Knee pain and poor knee health – what to do?

Amy Graber PT, DPT

Knee pain is a very common physical therapy concern in patients of all ages and activity levels — we see it a lot here at Fit Family Physical Therapy. If you are wondering what may be causing your knee pain or how to relieve your pain, we are here to help! 

What is poor knee health?

Knee pain is a very common orthopedic physical therapy concern among patients of all activity levels. Johns Hopkins Medicine states, “many knee problems are a result of the aging process and continual wear and stress on the knee joint (such as, arthritis). ” But, what does poor knee health look and feel like?

Patients coming to physical therapy with “bad knees” (or poor knee health) are generally describing painful knee joints, unstable knee joints, or just general weakness of the surrounding musculature. Pain with weight bearing is usually present and can increase with kneeling, squatting, or use of stairs. If an individual has an unstable knee, they may experience abnormal movement of the joint with lateral or rotational movements and general lack of stability with heavier loads. There is no particular appearance of a knee in poor health and you may, in fact, get more information from looking at the muscles surrounding the knee!

Recommended exercises for knee pain

A great exercise to strengthen your knees is a step up. To perform, step up on a 10-18” box with one leg, bring the opposite leg up to meet it, and return the opposite (2nd) leg to the floor. Then, alternate and step up with opposite foot. To increase difficulty you can add dumbbells to your hands, or try to complete consecutively for 15 reps on one foot before switching legs.

This exercise targets the quadriceps that directly acts on the knee joint, and also the lateral hip musculature which has an indirect affect on knee joint stability by controlling the femur (top part of the knee joint).

Another really good exercise for knee pain is a lateral lunge. To perform, stand with feet together. Step out to the side up to 2 feet and shift your weight to that foot. As you shift your weight, lower your hips and bend your knee as if you were squatting, while maintaining opposite leg straight. Return your foot back to starting point with feet together. Repeat on opposite side.

This exercise targets many muscles of the lower extremity, including the glutes. Your glutes contribute to stability of your knee in the frontal plane (side to side movement) and transverse plane (rotational movement). Providing this kind of strength can help to avoid injury with change of direction activities.

If you are adding these exercises into your routine, always remember to start off with limited range of motion (what feels good) and no weight. Add in resistance and increased range of motion once you establish control over the new movement. If you are experiencing pain with any of these exercises, consult with a trusted medical professional or a mobile physical therapist, like us! Did you know we offer a free phone consultation for knee pain or any other pain you are experiencing!

Other activities to improve knee pain

Aquatic therapy can be a great short-term solution for knee pain and poor knee health, especially for individuals with knee osteoarthritis. The properties of water allow for reduced weight bearing and load through the knee joint, while still allowing for opportunities to strengthen the surrounding muscles. You can perform exercises like step ups, squats, forward and backward walking, and lateral stepping in water just as you can perform on land. The water serves as a relieving environment for patients initially which could allow them to continue with a program for a greater duration, or even build strength before transitioning to a land-based exercise program, which is shown to be helpful for knee pain as well. (Citation: https://pubmed.ncbi.nlm.nih.gov/27007113/)

Activities to avoid if you have knee pain

Initially, it is best to avoid some activities that are significantly increasing your pain, until you can come up with a treatment plan that treats the root cause of your knee pain. Rest is not necessarily the answer, but activities that drastically increase your pain may not be the best solution early on. You want to build tolerance to higher loading through the knee joint by increasing strength and volume of surrounding musculature. As you build tolerance to loading, you can begin to resume and attempt those activities that were once painful.

Kneeling is another activity that might be best to avoid with knee pain caused by osteoarthritis. The direct pressure and impact on your patella (knee cap) and knee joint (femur and tibia) is unlikely to be relieved with any treatment besides surgery. So it is best to avoid this activity if it causes you pain.

Many people wonder if knee popping or clicking is concerning. You can check out our post about knee pops, clicks, and catches here.

A good exercise plan for knee pain

It’s important to strengthen your knees in multiple planes of movement. Our body naturally moves in three planes: front/back, side/side, or rotational. Our knee primarily moves in the front and back direction as it bends and extends but there are many forces at the knee joint that act in all three planes.

We need our muscles to help control those forces at the knee joint to avoid injury. Because of this, your exercise program for building knee strength should include movement that is forward/backward, side to side, or rotational in nature.

We recommend working with a physical therapist to find the root cause of your knee pain and create a customized exercise plan to fit your individual needs. A good exercise plan is one that is tailored to your (k)needs!

Still need more help with your knee pain?

Concerned about your own knee pain symptoms? Need mobile physical therapy in Scottsdale? Contact us at Fit Family Physical Therapy for a free physical therapy consultation phone call. We can address your concerns and help you determine an appropriate course of action for your shoulder pain. Skip the line with physician and insurance wait times, talk to us, and start your path to pain- and symptom-free activity today!

You can also check out our exercise library on YouTube! We have a knee physical therapy playlist just for you! As always, if you’re unsure about your ability to perform any of these exercises, reach out to us or a healthcare provider first.

About the Author

Amy Graber PT, DPT has practiced physical therapy in a variety of settings. She has worked specifically with the pediatric population, assisting infants and young children reach developmental milestones, or rehabilitating young athletes. Amy has also worked extensively with adult patients and finds equal joy in helping adults reduce disability and reach their movement potential. She has specific experience with orthopedics, gait & balance training, and geriatrics.