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Last reviewed: June 2025
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified physiotherapist or GP before starting any new exercise programme, particularly if you have an existing injury or condition.
Knee pain is one of the most common complaints among adults, and it doesn’t discriminate by age or fitness level. Frequent knee pain affects approximately 25 percent of adults, limiting function and mobility while significantly reducing quality of life. The good news: a physio-recommended routine of targeted exercises can help reduce pain, rebuild strength, and restore confidence in your movement. This article walks you through a complete programme of warm-up, mobility, and strengthening exercises designed by physiotherapists, along with guidance on frequency, red flags, and when to modify your approach.
Key Takeaways
- Targeted exercise is one of the most effective non-surgical approaches for managing knee pain, supported by research from Harvard Medical School and multiple clinical sources.
- Warming up before loading the knee is essential: activation drills prepare the joint and surrounding muscles for safe movement.
- Mobility and stretching address stiffness above and below the knee, which is often where the real problem originates.
- Strengthening the quadriceps, glutes, and hamstrings builds a protective framework around the joint, reducing stress on cartilage and ligaments.
- Consistency matters more than intensity: three to four sessions per week at moderate effort tends to produce better outcomes than occasional hard workouts.
- Certain symptoms require immediate medical attention: sharp locking, giving way, significant swelling, or inability to bear weight are all red flags.
Can Exercises Help Knee Pain?
The short answer is yes, and the evidence behind this is strong. Dr. Lauren Elson of Harvard Medical School has stated that exercise is one of the most important things you can do for knee pain. Strengthening the muscles around the knee joint can help your body tolerate pain and stress on the joint itself, reducing the load that cartilage, ligaments, and menisci have to absorb on their own.
There is a common misconception that resting a sore knee indefinitely will fix the problem. In reality, prolonged inactivity often makes things worse. Muscles weaken, joints stiffen, and the cycle of pain and avoidance deepens. Physical therapist Kari Orlandi puts it well: “Motion is lotion. It provides a good exchange of nutrients for the cartilage. It helps to decrease swelling. It gets your muscles working. All of these good things happen when you stay moving.”
One important nuance: knee pain is often caused by problems occurring above or below the knee itself. Weak glutes, tight hip flexors from prolonged sitting, or stiff ankles can all alter your movement patterns and dump excess stress onto the knee joint. This is why a comprehensive exercise programme targets the entire lower limb chain, not just the knee in isolation.
For desk-bound professionals who spend eight or more hours seated, the risk is compounded. Prolonged sitting shortens the hip flexors, weakens the glutes, and reduces blood flow to the lower extremities. Taking movement breaks every 30 to 45 minutes can help counteract this. Even a brief walk to the kitchen or a set of standing knee lifts keeps the joint lubricated and the muscles engaged.
Body weight also plays a significant role. Every extra pound of body weight exerts roughly three extra pounds of pressure on the knees and other weight-bearing joints. That means losing just 10 pounds could decrease the stress on your knees by approximately 30 pounds, a meaningful reduction for anyone dealing with chronic knee discomfort.
A systematic review published in the British Journal of Sports Medicine (Fransen et al., 2015) found that land-based therapeutic exercise provides short-term benefit in terms of reduced knee pain and improved physical function among people with knee osteoarthritis. The Chartered Society of Physiotherapy also supports exercise as a first-line intervention for most musculoskeletal knee complaints, recommending it ahead of imaging or surgical referral in the majority of cases.
Warm-Up / Activation
Skipping a warm-up before knee exercises is one of the most common mistakes people make. Cold muscles and stiff joints are more vulnerable to strain, and jumping straight into loaded movements can aggravate an already irritated knee. A proper warm-up takes five to ten minutes and serves two purposes: it raises tissue temperature and it activates the specific muscle groups you are about to use.
Why Activation Matters
The quadriceps, glutes, and hamstrings all play critical roles in stabilising the knee. But after hours of sitting, these muscles are often inhibited, meaning they do not fire efficiently when called upon. Activation drills “wake up” these muscles so they can do their job during the strengthening portion of your routine.
Rebecca Bossick (BSc (Hons) Physiotherapy), a physiotherapist at One Body LDN, notes: “I see a lot of clients who jump straight into squats or lunges without any preparation. The knee doesn’t exist in isolation. If your glutes aren’t firing properly, your knee takes the hit. Two minutes of glute activation before your main exercises can make a real difference to how your knee feels during and after the session.”
Warm-Up Exercises
- Stationary cycling or brisk walking (3 to 5 minutes): Low-impact cardiovascular activity that increases blood flow to the lower limbs without stressing the knee. If you have access to a stationary bike, keep the resistance low and the seat height appropriate so your knee does not flex past 90 degrees at the bottom of the pedal stroke.
- Glute bridges (2 sets of 10): Lie on your back with knees bent and feet flat on the floor. Press through your heels to lift your hips, squeezing your glutes at the top. Hold for two seconds, then lower slowly. This activates the gluteus maximus, which is often underactive in people who sit for long periods.
- Mini-band side steps (2 sets of 10 each direction): Place a resistance band just above your knees and adopt a quarter-squat position. Step sideways, keeping tension on the band throughout. This targets the gluteus medius, a muscle that stabilises the pelvis and prevents the knee from collapsing inward during movement.
- Standing knee lifts (2 sets of 8 each leg): Stand tall and slowly lift one knee to hip height, pause for a second, then lower. This activates the hip flexors and challenges single-leg balance, both of which are relevant to knee stability.
The goal is not to fatigue yourself before the main exercises. Keep the effort moderate and focus on feeling the right muscles working.
Mobility / Stretching
Stiffness in the muscles and tissues surrounding the knee is a major contributor to pain. Tight quadriceps pull on the kneecap, tight hamstrings alter how the knee bends, and restricted calf muscles change ankle mechanics in ways that stress the knee from below. A targeted mobility routine addresses all three areas.
Quadriceps Stretch
Stand near a wall or chair for balance. Bend one knee and bring your heel toward your glute, grasping your ankle with the same-side hand. Keep your knees close together and your pelvis tucked slightly under to avoid arching the lower back. Hold for 30 seconds per side. If this position is uncomfortable, you can perform the same stretch lying on your side.
Hamstring Stretch
Sit on the edge of a chair and extend one leg straight out in front of you with the heel on the floor. Keeping your back straight, hinge forward from the hips until you feel a stretch along the back of your thigh. Hold for 30 seconds per side. This is particularly useful for people who sit at desks all day, as the hamstrings tend to shorten in the seated position.
Calf Stretch
Stand facing a wall with one foot forward and one foot back. Keep the back leg straight and the heel pressed into the floor. Lean gently into the wall until you feel a stretch in the calf of the back leg. Hold for 30 seconds, then switch. To target the deeper soleus muscle, repeat with a slight bend in the back knee.
IT Band Foam Rolling
The iliotibial band runs along the outside of the thigh and can contribute to lateral knee pain when it becomes tight. Lie on your side with a foam roller under the outer thigh, and slowly roll from just above the knee to the hip. Spend extra time on any tender spots, pausing for 10 to 15 seconds. This is not comfortable, but it can be effective for reducing tension.
Exercise improves circulation and reinforces proper mechanics, which is critical for successful knee injury recovery. Dr. Joseph J. Ciotola, an orthopaedic specialist, describes the effect of low-impact movement on synovial fluid as “a little oil for rusty hinges.” That analogy captures the essence of why mobility work matters: it keeps the joint lubricated and moving through its available range.
A NICE guideline (CG177) on osteoarthritis recommends exercise as a core treatment, alongside weight management and education, before considering pharmacological options. Stretching and mobility are integral components of any evidence-based exercise programme for knee pain.
Strengthening Exercises
This is where the real progress happens. Strengthening the muscles around the knee creates a supportive framework that absorbs shock, stabilises the joint during movement, and reduces the load on damaged or degenerating structures. Research consistently shows that targeted physical therapy helps improve joint stability, strengthen supporting muscles, reduce inflammation, restore mobility, and prevent future injury.
Straight Leg Raises
Lie on your back with one knee bent and the other leg straight. Tighten the quadriceps of the straight leg and lift it to the height of the opposite knee. Hold for three seconds, then lower slowly. Perform 3 sets of 10 per leg. This exercise strengthens the quadriceps without bending the knee, making it suitable for people with significant knee pain.
Wall Sits
Stand with your back against a wall and slide down until your thighs are roughly parallel to the floor, or as far as comfortable. Your knees should stay behind your toes. Hold for 15 to 30 seconds, building up to 60 seconds over time. This isometric exercise builds quadriceps endurance without the impact of dynamic movements.
Step-Ups
Using a step or sturdy platform (15 to 20 cm high to start), step up with one foot and bring the other foot to meet it. Step back down, leading with the same leg. Perform 3 sets of 8 to 12 per leg. Focus on controlling the descent, as eccentric control is where many people with knee pain struggle most.
Terminal Knee Extensions
Attach a resistance band to a fixed point at knee height and loop it behind your knee. Stand facing the anchor point with a slight bend in the banded knee. Straighten the knee against the band’s resistance, focusing on fully locking out the last 20 degrees of extension. This targets the vastus medialis oblique (VMO), a portion of the quadriceps that plays a key role in kneecap tracking.
Single-Leg Romanian Deadlifts
Stand on one leg with a slight knee bend. Hinge forward at the hips, extending the free leg behind you for balance, until your torso is roughly parallel to the floor. Return to standing. Perform 3 sets of 8 per leg. This strengthens the hamstrings and glutes while challenging balance, a combination that is highly relevant to knee stability.
Around 46 percent of people over 50 experience knee pain, and around 30 percent of younger adults deal with it too. As we age, muscle mass naturally decreases, making regular strengthening exercise even more important for maintaining joint health and function.
| Exercise | Primary Muscles | Sets x Reps | Difficulty |
|---|---|---|---|
| Straight Leg Raises | Quadriceps | 3 x 10 | Beginner |
| Wall Sits | Quadriceps, Glutes | 3 x 15-60s hold | Beginner |
| Step-Ups | Quads, Glutes, Calves | 3 x 8-12 | Intermediate |
| Terminal Knee Extensions | VMO, Quadriceps | 3 x 12-15 | Intermediate |
| Single-Leg RDL | Hamstrings, Glutes | 3 x 8 | Intermediate |
How Often Should You Do These?
Consistency is more important than volume. Performing these exercises three to four times per week is a reasonable target for most people. Each session, including warm-up, mobility, and strengthening, takes approximately 25 to 35 minutes, which is manageable even for people with demanding work schedules.
Aerobic exercises like walking, swimming, and cycling can relieve pain, improve function and mobility, and improve gait and quality of life. Aim to include two to three sessions of low-impact cardio alongside your knee-specific routine. A 20-minute walk at lunch or a swim after work counts.
Kurt Johnson (M.Ost, Master of Osteopathy) at One Body LDN often tells clients: “People expect to feel better after one session, and sometimes they do. But the real gains come from doing the boring stuff consistently for six to eight weeks. That is when the tissue actually adapts and the pain starts to shift in a meaningful way.”
It is worth distinguishing between an immediate trigger, like an awkward twist during a gym session, and the root cause, which is often accumulated deconditioning or biomechanical dysfunction from months or years of inactivity. Addressing the trigger alone without building long-term strength and mobility is a recipe for recurrence.
If you are recovering from a specific injury, your physiotherapist may adjust the frequency and intensity based on your stage of healing: acute (0 to 6 weeks), sub-acute (6 to 12 weeks), or chronic (beyond 12 weeks). Each phase has different goals and tolerances.
When to Stop or Modify
Not all knee pain during exercise is a sign of harm. A mild ache or sense of fatigue in the muscles around the knee is normal, especially when you are starting a new programme. Pain that is sharp, sudden, or located directly within the joint is different, and it warrants attention.
Red Flags That Require Urgent Medical Evaluation
- Sharp pain that causes the knee to lock or give way
- Significant swelling that develops within hours of exercise
- Inability to bear weight on the affected leg
- A popping sensation followed by immediate pain and instability
- Redness and warmth over the joint, particularly if accompanied by fever
If any of these occur, stop exercising and seek medical advice promptly. These symptoms may indicate ligament tears, meniscal damage, infection, or other conditions that require professional assessment.
When to Modify Rather Than Stop
Mild discomfort during exercise that settles within 24 hours is generally acceptable. If pain persists for more than 48 hours after a session, reduce the intensity or volume at your next workout. You might also swap high-load exercises like step-ups for lower-load alternatives like straight leg raises until symptoms settle.
Dr. Clint Soppe, an orthopaedic surgeon, emphasises that activity modification is very important when treating conditions like arthritis: “A big part of that is doing things that are less irritating to the knee.” This does not mean avoiding exercise altogether. It means choosing the right type and dose of movement for where you are right now.
It is also important to consult with a physiotherapist or GP before starting any new exercises to avoid worsening an injury. A professional can assess your specific condition, identify contributing factors like hip weakness or ankle stiffness, and tailor a programme to your needs.
Frequently Asked Questions
Is it OK to exercise with knee pain?
In most cases, yes. Gentle, targeted exercise is one of the best things you can do for a painful knee. The key is choosing the right type of movement and avoiding activities that provoke sharp or worsening pain. Low-impact options like cycling, swimming, and the strengthening exercises described above are generally well tolerated. If you are unsure, a physiotherapist can help you determine what is safe for your specific situation.
How long before I notice improvement?
Most people begin to notice some improvement within two to four weeks of consistent exercise, though meaningful changes in strength and function typically take six to twelve weeks. This timeline varies depending on the underlying cause of your pain, your baseline fitness, and how consistently you follow the programme.
Should I use ice or heat on my knee?
Ice can be helpful for acute flare-ups or after exercise if the knee feels swollen or warm. Apply for 10 to 15 minutes wrapped in a cloth. Heat tends to work better for chronic stiffness, particularly first thing in the morning. Some people benefit from alternating between the two. Neither is a substitute for exercise and rehabilitation.
Do I need an MRI for knee pain?
Not usually, at least not initially. Most knee pain can be diagnosed through a thorough clinical examination. MRI findings often show changes that are normal for your age and do not correlate with your symptoms. Routine imaging is generally discouraged unless red flag symptoms are present or conservative treatment has failed after several weeks.
Can I still run with knee pain?
It depends on the type and severity of your pain. Mild patellofemoral discomfort may respond well to a temporary reduction in running volume combined with strengthening exercises. Sharp or worsening pain during running is a signal to stop and get assessed. A physiotherapist can help you modify your training load and address any biomechanical issues contributing to the problem.
Are squats bad for your knees?
Squats are not inherently bad for knees. Performed correctly, they strengthen the quadriceps, glutes, and hamstrings in a functional pattern. Problems arise when form breaks down, when the load is too heavy, or when an existing injury is aggravated. Starting with partial-range squats or wall sits is a sensible approach if full squats are uncomfortable.
Your Next Steps
The best exercises for knee pain are not complicated. They require consistency, attention to form, and a willingness to start at a level that matches your current capacity rather than where you think you should be. A structured routine of warm-up, mobility, and strengthening work, performed three to four times per week, gives most people a realistic path toward less pain and better function.
If your knee pain has been lingering or you are unsure where to start, working with a qualified physiotherapist can make a significant difference. At One Body LDN, named London Physiotherapy Clinic of the Year 2025 and rated 4.9 on Google from over 6,500 reviews, the team combines hands-on treatment with tailored exercise rehabilitation to address the root cause of your pain. All major private health insurers are accepted, and no GP referral is needed. Book your first session to get a personalised plan that fits your life.
References
- https://stvincents.org/about-us/news-press/news-detail?articleId=59414&publicid=461
- https://www.health.harvard.edu/pain/take-control-of-your-knee-pain
- https://hartfordhospital.org/about-hh/news-center/news-detail?articleId=55094
- https://muscleandjointphysicaltherapy.com/top-exercises-for-knee-pain-relief-a-physical-therapists-guide/
- https://www.aarp.org/health/healthy-living/exercises-for-knee-pain/
- https://www.healthline.com/health/exercises-for-knee-pain
- https://benchmarkphysio.com.au/7-exercises-for-knee-pain/
- https://www.everydayhealth.com/orthopedic-conditions/these-exercises-are-best-for-knee-pain-research-finds/
- Fransen M, et al. (2015). Exercise for osteoarthritis of the knee: a Cochrane systematic review. British Journal of Sports Medicine, 49(24), 1554-1557.
- NICE Guideline CG177: Osteoarthritis: care and management. National Institute for Health and Care Excellence.
