"A weak muscle pumps less blood in and out of the joint, meaning the knee won't have enough nutrients, and over time they won't be able to work properly," says Mitch Torres, PT, physical therapist and lead editor for Knee Force. Additionally, "strong muscles also act as shock absorbers. They protect the knee joint by absorbing the impact coming from the floor. Weak muscles won't be able to do this, so the whole impact will be received by the joint tissues. Over time, this makes them prone to injury as well."
So when muscles like your quadriceps or glutes are weak, Joseph Rayner IV, PT, DPT, a Texas-based physical therapist, says that your knees might pick up the slack, becoming responsible for an intolerable amount of stress that leads to pain.
"When the gluteus maximus and-or gluteus medius are weak, it will require the quadriceps to have to work harder to handle the demands of an activity," says Dr. Rayner. "If the quadriceps is also weak, then the patellar tendon will also have a hard time managing the loads of the activity. Lastly, when our muscles and tendons have reached their full capacity, the passive stabilizers of our knee, like our ligaments, will have to take on the rest of the load."
Note that when you're managing knee pain, the exercises you perform should only cause minor pain—no more than a three out of 10. And if things aren't getting better, it's time to visit a professional.
"If you have pain that immediately starts with or without a pop, and you notice swelling shortly afterward, you very likely sustained an injury that should be looked at by a medical doctor or a physical therapist," says Torres. "The more intense your symptoms are, the more likely you should go see a medical doctor. If you have pain that gradually sneaks up on you without a very obvious, abrupt incident you may or may not have an injury. In this case, seeing a physical therapist would likely save you time and money to resolve the issue."
To manage knee pain due to weak surrounding muscles, the solution is—you guessed it—to strengthen those muscles. Explore a few knee-strengthening exercises to try below.
5 knee-strengthening exercises
1. Wall squats
Ryan Balmes, DPT, a board-certified orthopedic and sports physical therapist and spokesperson for the American Physical Therapy Association, says wall squats are great for strengthening the glutes and quads. You can either perform a wall quat hold or a wall squat for reps. For each, begin with your back on the wall and slowly walk your feet out, keeping your back against the wall, bending at your hips and knees until you're in a seated position where your knees are in line with your hips and your ankles are directly under your knees pointing g straight forward in line with your toes. To hold, just stay in that position for 30 seconds and then come up to rest. Repeat this five times. For reps, once you slide down the wall and get into the wall squat position, come right back up. Repeat three sets of ten.
2. Isometric lunge
An isometric exercise is one that is done by holding a muscle contraction, explains Dr. Rayner. Standing up straight, step one foot back and lower down into a lunge position until you feel a light level of pain or until your bottom knee nearly touches the ground. Make sure your front knee stays in line with your front ankle, and your back knee stays right under your hips. Hold this position for 30 to 45 seconds and repeat three to four times.
Watch this to learn proper lunge form:
Deadlifts help to strengthen the hamstrings and glutes, and "also help stabilize the knee, so the stronger they are, the safer the joint will be," says Dr. Torres. Start standing with your feet shoulder-width apart and your toes slightly pointing out. Next, bend your knees a little and bend forward at the hips, keeping your back flat, with most of the movement at your hips. Stand back up again, squeezing your hamstrings and glutes to do so.
4. Side-lying hip abduction
This exercise targets your gluteus medius. Dr. Balmes says to start lying on your side opposite the painful leg with your hips and legs stacked on top of each other. Lift your top leg up, making sure it stays in line with your lower leg and doesn't drift down in front of you, and then lower it back down. Repeat three sets of 10 reps.
5. Lateral step downs
Work your quads by working in reverse with lateral step-downs. Start with one foot on a 12-inch step and the other foot hanging off the side of the step, says Dr. Rayner. Take about three seconds to lower yourself to the point that your hanging
foot taps the ground. For the leg that is stabilizing you on the step, be sure to keep the knee from caving inwards—it should stay in line with your second toe. Complete two to four sets of six to 10 reps.
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