You can be free of pain without surgery

Most people over age 50 can expect to live longer than their parents or grandparents, but many are doing so without their original knees.

What’s happening: Knee-replacement procedures, known as total knee arthroplasty, have become one of the most commonly performed surgeries in the US.

Each year, more than 600,000 Americans undergo knee replacement to help relieve the pain associated with knee osteoarthritis, rheumatoid arthritis or other forms of degenerative joint disease—and the numbers just keep rising. This trend is due largely to an aging population and obesity, a leading cause of joint damage.

But is surgery really the right solution for all these people? Not necessarily.

Here’s the catch: Many people who receive knee replacements could have avoided surgery—along with the risk for infection and the painful weeks of postsurgical rehabilitation—with simple exercises that strengthen the knee and help prevent deterioration of the tendons, ligaments and bones.


In addition to exercise, normal body weight is critical for long-term knee health. If you’re overweight or obese, your knees are subjected to unnecessary force. Research has shown that losing as little as 11 pounds can cut the risk of developing knee arthritis by 50%.

But if you’re overweight, losing any amount of weight can help. One study, published in the journal Arthritis & Rheumatism, found that every pound of lost weight translates into a four-pound reduction in knee stress—with each and every step.

Why exercise helps: Patients who stretch and strengthen the muscles around the knees have better joint support. There is also an increase in synovial fluid, a gel-like substance that keeps the joints moving smoothly.

What’s more, exercise increases bone density in these patients and results in better range of motion.


Everyone can benefit from knee exercises. Even if you don’t suffer from knee pain now, the following exercises may help prevent problems from developing. People who have received surgery to replace or repair a knee also can benefit by strengthening their muscles to help guard against future knee injuries.

The goal of knee exercises is to work the muscles around the joint. These include the quadriceps (on the front of the thigh)…the hamstrings (back of the thigh)…and the muscles in the calves. Strength and flexibility in these areas support the knees and help keep them aligned. Alignment is critical because asymmetry increases pressure and joint damage.

Perform the following regimen daily—it can be completed in about 15 to 30 minutes. If you have an advanced knee problem due to a condition such as rheumatoid arthritis, your doctor may also prescribe additional exercises that are targeted to address your specific issues.

Important: All of the exercises described in this article should be performed within a range of motion that does not cause pain. If a slight strain occurs with the first repetition, that is acceptable, as long as the pain diminishes with subsequent repetitions. If the pain worsens with subsequent repetitions, stop the exercise.

Four must-do knee exercises…

fs_knee_chestKnee-to-Chest Stretch. This exercise improves flexibility in the lower back, hips and hamstrings. People who do this stretch will notice an opening of their hips, allowing them to stand taller. This improvement in posture is important for reducing knee stress.

Bonus: You can use this movement to diagnose knee problems. If the knee you’re bending doesn’t come straight toward your shoulder and stay in line with your foot, you’ll know that you have an alignment problem that needs to be corrected.

This knee exercise can be performed in bed if that is more comfortable than doing it on a carpeted floor or on a padded surface.

What to do…

  • Lie on your back with your knees bent and your feet flat on the floor (or bed).
  • Using both hands, slowly pull one knee toward your chest. (To avoid straining the knee, grip behind it, not on the front.) Go as far as you can without discomfort—you should feel a stretch in your lower back, but no pain.
  • Hold the position for 15 to 30 seconds, then slowly lower the leg. Perform the movement eight to 12 times. Repeat with the other leg.

fs_knee_resistanceKnee-to-Chest Stretch with Resistance. This is similar to the exercise described above, except that you use a latex exercise band (such as Thera-Band) to increase resistance and strengthen muscles.

  • Lie on your back with your legs straight. Loop the latex band around the bottom of one foot. Grip the loose ends of the band with both hands.
  • Use the band to pull your knee toward your chest.
  • Hold the position for 15 to 30 seconds, then straighten the leg while pushing against the band—hold the band taut to increase resistance. Do this eight to 12 times, then repeat with the other leg.

fs_one_legStanding One-Leg Balance. This move is more challenging than it looks because you’re using the weight of your body to strengthen your legs as well as the “core” muscles in the abdomen. These muscles, which connect the torso and pelvis, help control motions in your whole body. Core weakness is a common cause of asymmetric motion, which often leads to knee problems.

  • Stand next to a wall, with your right shoulder just touching the wall.
  • Lift your left knee until the foot is off the floor. If you can, keep raising it until the thigh is about parallel to the floor. Make sure that your posture is upright at all times.
  • Hold the position for about 15 seconds, then lower your foot. Repeat eight to 12 times, then turn around and do the same thing with the other leg.

Important: If you can’t balance for 15 seconds—or if you find yourself using the wall for support or moving your arms or dancing around to balance on one foot—your legs are weaker than they should be. This means you should definitely also do the next exercise.

Note: Even if you can easily perform the one-leg balance above, it’s a good idea to do the one below to maintain your strength.

fs_leg_resistanceStanding One-Leg Balance with Resistance. This is similar to the exercise that’s described above, except that you use a latex band to strengthen muscles in the thighs and hamstrings.

  • Stand with your right shoulder barely touching a wall. Loop a latex band under your left foot. Hold the loose ends of the band in each hand.
  • With your hands at waist level, raise your left foot until your thigh is about parallel to the floor. Shorten the band by wrapping it around your hands to keep some tension on the band.
  • While holding the band taut and your knee elevated, slowly press your foot forward, as though you’re taking a big step. Keep the band taut to increase resistance. Maintain your balance!
  • Now, pull on the band to return to the bent-knee position. Repeat eight to 12 times, then turn around and repeat with the other leg.