, Dr. Rivadeneyra says.

"These movements will lead to greater quality of movement that will take the stress off the knee, decrease inflammation within the joint and shuttle healing blood to the area to speed the recovery process," says Andy Coggan, CPT, a certified personal trainer and corrective exercise specialist with Gold's Gym in College Station, Texas.

You can also largely reduce stress on your knee during lower-body exercises by limiting how much you allow your knee to bend, like capping any knee flexion at 90 or even 45 degrees.

Keeping your weight balanced in the heel of your foot will also transfer excess weight to your hips and core and off your knees.

Additional reporting by Rachel Grice.