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7 Exercises to Relieve Knee Pain

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The knee is almost always the first joint to go when people “start getting old.” How many people do you know have given up any kind of serious physical activity because of their “bad knees”? How many people avoid the gym because their knees are supposedly too stiff? How many people take the elevator to go up a floor, avoid hikes because they can’t handle the hills, or give up on their favorite sports—all because their knees hurt?

It’s too many. It’s a damn shame, and it doesn’t have to be like that.

The knee is actually a very powerful joint. Surrounded on two sides and supported by powerful muscles, tendons, and ligaments, buttressed by cartilage and fascia, and capable of great feats of recovery and regeneration, the knee is stronger and more resilient than most people realize. However, the knee has to be cultivated and strengthened. It has to engage in various movements to help it get stronger and make it stop hurting. If you want to reduce knee pain—or stave it off before it happens—these are the knee strengthening exercises for you.

1. Couch Stretch

The couch stretch, a movement and term coined by Kelly Starrett of Ready State fame, is a stretch that does not do hours of sitting. When we sit, our hip flexors remain in a flexed position. They’re flexed but not flexed. It’s a passive flexion that leaves them tight and weak. Then, when we go to do some squats or any other dynamic knee-centric sport or movement, we have to deal with all that tension upstream of the knee.

Try squatting. Just a basic air squat. See how it feels to rest in the bottom position. Maybe it’s okay, maybe it’s hard. Either way, take a mental note of how you feel squatting. Next, try the neckch stretch for one minute or two on each side. Then try squatting again. You should feel much less pressure on your knees and a greater ability to rest in the bottom position comfortably.

2. Knee Circles

To perform the knee circles, place your hands on your quadriceps, just above the knee caps. Allow the weight of your upper body to push down and rest on your hands. Then, give a few slow knee bends, flexing and extending your knees to “set” your menisci. Begin doing slow knee circles, first clockwise and then counterclockwise. Do about 30 seconds in each direction slowly, gradually, and deliberately, and really feel like you’re hitting every angle of your knee.

Knee circles are great for people with meniscus issues. They allow you to compress every part of the meniscus and help generate the stimulus needed to promote healing and regeneration. Because they’re low intensity, slow, and deliberate, knee circles rarely hurt. If you feel a sharp pain, try reducing the angle of flexion. These are a great warmup before leg workouts, or even done every morning as a warmup for life.

3. Tear Drop Squats

The teardrop squat is named for its ability to target the teardrop muscle of the quadriceps, also known as the vastus medialis obliques (VMO). Located on the medial part of your quad, the VMO is an important muscle for controlling the alignment of the knee cap, preventing knee pain and can also improve the aesthetics (tear drop) of your legs. When your VMO is weak, your knee is liable to buckle inward. Thus, strengthening the VMO through targeted movements can both improve your performance and help prevent catastrophic injuries (many MCL and meniscus tears happen when the VMO fails and the knee buckles inward).

Traditional leg workouts often do not adequately target the VMO, but the teardrop squat can help to engage it by maintaining an upright torso and keeping the feet on the balls of the feet as you squat down, allowing little to no space between the glutes and calves at the bottom of the movement. This extremely deep knee position hits the VMO.

In this video, you can see Mark Bell, who coined the term and came up with the exercise, show how it works. Set up a resistance band across a squat rack and use as much or as little of it for assistance as you squat down and back up. Move your hands farther apart for more assistance. Move them closer together for less.

Tear drop squats are a good accessory lift to throw in at the end of workouts, or even a couple sets as a warmup for heavier leg days.

4. VMO Step Downs

VMO step downs are also a great exercise for strengthening the VMO that you can do almost anywhere. Stand on a step or a short box with one foot hanging off the side and step down, touch the heel of your hanging foot to the ground and then go back up. Do not push off with the hanging foot; all the work comes from the foot that’s planted on the step.

This is all knee flexion. There should be little to no hip flexion. Keep your torso upright and straight. Don’t bend or hinge at the hips.

5. Deep Knee Split Squats

To perform a deep split squat, start by reaching one foot far behind you and put one in front of you with your torso centered between both. Slowly lower yourself into a squat, pressing forward until your knee goes over your toes. Hold this position for a moment to feel the stretch in your ankle, knee, and quad. Then, press back and up to return to an upright position. Be sure to focus on the stretch in your ankle and knee as you perform the exercise.

If these are too easy unweighted, progress to weighted with dumbbells, weight vests, or even barbells. They can be a legitimate strength training workout on leg days, or you can keep it light as accessory work.

6. Shin Raises

The tibialis anterior is the muscle running along the front of your shin. It controls ankle movement and stability, helps absorb the impact of knee flexion, and, most importantly, goes undertrained in the majority of people. A lot of knee pain occurs because the tibia is too weak to control the knee during the hard impactful flexion that occurs during jumping and landing, running and planting, and lifting.

Tibia raises involve starting with your ankle in plantar flexion (toes pointing down), then performing dorsiflexion (toes moving toward the knee) against a load (weight, band, etc). That’s it. You can do them standing or sitting. All that matters is starting in plantar flexion and performing dorsiflexion against a load.

To do shin raises, you have a few options. My guy Brian in the gif below has attached a dumbbell to the straps of his sandals. There is also specialized equipment designed to help you do weighted tibia raises, or you can use resistance bands or weight room cable machines. Worst case scenario you can even do them without any weight at all. Tibia raises are a great accessory lift on leg days.

7. Backward Weighted Hill Walks

Walking backward up a hill with a weight vest on or carrying weights is a low stress way to increase quad activation, strengthen the muscles surrounding (and controlling) the knee, and promote blood and healing synovial fluid flow to the knee. It lubricates your knees and gets you prepared for further intensity. The real beauty of the backward uphill walk is there’s no eccentric—it’s all concentric. Doing these before any leg workout is a fantastic way to warm up your knees without exhausting them.

You can also do a weighted backward sled drag using a prowler, weight sled, or even an automobile.

If you suffer from knee pain or worry about incurring it, incorporate these 7 knee strengthening exercises into your training sessions. Even if you don’t have knee pain, there’s no downside to strengthening your knees and the muscles that support them.

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About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprintwhich was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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