Knee Pain in Women: 5 Exercises for Less Pain

Approximately 1 in 5 women over the age of 18 experience knee pain.  This prevalence of knee pain in women is even higher in those older than 60.  The reasons women are more susceptible to knee pain and injury are based on anatomical, biomechanical, and hormonal factors.  The wider shape and structure of the female pelvis and hips may predispose women to knee injuries.  Women also tend to run, walk and jump with different mechanics than males.  Finally, the female hormones, such as estrogen, make their joints and ligaments are looser and susceptible to injury.

Some of the contributing factors to knee pain in women (pelvis structure, etc.) are not changeable.  However, other factors are under your control.  Several studies have linked problems in muscle strength and coordination to knee injuries and pain in women of all ages.  In particular, deficits of the hip, pelvis, and core muscles are more common in females than males with knee pain.  Thankfully, studies prove these deficits can be improved with exercise and the right exercise programs significantly reduce knee pain.

Proven Exercises for Knee Pain in Women

A 2014 study conducted in Brazil investigated the effects of two different types of exercise programs in women with knee pain.  One group of women performed 8 weeks of traditional thigh muscle strengthening exercises such as the leg extension, leg press, and squats.  The other group of women performed 8 weeks of core, pelvis, and hip muscle strengthening exercises.  These exercises focused on strengthening the hip muscles and improving control of the pelvis and trunk.  Control of the pelvis and spine has been linked to knee injuries in females but these factors are often overlooked in traditional physical therapy programs.

Three months after the study began, the group of women doing the hip, pelvis, and core exercises outperformed those doing the traditional exercises.  Women who performed the hip and core exercises were experiencing less knee pain.  These women also were more satisfied with their overall improvement and functioning at a higher level than those who performed the traditional strengthening exercises.  It is also important to note the women who improved the most demonstrated larger improvements in the lower limb, pelvis, and trunk control during a single leg squat.   This proves the benefits of this type of exercise program.  The following 5 videos are a few examples of the types of exercises that are most helpful for women with knee pain.

90/90 March

Training begins with developing an awareness and control of the pelvis and trunk in supported positions.  The 90/90 March begins with a neutral spine, bracing, and diaphragmatic breathing.   Elevate the legs so the hips and knees are at right angles.  Maintain a neutral spine, bracing, and proper breathing as you slowly alternate lowering the heels to the floor.  Gently touch the heel to the floor without relaxing.   Perform 10 to 20 slow repetitions on each side.  To learn about other progressions of these types of exercise go here.

Hip Extension in Plank Position

Exercises targeting the gluteus medius and gluteus maximus are very important for those with knee pain.  Start facedown supported on the elbows in a plank position with the trunk, hips, and knees in neutral alignment.  Initiate the movement by lifting one leg with the knee bent.   Extend the hip slightly past neutral by bringing the heel toward the ceiling.  Hold this position for 2 seconds.  Maintain the plank position throughout all repetitions on one side.  Complete the desired number of repetitions on one side before beginning with the other leg.

A common error with this exercise is to arch or overextend the spine when lifting the leg.  Also, as the abdominal muscles tire, the hips may rise.  Be sure to maintain a neutral trunk, hip, and knee alignment throughout the exercise.  To learn about other progressions of these types of exercises go here and here.

Sitting 1-Leg Balance

Once exercises are mastered in non-weight bearing positions they are progressed to weight-bearing on 2- and then 1-leg.  Single leg balance on a stability ball is a great place to start this transition.  Begin sitting upright on a ball with your hands on both sides of the pelvis.  Maintain upright and tall throughout the exercise.  Slowly extend 1 leg and hold this position for 10 seconds.  Try alternating sides with each repetition.  Pay special attention to minimizing any lean of the trunk as you transition between legs.

Standing Lateral Rotation

The deep rotator muscles of the hip are important because they assist with controlling rotation (twisting) of the thigh and knee.  This exercise can be challenging at first.  With practice, balance and control will improve.  Start by grasping a resistance band in both hands.  Hold the hands close to the body.  Stand on 1-leg and slowly rotate the body to the opposite side.  Pause 1 second then slowly return to the starting position.  This exercise is typically performed for 10 to 15 repetitions with multiple sets.

Pelvic Drop Exercise

With 1 leg, stand on a small step.  Place the hands on the sides of the pelvis.  The knee remains straight throughout the exercise.  Slowly lower the pelvis and leg down towards the floor.  Lightly tap the floor and return to the starting position.  This exercise targets the gluteus medius muscle and trains control of the pelvis.  Most women struggle in these areas.  This can be a challenging exercise because it requires adequate balance and strength of the glute muscles.

Closing Thoughts about Knee Pain in Women

 Many women are plagued by persistent and nagging knee pain.  However, exercise targeting the hips, pelvis, and core is a proven treatment approach.  These 5 exercises are only a small sample of an effective physical therapy program for knee pain.   Performing thigh muscle strengthening exercises alone is not enough.  Your physical therapist can perform an individual assessment and design an exercise program based on your deficiencies and goals.   Contact us today if you questions about which exercises are right for you.

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