Fitness

7 Pilates Exercises To Try If You've Got Knee Pain

It's all about strengthening the surrounding muscle groups.

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Pilates moves that help with knee pain.
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If you’re experiencing knee pain, adding a few simple Pilates moves into your weekly workout routine might be the ticket to relief. Pilates is a good go-to form of exercise for this because it strengthens the muscles around the knee and it helps with patella tracking, aka the natural motion of sliding, rotating, and lifting when you bend or extend the joint, says Laura Wilson, a celebrity trainer and founder and CEO of Natural Pilates.

“Happy knees are dependent on the balance of all the muscles around them,” adds Joy Puleo, M.A., NCPT, the director of education at Balanced Body. That’s why it’s so easy for your knees to get out of whack in the first place. If a muscle is too tight or too weak, Puleo says the whole system gets thrown out of balance — and that’s when your knees become much more prone to pain and injury.

Pilates can help as it fixes imbalances by moving your body through various ranges of motion, says Kyle Georgina Marsh, a Pilates instructor and co-founder of True II Form Pilates & Wellness. It also reaches muscles that are often neglected in other forms of exercise, she notes. And it does all of this while being low impact (read: easy on the joints).

While Wilson recommends checking in with a Pilates instructor or doctor for ongoing knee pain, it is often possible to set things right by strengthening your lower muscles. Marsh suggests doing Pilates moves, like the ones listed below, two to three times a week until your knee pain goes away.

1. Hip Rolls

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Wilson suggests starting off with hip rolls or bridges. “This exercise helps with knee pain in two ways: by strengthening the glutes, hamstrings, and lower back, and also by actively stretching the front of the knee joint in the bridge position,” she says.

- Lie on your back with a neutral spine, your knees bent, and feet planted hip-distance apart.

- Flatten your spine onto the mat.

- Inhale through your nose.

- As you exhale, roll your spine one vertebra at a time off the mat until your hips are lifted in a long line from your knees to your shoulders.

- Keep your abs engaged to avoid overextending your lower back.

- Breathe in again.

- On an exhale, slowly roll back down.

- Do 10 to 20 reps.

- Add hip pulses at the top if there is no pain.

2. Kneeling Thigh Stretch

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Marsh says kneeling thigh stretches can do wonders for the knees by strengthening the quads and the glutes.

- Roll up a mat or a towel to pad the knees.

- Come into a kneeling position on the towel with your knees about hip-width apart.

- Stack your head, shoulders, and hips directly above your knees so your body is in a straight line.

- Squeeze your butt muscles and press both your shins and knees down into the mat.

- Hinge your whole body back from the knees as far as you can go.

- Use your thighs and squeeze your butt to bring everything back up to vertical.

- Repeat 4 to 5 times.

3. Clamshells

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“This move helps to strengthen the muscles around the knee: the abductors, adductors, gluteus maximus, and gluteus medius,” says Allie Guillerm Tichenor, a Pilates instructor and owner of Pilates Punx.

- Lie on your side with your hips and shoulders in line with the back edge of the mat.

- Prop your neck and head up with your hand, with your elbow down on the mat.

- Have a 90-degree bend at the hips and knees with your feet stacked one on top of the other.

- Keep your heels together as you open your top knee to the ceiling.

- Open as high as you can without rocking back on your hips.

- Lower your knee back down and repeat.

- Do 10 reps on each leg.

4. Bridges With A Ball

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You can also do a bridge pose with a Pilates ball between your knees for a challenge. “This move helps to strengthen your glutes, hamstrings, and inner thigh muscles, which will all help to stabilize the knee,” says Jaylee Thomas, a Pilates instructor and owner of RE:MIND meditation + movement.

- Lie flat on your back with knees bent, feet hip-distance apart, and your heels directly in line with your knees.

- Place a small ball or towel between your knees.

- Inhale to prepare. On the exhale, keep your abs engaged as you squeeze the ball and lift your hips up.

- Hold for an inhale at the top of the bridge, then lower your hips back down on the exhale.

- Repeat 10 to 12 times for 3 to 4 sets.

- On your last rep, pause at the top and pulse the ball 10 to 15 times.

5. Side-Lying Leg Lifts

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“These exercises are an excellent way to keep the musculature surrounding the knee balanced,” says Jackie Wiener, MS, NCPT, a national certified Pilates teacher with Pilates Place Studios Miami and South Beach. “Many knee injuries occur when one muscle is too strong and the other becomes weak. Once injured, these are simple but extremely effective exercises that can help rehabilitate the affected area.”

- Lie on your side.

- Align your hips and shoulders.

- Keep your legs extended out straight.

- Slowly lift your top leg as high as you can.

- Maintain straight hip alignment.

- Lower your leg.

- Do 3 sets of 10 on each side.

6. Leg Circles

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Wiener also recommends this Pilates exercise.

- Lie on your back with your legs bent and feet placed hip-width apart.

- Raise one leg up.

- Draw a circle in the air with your foot.

- Go clockwise 8 times, then counter-clockwise 8 times.

- Repeat on the other leg.

7. Single-Leg Kicks

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Lesley Logan, a certified Pilates instructor with OnlinePilatesClasses, suggests giving single-leg kicks a try. “This move will help strengthen the hamstring-glute connection while opening up the front of the hip,” she tells Bustle. “Many people have an imbalance in their quads versus their hamstrings, which can put undue pressure on the knee joint and cause pain. The more we balance the two muscle groups, the easier it is on the knee joint.”

- Lie on your stomach.

- Prop up on your forearms.

- Keep your arms parallel.

- Press down into your mat so your shoulders stay down.

- Stretch your legs long and press them down into the mat.

- Keep your foot long as you “kick” one foot towards your butt two times.

- Press that leg back down and repeat on the other side.

- Do 5 to 8 kicks per leg.

Studies referenced:

Andriacchi, T.P. (1984). A study of factors influencing muscle activity about the knee joint. J Orthop Res. https://pubmed.ncbi.nlm.nih.gov/6481510/

Kaya, D. (2012). How can we strengthen the quadriceps femoris in patients with patellofemoral pain syndrome?. Muscles, Ligaments and Tendons Journal, 2(1), 25-32. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666499/

Kim, K. (2016). The effect of gluteus medius strengthening on the knee joint function score and pain in meniscal surgery patients. Journal of Physical Therapy Science, 28(10), 2751-2753. https://doi.org/10.1589/jpts.28.2751

McLeod, K. (2012). Vibromyographic analysis of knee muscle imbalances in knee osteoarthritis. Journal of Biomedical Science and Engineering. DOI:10.4236/jbise.2012.54025

Saleem, N. (2022). Effect of Pilates based exercises on symptomatic knee osteoarthritis: A Randomized Controlled Trial. J Pak Med Assoc. doi: 10.47391/JPMA.495. PMID: 35099429.

Experts:

Laura Wilson, celebrity trainer, founder and CEO of Natural Pilates

Joy Puleo, M.A., NCPT, director of education at Balanced Body

Kyle Georgina Marsh, Pilates instructor, co-founder of True II Form Pilates & Wellness

Allie Guillerm Tichenor, Pilates instructor, owner of Pilates Punx

Jaylee Thomas, Pilates instructor, owner of RE:MIND meditation + movement

Jackie Wiener, MS, NCPT, national certified Pilates teacher with Pilates Place Studios Miami and South Beach

Lesley Logan, certified Pilates instructor with OnlinePilatesClasses

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