The secret to a healthy knee joint? That would be strength. The knee carries the  weight of our body with each step we take, constantly flexing and extending  throughout the gait cycle to transfer the trunk forwards whilst we walk. The impact  penetrating this joint with each step equates to twice our bodyweight whilst  walking and four times our bodyweight whilst running. To put that into perspective,  if you were to run 5km, which takes roughly 3250 steps per leg, that’s 1,092,000kg  of force across EACH knee joint during that run alone.  

Why do we get joint pain?

There are several structures in the knee which are designed to absorb this impact  such as the meniscus which is a c-shaped pad of cartilage acting as a shock absorber. There is cartilage lining each of the bones that make up the knee joint  too. However, wear and tear of this cartilage occurs as we move through life, so  cartilage alone is not enough to protect the knee.  

The quadriceps, hamstrings, calf and glute muscles all have EXTREMELY  important roles in supporting, stabilising and protecting the knee joint. The quads act to ensure that the knee is capable of extending sharply whilst ensuring the  knee cap tracks over the femur neutrally. The hamstrings aid knee flexion and  support the joint posteriorly. The calf muscle also aids knee flexion and controls  the shift of the tibia during the gait cycle which prevents hyper-flexion during  walking. The glutes prevent knee valgus and increased pressure on the medial  aspect of the knee (which is prone to arthritic changes).  

We need to overload muscles in order to strengthen them and that means adding  RESISTANCE. A really simple way of doing this, is by using resistance bands. This  article includes my favourite resistance band exercises to target each muscle  group that supports our precious knee joint. 

Quads  

Resisted leg extensions. All you need is a chair and your resistance band. The idea is to keep the movement slow and controlled, resisting the band which is wanting to snap your leg back underneath you. The more you control the lowering of your knee, the more eccentric control you will gain in your quads which is vital to  support you knee on aggravating movements such as descending stairs or slopes.  

Hamstrings  

Romanian deadlifts. Lengthening a muscle under tension is a great tool to use to  keep tendons strong and healthy. If you experience pain at the back of your knee,  the distal hamstring tendons could be at fault. Not only does this hip-hinging  exercise strengthen the hamstrings to provide posterior strength to the knee whilst  keeping the tendons healthy but it also helps to increase flexibility! Increasing  flexibility in the hamstrings is vital as tightness can increase posterior pressure at  the knee which may ultimately lead to pain.

Glutes  

Glute bridge with abduction. The glutes consist of 3 muscles; the maximus,  medius and minimus. Each muscle plays a pivotal role in supporting the lower limb  and controlling the alignment of the knee. This exercise activates all three glute  muscles - the maximus drives the movement and then stabilises the pelvis whilst  the medius and minimus abduct the legs. We’re killing three birds with one stone!  

Glute Medius & Minimus 

Crab walks. The “side glutes” are so vital to knee stability, so I’ve selected another  glute exercise that biases them. Ensure that your knees are pointing straight  forwards throughout the entirety of the movement and take each step slow and  steady. Maintain a soft bend in your knees throughout and work against the  resistance band at all times to maintain that time under tension and eccentric  control! The stability around your knee will be through the roof after nailing this  one!  

Calf  

Banded ankle pumps. The calf is comprised of 2 muscles - the gastrocnemius and the soleus. The gastrocnemius crosses both the ankle and knee joint. It assists  with knee extension and is vital for reduced anterior load during the gait cycle. In  other words, the calf muscle must be very strong in order to prevent increased load at the front of the knee which could lead to pain and discomfort. These ankle pumps mobilise, strengthen and bring blood to the calf muscle so are ideal for prepping the muscle for high impact activity!  

Although these exercises are tried and tested, it is still very important to gain  professional advice if you are struggling with knee pain. Form, technique and  prescription are vital for reaching your goals and making progress so consulting a  health professional is a must when managing joint pain! 

This blog is written by Lauren Jackson BSc (Hons) Physiotherapist HPC Registered. 

Lauren graduated from the University of East Anglia with a first class honours degree in Physiotherapy in 2020. After completing professional placements in a variety of specialities, she completed her last year of study working in the USA in a busy outpatient clinic, using innovative and advanced methods to treat a multitude of clients including athletes and post-operative patients.

Lauren incorporates manual therapy, therapeutic massage, rehabilitative exercise, gait re-education & valuable advice and support to address all kinds of conditions, to treat & prevent further musculoskeletal issues from arising.

Lauren is also a qualified gym & Pilates instructor and has qualifications in sports massage and sports taping which she utilises to aid her patients’ recovery. She has an avid passion for fitness & exercise so understands the importance of returning to full health as quickly as possible. Lauren is proficient in person-centred practice to ensure that her Physiotherapy treatment is tailored to her patients' goals and lifestyle.

Note: This article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.