What are the best leg exercises for knee pain?

It’s such a common question and over many years, working with hundreds of patients, I’ve pulled together a selection of mid-level exercises that I have found work well for all sorts of knee pain.
Here you will find some of the best leg exercises incorporating strengthening, balance and stretching exercises that can help many causes of knee pain.
Muscles can get weak and tight over time or after an injury without us really noticing. When this happens, it changes the way the knee moves and how the forces go through the knee which causes pain. Most causes of knee pain will benefit from knee exercises.

****The exercises here are mid-level exercises. If they feel too strenuous or your knee movement is quite restricted, try simpler exercises first.

1) Bridging: Stage 1
Purpose: One of the best leg exercises for increasing all-round strength and control – strengthens the hamstrings whilst also working the quads and buttock muscles. Also helps develop core strength and stability

Starting Position: Lie on your back with both knees bent about 90° and your feet on the floor/bed
Action: Clench your buttocks and lift your bottom off the bed as high as you can without arching your back. Hold for 3-5 seconds and slowly lower
Repetitions: Repeat 10-25 times, 1-2x daily

Note: 1) Keep your back straight – don’t let it arch as you lift up, make your bottom doing the work
2) Don’t hold your breath – keep breathing normally
3) Don’t let your knees drop out – imagine you are trying to hold a tennis ball between your knees

2) Wall Squats
Purpose: One of the best leg exercises for strengthening the quadriceps. A little twist on normal squats – doing them against the wall reduces the pressure going through the knee compared to conventional squats whilst still increasing the strength

Starting Position: Stand with your back against a wall, feet about 6 inches from the wall, knees apart, toes pointing forward
Action: Slide down the wall, allowing your knees to bend. Hold for a few seconds and then push back up
Repetitions: Repeat 10-25x, 2x daily
Progression: 1) Increase the depth of the dip (up to 90°)
2) Hold the bent knee position for longer (aiming for 10secs)

Note: As you squat, don’t let your knees come too far in or out – Keep your knee in line with your second toe so you can always see your big toe past the inside of your knee.

3) The Clam
Purpose: One of the best leg exercises for strengthening the buttock muscles. Almost everyone I’ve seen with knee pain has weak glutes. The glutes help support the knee and make sure the forces are evenly spread throughout the joint.

Starting position: Lie on your side with your hip and knees bent approx 90°, feet together
Action: Keeping your feet together, lift the top knee up as high as you can. Hold for 3 seconds and slowly lower
Repetition: Repeat 10-25x on each side, 2x daily

Note: Do not let your top hip roll backwards

4) Step Ups
Purpose: Strengthen the quadriceps and improve knee control/stability
Starting Position: Stand facing the bottom of the stairs/single step and put the leg you want to strengthen up on the step. Hold onto the wall/rail for support if required

Action: Slowly, step your other leg up onto the step and then lower it back down to the floor.
Repetition: Repeat 10-30 times, 2x daily
Progression: 1) Don’t hold onto anything
2) the slower you do the exercise, the harder it will work your knee muscles

Note: 1) Make sure you can see your big toe at all times – keep your kneecap in line with your second toe, don’t let the knee fall inwards
2) If you don’t have any steps at home, be creative e.g. large book

5) Side Step Downs
Purpose: Strengthen the quadriceps, improve balance, improve knee stability
Starting Position: Stand sideways on top of a step. Hold the wall/rail for support

Action: Slowly lower your good leg down to the floor and then bring it back up (keeping your other foot up on the step throughout)
Repetition: Repeat 5-20x, 2x daily
Progression: Stand facing forwards and step down instead of sideways, lightly touching the good leg to the floor

Note: 1) You are aiming to do this in a slow, controlled fashion
2) Don’t let the knee twist inwards

6) Solo Heel Raises
Purpose: Strengthen the calf muscles to help support the knee

Starting position: Stand on one leg holding onto something stable for balance
Action: Push up onto your tiptoes so your heel is up of the ground as high as you can. Hold for 3-5 secs and slowly lower
Repetition: Repeat 10-30 times, 2x daily
Target: When you can do 30 repetitions on a single leg, that is a good sign you have good strength in your calf muscles