Exercises for knee pain

Pain in the knees may be due to osteoarthritis, old injuries, stiff joints or osteoporosis. In India, one in every eight men or three women suffers from osteoporosis, which is a debilitating bone disease that reduces bone density.

Physical activity, including weight bearing exercises, running, skipping, swimming, aerobics and brisk walking can help prevent the joint stiffness and increased susceptibility to fractures associated with osteoporosis.

The following beginner exercises for the knees can improve strength and endurance in the hip and thigh muscles, and range of movement of the knees and hips. This way, they can prevent stiffness in the knees and ease the pain of osteoporosis, arthritis or that of any injury.

Start by doing these thrice a week and gradually build up to seven days a week.

1. Quadriceps strengthening exercise: Lie on the floor or on the bed on your back. Contract your thigh muscles and pull in your toes while pushing out your heels. Hold this position for five seconds before releasing the pressure. Do ten repetitions initially, then gradually add an extra repetition each time you exercise. This exercise strengthens the muscles in the front of your thigh that work the knees.

2. Leg extension or stretching: Sit in a chair and stretch out one of your legs. Bend it at 45 degrees and hold the stance for a few seconds, then straighten it out again. You can add ankle weights once the knees adapt to the movement. Start with ten repetitions and work up to 25, adding one extra repetition a day as you get used to the exercise. You can add weights once you are comfortable with 25 repetitions on each side.
3. Straight leg raise: Lie flat on the floor or on the bed. Contract the thigh muscles of one leg and raise it from the floor or bed at about 45 degrees without bending the knee more than 30 degrees. Hold the position for a few seconds, then bring the leg down and relax. Repeat with the other leg. Initially do 10 contractions per leg, then increase them by one every day.

4. Hip abductor strengthening exercise: This exercise strengthens the muscles on the side of the thighs that work your knees. Here’s how you do it. Lie down straight on your side. Raise the upper leg slowly while keeping the knee fully straight by about 30 degrees. Hold the position for a few seconds before relaxing and bringing the leg down. Repeat this for the other leg. Start with five contractions per day and then add one every few days. Repeat this exercise with the knee bent at 90 degrees. These exercises strengthen muscles on the side of the thighs.

5. Step ups: Stand in front of a small footstool or a step. Place one foot on the step and let the other foot hang loose. Hold this position for a few seconds before returning both feet to level ground. Start with 10 repetitions at each session and gradually build up to doing more.

6. Hamstring strengthening exercise: Lie face down and fold one leg at the knee, pulling as hard as you can by tightening the muscles at the back of the thigh. Then straighten the leg. Start with 10 contractions a day and gradually work up to 25 a day by adding an extra contraction each time.

The following exercises are more strenuous:
1. Straight leg raise with weights
This is similar to exercise no 3 above but the ankle weights are added. Start low, say with a two pound weight and then build it up. Start with five repetitions for a few days and increase as in exercise 3 above.
2. Hip abductor stretches
Lie on your side at the edge of a bed or a table with your back towards the edge. Drop the upper leg behind and let it go far as it can without causing any pain. Hold the position for a few seconds before pulling up the leg. Repeat with the other side. Start with 10 repetitions and increase the number cautiously.
3. Standing press
Stand with your back against the wall and legs stretched out somewhat. Bend your legs gradually at the knees while sliding your back down along the wall till your knees form an angle of about 15 degrees. Hold the position for a few seconds before relaxing. Start with 10 repetitions and gradually begin to add one contraction per day.
4. Single leg knee bends
Hold on to two supports or railings on either side of you and raise one leg slightly off the ground. Now bend your other knee and lower yourself, putting your weight on the heel of the leg that is touching the ground. Hold the position for a few seconds before relaxing. Repeat with the other leg. Start with five repetitions and increase the number gradually.
5. Quadriceps stretches
Lie down on your stomach and try to hold your ankle with your hand. Then pull it towards your buttocks. Do not try more than 10 repetitions on each side as this exercise is tough on your knee caps.

If you have painful or arthritic knees or stiff knees due to a past injury, full squats or sit-ups can cause more harm than good. If you do sit-ups or squats, do not bend your knees more than 90 degrees. This means that as you squat, your knees should remain above your ankles and not go past them. Activities such as biking, swimming, skipping or brisk walking will improve the stamina of the leg muscles and also help to prevent stiff knees.

Remember to consult your doctor to confirm the suitability of the type and level of exercise you intend to start and also keep him updated regarding any aggravation in symptoms. Vigorous exercise can sometimes damage the knee joint and its delicate ligaments further and actually aggravate the problem.

Also read: Exercise during pregnancy

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Image: Flickr/creativecommons Studeo Grinta