How to strengthen a hurting knee

Bridge with T-Band

So, we’ve tried to regain mobility by stretching the muscles around the knee joint – calf, quad, hamstring, and IT Band – and we’ve addressed a great way to mobilize the restricted areas around the knee complex…all in an effort to minimize knee pain.  Both of these approaches should have at least lessened your pain intensity, but now we need to try to keep the pain away.   As I stated in the last post, the best way to keep yourself from re-injury is by establishing appropriate strength to the involved muscles.  Without an assessment from a PT, the involved muscles in each person’s given situation are impossible to determine…but I will focus on what I see most often, which should still help many of you. 

Calf Raise

Most injuries are a result of either too much of the same activity, poor form/technique, or come about from doing too little activity.  Balancing motor control will allow you to move properly and limit those factors that are often the underlying cause of your pain.  These exercises can also be used in a “prehab” application to help prevent knee pain; however, the focus of this post is to help those already in pain.  

T-band Abduction Mini Chair Squat

One of the most common questions I get is, “How can I start getting back to doing things ‘normally’ when it hurts to try?”  The simple answer: “DON’T push into pain.”  When you are already injured or hurting, the no pain, no gain adage goes out the window.  Instead, follow the guideline of self-pain rating on a 10 point scale…0 = No pain, 10 = Emergency room pain.  Keep yourself < 3-4/10.  Some pain is expected, as you are already in pain. “Sharp” pain should always be avoided, and your pain should continue to lessen.  These exercises focus on stability and work through a small, safe range for starters…with minimal activity at the knee complex itself.  Give these a try, you should feel yourself regaining some strength, stability, and gradually returning to your “normal” activities. If not, you may need to see a PT/medical professional for a more specific approach.

  • Bridge – Squeeze your butt FIRST! Next, push knees apart against the band and keep them shoulder width apart throughout the exercise. Use your butt muscles to lift your bottom off the ground. You will feel your butt + the front, side and back upper thigh muscles working to stabilize…don’t arch your back. Hold knees apart and butt up for 3 seconds. Lower and repeat.
  • Calf raise – Using a chair for balance, lift heels off the ground. Slowly lower back down & repeat. 
  • T-Band Abduction + Squat – With a band looped just above your knees, perform a small (mini) squat, making sure you are keeping your knees apart at shoulder width by pushing against the band.  It may be helpful to use a chair to get the correct form, but only if the chair is tall enough so you are NOT squatting too deep…again, this is a mini squat exercise. Squat like your sitting down.

“There is a good and a bad way to perform a squat, but sometimes these exercises are irritating to the knee joints regardless of form.  There are many other alternative exercises to strengthen the butt, quads and hips that can be used until the legs are strong enough to handle squats.” Chantal Donnelly, PT.  Chantal is absolutely correct.  These exercises are a good place to start for many of you, but again, please keep your pain range in mind.

  • As a guideline, perform 2 sets of 15 of these exercises…some of you may need more, some less.  After exercising these muscles would be a PERFECT time to stretch, as the muscles should be warmed up and somewhat fatigued. By working the muscles above and below the knee itself, we have started a low-level stabilizing program that should give most of you a great starting point in your return to normalcy.  Good luck, and feel free to ask any questions!