"There are many muscular attachments around the hips that help control the motion of the knee joint and your leg," Jaclyn Fulop, PT, founder of Exchange Physical Therapy Group, told Well+Good in 2020. "Knee pain is often due to muscle imbalances from tightness and weakness, and sedentary behavior for long periods of time can cause knee pain due to these imbalances."
- Brian Spencer, instructor at East River Pilates in New York City
- Chloe de Winter, physiotherapist, master Pilates instructor, and founder of Go Chlo Pilates
- Jaclyn Fulop, PT, physical therapist and founder of Exchange Physical Therapy Group
- Mitch Torres, PT, a physical therapist and lead editor for Knee Force
For example, she explains that when your gluteus medius (one of your butt muscles) is weak, it allows your thighs to rotate and pull inwards, which causes excessive strain around your knee joint. And tightness in your vastus lateralis (part of your quadriceps) can pull your kneecap in a wonky direction and damage the cartilage underneath.
When your muscles aren't firing optimally, that also means your joints don't get all the good stuff they need to thrive. "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," Mitch Torres, PT, physical therapist and lead editor for Knee Force previously told Well+Good. 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 what's a girl or guy in knee pain to do?
It should go without saying that any knee pain should be checked out by a doctor, who can determine if there is something more serious going on. But a good bet is also to keep your muscles strong. "You can help to correct muscle imbalances with strengthening of the gluteus medius and the vastus medialis, and stretching the lateral musculature," says Fulop. Stretching and strengthening the hips can also be useful, since strong, mobile hips can help prevent movement in the kneecap and protect the cartilage in your knee.
One smart option to make this all happen: Doing this Pilates for knee pain workout. In the latest episode of Well+Good's "Trainer of the Month Club," Chloe de Winter, a Pilates instructor based in Australia, walks us through her 20-minute Pilates for knee pain routine.
Each move is designed to create the strength your body needs to support those knees for the long haul—and none of the exercises should give you pain. If they do for any reason, try a variation, or skip ahead to the next move. But we're gonna bet you'll end up stepping off the mat with an extra spring in your step.
A 20-minute Pilates for knee pain workout
Now, who's ready to kick knee pain to the curb? Here's what you can expect.
Format: A Pilates mat workout, all done on the floor.
Equipment needed: Nothing but a mat to lie down on (comfy carpet works just fine, too). Though you can increase the challenge of a couple of the exercises with a booty band or Pilates ball (or rolled-up towel) if you want.
Who is this for?: This is a beginner-friendly workout for anyone who wants to strengthen the muscles that support their knees.
De Winter starts off her Pilates for knee pain routine with an outer-hip exercise she swears by: clams. The movement consists of lying on your side (pick a side, any side), with one leg atop the other with a bend in the knees, and pulsing one knee up toward the ceiling while keeping the heels touching and the pelvis stacked.
"We are really going to work into the muscles of the hip," says de Winter. "Now the glute muscles all around the hip help support those knee joints. Strong glutes mean supported knees.” By strengthening the hip and glute muscles, de Winter says that you'll feel more supported during walks, runs, and even while standing.
Just in case clams alone don't get those glutes burning (though they likely will), de Winter ups the ante by progressing to clams from a heels lifted position with the feet a few inches off the floor so that you can access a greater range of motion. She eventually adds kickouts at the top of each clam to really challenge those buns.
Want even more? De Winter says you can add a resistance band. Too much? Don't hesitate to take a break and punch out those glutes whenever you need. (Trust us, you're gonna feel it.)
To make sure you've got the clam basics down, check out this demo:
The next way de Winter works the muscles around the knees is with the Pilates bridge, which works the backs of the legs, including the glutes and hamstrings. "Really important muscles to really strengthen," says de Winter, adding that they're particularly good for the knees.
To do this exercise, lie down on your back, place your feet flat, raise your hands into the sky, and lift your hips up to form a straight line from your shoulders to your knees, keeping a neutral spine. "Press through your heels like you're trying to dig a hole," says de Winter.
If you're feeling lower back pain during bridges, one tip de Winter gives is to scoop the tailbone to take the pressure off. Remember, "It's not about the height that you lift. It's about really getting the muscles to activate and fire up," she says.
The workout continues with three different variations of the bridges: pulses at the top, bridges with heels lifted to engage the calves, and then alternating leg lifts to march with the hips in a bridge position (hello, hamstrings!).
Start by nailing that Pilates bridge form:
De Winter tops off this knee-friendly Pilates series with abdominal work to really engage the core and provide the base and foundation for you to move about the world in one solid piece, without putting undue pressure on other parts of the body (like the knees!).
This final section includes slow, gentle crunches; alternating marches that eventually add in an upper body twist to build into bicycles. Then de Winter caps everything off with triceps dips so you get a bit of a full-body burn, and she ends it all in a delicious butterfly pose to stretch those hips, inner legs, and your back.
If you find that ending pose leaves you craving more stretches, you can make it a double feature by moving into Well+Good's stretch series for knee pain, led by East River Pilates instructor Brian Spencer. Because, as Spencer says, “If it surrounds the knee, it’s a good idea to try and release it.” Expect deep calf massages, a series of lunges to open up your hips and quads, some hamstring and IT band stretches to help you get the backs and sides of your legs, which will support your knees from 360 degrees. Check it out, and thank us later:
Additional reporting by Zoe Weiner
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