Maintaining Healthy Knees: The Role of Strengthening Exercises

Can incorporating stretches and exercises help relieve pain and provide more support for individuals with knee pain?

Knee Strengthening

The knee is the largest joint connecting the shin and thigh bones. Its cartilage, muscles, ligaments, and nerves all play a role in maintaining the joint’s health and movement. Individuals of all ages can experience knee pain, but it is more common in those with labor-intensive jobs, arthritis, and athletes. A healthcare provider will prescribe targeted stretches and exercises for individuals with pain, inflammation, or a health disorder that affects the strength of their knees to relieve knee pain while strengthening the muscles around the joint. Knee stretches and exercises are great for those with sore knees and knee pain or stiffness, but they can also be used as preventative medicine.

Exercise Benefits

Doing knee-strengthening exercises can significantly improve joint health. The benefits associated with exercises include (Zeng C. Y. et al., 2021)

• Reduced pain, stiffness, and joint dysfunction.
• Reduced inflammation.
• Improved mobility.
• Improved strength.
• Cartilage degeneration prevention.
• Bone loss prevention.

Leg Lifts

Leg lifts are done by lying on the back with one leg bent and the other fully extended. To perform the exercise: (American Academy of Orthopaedic Surgeons, 2009)

1. Raise the extended leg, keeping it straight.
2. Hold for three to five seconds once the leg is elevated roughly one foot off the floor.
3. Lay it back down to rest.
4. Repeat the exercise 20 times for each leg.

What To Avoid

When performing the single-leg lift, there are certain things to avoid as they can lead to other issues or injuries. This includes: (American Academy of Orthopaedic Surgeons, 2009)

• Arching the back
• Flexing the neck
• Moving too quickly through the motion.
• Using momentum instead of the muscles.

To know the exercise is being performed correctly, individuals should feel it in the front of their thighs.

Hamstring Stretch on a Bench

If a weight bench is available, doing hamstring stretches can help strengthen the knee. To perform this stretch:

1. Sit straight on the bench, with one leg straight out and the other planted on the floor.
2. With the knee straight, hinge over from the hips, keeping a straight, neutral spine.
3. Slowly push the chest towards the leg straight out on the bench. Hold for 15 to 30 seconds.

This exercise helps with overall strength, stamina, and balance. (Kothawale S. Rao K. 2018) (Wang H. et al., 2016)

What To Avoid

Avoid curving the spine to get closer to the thigh during the stretch. The key is not how far you can bend down but getting a deep stretch. Individuals not yet flexible enough to go all the way down should bend until comfortable but can still feel the stretch in their hamstrings. With practice and time, flexibility will improve. This stretch should be felt in the hamstrings.

Step Exercises

Step exercises, or step-ups, involve using a platform at least 6 inches high. To perform the exercise:

1. Put one foot onto the platform and use that leg to lift the other foot off the floor.
2. Hold the position with the foot hanging loosely for 3 to 5 seconds, then place the foot back on the floor.
3. Repeat each motion 20 times on each leg. (American Academy of Orthopaedic Surgeons, 2009)

What To Avoid

Avoid locking the knees when stepping up on the platform. Locking the knees switches off the muscles that need strengthening (American Academy of Orthopaedic Surgeons, 2009). Step exercises work out various areas of the leg. Individuals should feel this exercise in the thigh, hip, and buttocks.

Post-Exercise Stretching

Post-exercise stretching is vital in physical rehabilitation and strengthening. Stretching after exercise, individuals can (Afonso J. Clemente. et al., 2021)

• Relieve and reduce soreness.
• Expedite recovery times.
• Increase range of motion.
• Strengthen the knees more quickly and effectively.

Post-exercise stretches for knee pain and weakness can include:

Quadricep Stretch

This stretch targets the quad muscles located in the thighs. To perform this stretch:

1. Stand with the feet planted flat on the floor, spaced the same width as the shoulders.
2. Bending the left knee, grab the foot with the left hand and pull the heel toward the buttocks.
3. Hold for 5 to 10 seconds.
4. Repeat on both sides.

What to Avoid

There is no need to pull the heel too far into the buttocks. The goal is to feel a deep stretch. Pushing it too far can lead to injury. (Lee J. H. et al., 2021)

Toe Touches

Toe touches will help stretch calve muscles and hamstrings. To perform this stretch:

1. Sit on the floor with the legs straight out in front.
2. Bend the body over the legs at the hips, reaching for the toes in front while maintaining a straight back.
3. Relax the shoulders and keep them away from the ears.
4. Once touching the toes, hold the stretch for 15 seconds.

What To Avoid

Individuals who cannot yet touch their toes should perform the same steps and reach only as far as is comfortably possible. Over time, flexibility will improve. (Lee J. H. et al., 2021)

Injury Medical Chiropractic Clinic

These are examples of exercises and stretches that a physical therapy and chiropractic team may prescribe. Each case is different and requires reviewing individual medical history and physical examination to determine the proper treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility to relieve pain and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

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Knee Pain Rehabilitation

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References

Zeng, C. Y., Zhang, Z. R., Tang, Z. M., & Hua, F. Z. (2021). Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Frontiers in physiology, 12, 794062. doi.org/10.3389/fphys.2021.794062

American Academy of Orthopaedic Surgeons. OrthoInfo. (2009). Knee exercises. orthoinfo.aaos.org/en/staying-healthy/knee-exercises/

Kothawale S. and Rao K. (2018). Effectiveness of positional release technique versus active release technique on hamstrings tightness. Int J Physiother Res., 6(1), 2619-2622. doi.org/https://dx.doi.org/10.16965/ijpr.2017.265

Wang, H., Ji, Z., Jiang, G., Liu, W., & Jiao, X. (2016). Correlation among proprioception, muscle strength, and balance. Journal of physical therapy science, 28(12), 3468–3472. doi.org/10.1589/jpts.28.3468

Afonso, J., Clemente, F. M., Nakamura, F. Y., Morouço, P., Sarmento, H., Inman, R. A., & Ramirez-Campillo, R. (2021). The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in physiology, 12, 677581. doi.org/10.3389/fphys.2021.677581

Lee, J. H., Jang, K. M., Kim, E., Rhim, H. C., & Kim, H. D. (2021). Effects of Static and Dynamic Stretching With Strengthening Exercises in Patients With Patellofemoral Pain Who Have Inflexible Hamstrings: A Randomized Controlled Trial. Sports health, 13(1), 49–56. doi.org/10.1177/1941738120932911