Knees
How to build knee strength, one controlled step
Strength around the joint is what the guideline names. When the pattern is osteoarthritis, NICE says to offer therapeutic exercise such as local muscle strengthening. A Cochrane review found land-based exercise reduced knee pain compared with not exercising. This page cannot tell you why your knee hurts.
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
Before you start
Stop and get the knee checked if it locks, gives way, is badly swollen, has changed shape, will not take your weight, or the pain followed a twist or a fall. Stop and speak to a clinician if a movement brings on sharp pain, dizziness, or symptoms that travel down an arm or a leg, and seek urgent care for any loss of bladder or bowel control or numbness around the saddle area.
This is the version everyone gets. Yours is different.
Start your first sessionThe short answer
For all people with osteoarthritis, NICE says to offer therapeutic exercise tailored to the person. The examples it names are local muscle strengthening and general aerobic fitness. It also says joint pain may increase when that exercise starts, and that regular, consistent exercise is beneficial for the joints.
A Cochrane review of land-based exercise for knee osteoarthritis found pain lower by about 12 points on a 100-point scale and physical function better by about 10 points, right after the programmes, compared with not exercising.
Build it where a step already asks for it
Sit to stand from a chair is the same up and down as a step, with the chair there so you can control the lowering. A seated straightening hold trains the thigh at the end of the range. A clamshell trains the hip that helps the knee track. None of this diagnoses your knee. It is the kind of strengthening the guideline names when osteoarthritis is the pattern.
Check first if the knee is not just sore
The NHS knee pain page says to get advice now if you cannot move the knee or put weight on it, the knee is badly swollen or has changed shape, or it locks, gives way, or painfully clicks. Painless clicking is described there as normal. A knee that fails those checks needs a person, not a stronger squat.
The sequence
- 1
Sit to stand · 8 slow repetitions
The same pattern as a step, done from a chair so you can control the lowering. This is the strength work the page is about.
- 2
Seated knee straightening · 10 slow holds each side
The thigh muscle controlling the last part of straightening, which is the work a step asks for.
- 3
Clamshell · 30 to 60 seconds each side
Side-lying work for the muscle on the outside of the hip that helps the knee track.
- 4
Heel raise · 30 to 60 seconds, lowering slowly
The calf shares the work of a step. The slow lowering is the useful half.
- 5
Shallow chair pose · 30 to 60 seconds
A small squat. Less depth if the knee complains. The knee stays in line with the middle of the foot.
- 6
One knee toward the chest · 30 to 60 seconds each side
Bends the knee with no weight on it, so you can see what range is comfortable after the strength work.
Work only in a range that stays tolerable. NICE notes that pain can rise when strengthening starts, and that consistent exercise is still what it recommends for osteoarthritic joints. Locking, giving way, or a knee that will not take your weight is a reason to stop and get it seen.
That sequence was written for everyone with this. Yours would be built around your answers.
Start your first sessionWhat the research says
NICE NG226, recommendation 1.3.1, says to offer therapeutic exercise tailored to the person for all people with osteoarthritis, for example local muscle strengthening and general aerobic fitness. Recommendation 1.3.3 says to advise that joint pain may increase when therapeutic exercise starts, and that regular consistent exercise remains beneficial for the joints.
Fransen et al., Cochrane review in the British Journal of Sports Medicine (2015), pooled land-based therapeutic exercise against non-exercise controls in people with knee osteoarthritis and found pain lower by 12 points per 100 and physical function better by 10 points per 100 immediately after treatment.
The NHS knee pain page says to get advice now if you cannot move the knee or put any weight on it, the knee is badly swollen or has changed shape, or the knee locks, gives way, or painfully clicks.
Sources
- 1NICE NG226, osteoarthritis in over 16s (2022), recommendations 1.3.1 and 1.3.3
Offer therapeutic exercise tailored to the person for all people with osteoarthritis, and advise that joint pain may increase when starting it while regular consistent exercise remains beneficial for the joints.
- 2Fransen et al., exercise for osteoarthritis of the knee, Cochrane systematic review (British Journal of Sports Medicine, 2015)
Across land-based exercise trials, knee pain was lower by 12 points per 100 and physical function better by 10 points per 100 right after the programmes, compared with not exercising.
- 3NHS, knee pain
Says to get advice now if you cannot move the knee or put any weight on it, the knee is badly swollen or has changed shape, or the knee locks, gives way, or painfully clicks.
Common questions
How do you build knee strength?
With local muscle strengthening, which is the example NICE gives for therapeutic exercise in osteoarthritis. Sit to stand, a seated straightening hold, and hip work are that kind of practice. This page cannot say why your knee hurts.
Will strengthening make knee pain worse at first?
NICE says joint pain may increase when therapeutic exercise starts, and that regular consistent exercise remains beneficial for osteoarthritic joints. Sharp pain, giving way, or a knee that will not take weight is a different signal. Stop and get it checked.
Is stretching enough to build knee strength?
No. Strength is load, not a stretch. NICE names local muscle strengthening and general aerobic fitness. A stretch can be a comfortable neighbour of that work. It is not a substitute for it.
What if my knee gives way?
The NHS says to get advice now if the knee gives way, locks, is badly swollen, has changed shape, or will not take your weight. Those are not a cue to add another squat.
Do I need a gym to strengthen my knees?
No. Sit to stand uses a chair. The straightening hold is seated. The Cochrane finding is about land-based therapeutic exercise, not about a particular machine.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called how to build knee strength, knee strengthening exercises at home, how to strengthen knees, exercises to build knee strength, thigh strength for knees, gentle knee strengthening. Movements are drawn from the clinically authored Vinys library. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.