Quadriceps Exercises For Knee Pain

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Quadriceps exercises for knee pain can make a massive difference with loads of different knee problems.

The quadriceps are a group of four muscles found on the front of the thigh.

When there is weakness and/or tightness in the quadriceps muscles, it places more strain on the knee and patella, and more force through the knee joint.

This can result in a whole range of knee problems such as Runners Knee, Patellar Tendonitis and Knee Bursitis.

Here we look at a whole range of quadriceps exercises for knee pain, each grouped into sets:

• Quad Setting: Great way to get the quads firing properly
• Sit To Stands: Great for functional rehab
• Squats: Some great twists to make squats suitable for all
• Lunges: A great challenge and functional
• Step Exercises: Work those quads even harder using a step
• Quads Stretches: Test if your quads are tight and learn how to stretch

Each set starts at beginners level and gets progressively more challenging.

If you have recently had an injury or knee surgery then quads sets are the perfect place to start

• Place a small rolled-up hand towel underneath your knee
  
  
• Gently push the back of your knee down towards the floor, squashing the towel
  
  
• Hold for 3 seconds and relax
  
  

Place a large rolled-up towel or roller under your knee, so your knee is bent about 30^o

• Squash the back of your knee down into the towel and pull your toes towards you to clench your quads, and lift your heel up, aiming to fully straighten your leg
  
  
• Hold for 3 seconds and slowly lower your heel, relax the foot and relax your thigh

Tips: If you want more of a bend in your knee to start with, use 2 or more towels rolled up together, a cushion or folded pillow

Progression: Use ankle weights or a resistance band

Keep the leg you want to work out straight and bend the other knee, foot planted

• Squash the back of your knee into the floor, pull your toes towards you, lift your heel up and raise your leg, keeping the knee straight
  
  
• Hold for 3 seconds then slowly lower the leg back down

Top Tips: Keep the knee straight throughout – the heel and back of the knee should touch down at the same time

Sit on a firm chair with both feet flat on the floor

• Slowly straighten your knee as you raise your foot upwards, aiming to get the knee fully straight
  
  
• Hold for 3 seconds and slowly lower

Progression: 1) Sitting in a higher chair or on a table so your foot is off the floor to start with allows you to move the leg through a greater range
2) Tie a resistance band to the chair leg and loop it around the front of your ankle. You will have to work harder to pull against the band

Scoot towards the front of the chair, feet flat on the floor hip distance apart

• Lean forward at your trunk and reach forward with your arms and rise to standing
  
  
• Then stick your bottom backwards and slowly lower back down to the chair, bring your arms back down

To Make It Easier: use a chair with arms and push through them as you stand up

To Make It Harder: increase your speed

Test Your Progress: see how many you can do in 30 seconds or 1 minute and repeat the test once a week

2. Single Leg Sit To Stand

This quadriceps exercise for knee pain is the same action as the previous one but is performed with only one foot on the floor throughout.

Not only does this help with quadriceps strengthening, it will also help to improve your balance.

The main focus initially should be on control rather than speed.

• Stand with your back against the wall, feet hip distance apart, approx. 1ft away from the wall
  
  
• Slowly slide down the wall, remembering to the top tips of squat technique
  
  
• Only squat as far down as you feel comfortable and in control
  
  
• Hold for 3-5 seconds and come back up

Progression: Gradually increase the depth of the squat and/or how long you hold it

The wall provides support and takes some of the weight off the knees making them less likely to aggravate knee problems and thus making wall squats brilliant quadriceps exercises for knee pain.

Stand, resting your fingers on a table or chair for balance

• Bend your knees and push your bottom back as if you were going to sit in a chair
  
  
• Return to standing position

Top Tips: Let most of the weight go through your heels, and push down through the heels as you come back up

Progressions: Don’t hold on to anything for support
: Increase the depth of the squat 
: Hold weights or a kettle bell as you do squats

Bend one leg back behind you, holding on to a stable support for balance

• Slowly let the standing knee bend, keeping your weight back
  
  
• Lower down as far as feels comfortable and controlled
  
  
• Return to starting position

Top Tips: Really think about the position of your feet, knees and hips with this one – follow the squat guidelines above

Progression: Once you can do these without your knees wobbling side to side, try not holding on to anything - fix your eyes on one spot to help with balance

Stand on your target leg and prop your other foot behind you on a chair

• Bend your knee and lower your body towards the floor keeping your knees behind your toes
  
  
• Return to starting position, pushing up through your heels

Why Do These? If you are looking for really challenging quadriceps exercises for knee pain, this is a great one. The support of the chair means you can lower down to a really deep squat so you really work the quadriceps muscles

1. Forwards Lunge

Stand with feet hip width apart

• Take a step forwards and slightly out to the side
  
  
• Allowing your knees to bend as you squat down
  
  
• Return to starting position
  
  
• Start with small dips and gradually increase the depth as able

Top Tip: Pop your hands on your hips as you do this exercise to check that you are keeping your pelvis straight rather than dipping to one side

Backwards lunges are very challenging quadriceps exercises for knee pain but extremely effective. They also work your glutes and hamstrings

• Stand with feet hip width apart and take a step backwards on to your toes, allowing your front knee to bend and letting your body squat down
  
  
• To come back up, push up mostly from the front leg with pressure directed through the heel

Progressions: Increase the depth of the lunge
: Hold weights whilst doing the exercise

Only do this one once you can do 20 reps on each leg of the forwards lunge with no ill-effects

• Stand with feet hip width apart and take a large step forwards, allowing the front knee to bend
  
  
• Let the back knee bend until it touches or comes close to the floor
  
  
• Push off the front leg to come back up

Progression: Step the front food onto a step or box as shown to increase the depth of the dip

Stand sideways with both feet near the edge of a step/box

• Slowly lower one leg down off the side of the step
  
  
• Gently touch the floor with your heel and then return to the starting position

Top Tips: Maintain proper knee alignment - knee in line with the 2nd toe and not passing in front of the toes
: If you don’t have a step, stand sideways on the bottom step of a staircase

NB These quads exercises works the leg that stays on the box

Stand with both feet towards the front of a step/box

• Slowly lower the unaffected leg down forwards off the step/box to lightly touch the heel to the floor
  
  
• Then return to the original position with both feet on the step/box

Top Tip: It’s very easy to let the knee collapse inwards with this one so keep thinking about your knee alignment throughout

Stand facing a step/box

• Quickly step up onto the step/box with one foot then the other then step quickly back down to the floor, one foot at a time
  
  
• Make sure you are landing on the balls of your feet

Progression: Aim to gradually increase your speed

Test Yourself: check how many your can do in 30 seconds/1 minute and retest yourself every week. As your quadriceps strength and endurance improves, along with your stamina, you should be able to do more steps in the given time

Once you have started to strengthen the quads, it can also really help to stretch them.

Muscles often get tight in response to weakness and pain, but if you start to stretch them before strengthening them, you can actually make things worse.

Stretching quadriceps exercises for knee pain should be started once you feel your strength improving.

In the quads stretches section we look at some simple tests you can do to see if you do have tight quadriceps, the best ways to stretch the quads and how to get the best results for the minimum effort.