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Are your knees grumpy and pretty vocal about it? Knee pain is one of the most common physical ailments, with about 25 percent of adults being affected, according to a study published in the American Family Physician Journal. That same study reported that knee pain has increased by 65 percent over the past 20 years and that close to 4 million people visit their primary care doctors to address knee pain. But there’s hope. By performing exercises to strengthen bad knees, you may be able to make them happy again — the key is to do the right moves.
“I think of strengthening above and below the knee because people used to just focus on the quad right above the knee, but that is not really the issue,” says physical therapist Sherri Betz, DPT, certified Pilates instructor, owner of TheraPilates Physical Therapy Clinic and an American Physical Therapy Association spokesperson. “The issue is control of the alignment of the foot, and the strength of the calf and strength of the hip, and glutes.”
Why So Many Women Have Knee Pain
The knee is vulnerable to injury for a variety of reasons. For starters, Betz explains that most of the shock absorption at the knee comes from muscles, and weaker muscles mean that you can be more prone to knee injuries. That’s why strengthening the muscles around the knee and performing exercises to strengthen bad knees is key to reducing strains and preventing injuries of this important hinge joint.
Also, women in particular are more prone to knee pain, in part because their hips tend to be wider. One study published in the Journal of Orthopaedics even reported that “female athletes tear their anterior cruciate ligaments at an alarmingly higher rate” when compared to their male counterparts. As a result of women’s wider hips, their Q-angle, or the angle formed between the quad and kneecap, is wider, which places more strain on the knees. A higher Q-angle also can cause tracking issues with the kneecap, which can lead to pain and even injury.
Ready to give your knees some love? Betz shares the top four exercises to strengthen bad knees that she gives her clients:
1. Heel Raise
Simple heel or calf raises can help protect your knees. “The calf crosses the back of the knee, and it also controls the ankle,” Betz says. “So it propels the body forward, and it’s also responsible for eccentric control.”
How-To: Start standing with your feet together. Your toes and knees should be in line and facing forward, and your pelvis should be level. Keep your knees straight but not locked out. If needed for balance, hold a dowel rod or a surface for stability. Keep your toes on the ground as you raise your heels up and then return your heels to the floor. Repeat this exercise 10 times. Work your way up to 15. To make this harder, try performing this exercise on one leg at a time with your arms crossed over your chest. You can even perform this exercise on an unstable surface, like a stack of yoga mats or a wobble board to recruit more muscles and mimic an uneven outdoor environment. Make sure the arches of your feet are lifted and are not collapsing inward.
2. Three-Way Hip
“Working the quadriceps and the vastus medialis oblique muscle in the forward movement with the knee remaining straight is like doing a dynamic straight-leg raise to strengthen all the muscles around the knee,” Betz says. “Side motion targets the gluteus medius, abductors for pelvic stability and ankle stability of the standing leg. Backward motion targets the gluteus maximus, hip extensors and promotes hip-extension mobility of the lifted leg and the anterior musculature of the standing leg.”
How-To: Stand up straight with your knees straight but not locked out. Your supporting leg should be aligned with your moving leg. Hold on to a dowel rod or other surface if you need balance support. From there, move your leg forward, to the side and to the back. It’s important to keep your moving leg straight and not bent throughout the exercise. Do 10 reps and then rest. To progress this exercise, add a resistance band above the knees, below and then above the ankles, in that order, as your strength increases.
3. Long-Stride Straight Lunge or “Marriage Proposal Lunge”
“I like lunges because it will target one leg over the other,” Betz says. “It’s a great way to test quad strength.”
How-To: Stand with your feet and knees in alignment. Next, step about 3 feet forward with one leg, keeping that alignment in a lunge position. Next, raise your back heel to stretch your calf and hip flexor, then bend your back knee. Keep your back knee in the same position as you bend your front knee. Start with a quarter bend of your back knee and gradually progress to one-half, three-quarters and then a full lunge in which your back knee touches the floor. Bend as deep as you can without any pain. If you feel any pain, you’ve gone too far. Repeat with your opposite leg. Try to keep your torso straight. If you find you’re leaning forward — Betz says that many do to compensate for weak quads — find a door frame that you can lean against to keep your back straight. Add hand weights for increased resistance with your lunge exercises. You also can hold on to and stand on a resistance band with your front foot.
4. Single-Leg Bridge
Strengthening your glutes is another important way to keep your knees healthy.
“If you were to stand on one leg, what holds you up and keeps your pelvis on the opposite side from dropping is the gluteus medius,” Betz explains. “That provides the stability of the pelvis, so if you’re weak there, your pelvis collapses, and that puts more stress on the knee. With the single-leg bridge, the leg that’s on the ground is really working to stabilize the pelvis and uses the glutes and hamstrings.”
How-To: Lie on your back and put your feet together and flat on the floor. Lift your hips up, and keep your shoulders, hips and knees in one line. Next, lift one of your legs. Keep your knee on the lifted leg bent in a tabletop position to make it easier. For more of a challenge, keep your lifted leg straight. Next, roll back down to the floor and then lift back up. After 10 reps, rest.