Knees
Knee strengthening exercises, and what each one is for
A knee is held together by muscles above it, beside it and below it, and a useful programme trains all three rather than repeating the one everybody knows.
Clinically reviewed by Lee Albert, NMT · 8 August 2026
Three jobs, not one
Most knee programmes are quadriceps programmes. The quadriceps matter, and they are one of three jobs. The muscles above the knee straighten it and absorb load as you come down stairs. The muscles at the side of the hip, the gluteus medius chiefly, control which way the knee travels when you put weight on one leg, which is why a knee that dives inward is often a hip problem wearing a knee costume. The calf below controls how the shin moves over the foot, and it decides how much of a step's force ever reaches the knee at all.
A programme that covers the three reads oddly at first, because half of it does not look like knee work. That is the point of it.
Strength before range
Knees respond to load, applied gradually. The quickest way to stall is to chase depth: a deeper squat is not a stronger one, and knees that are being asked to work hard through a small range are usually building more than knees being asked to work lightly through a big one. Depth is the last variable to change, after control, after tempo, and after the number of repetitions.
Slow lowering is the part most people skip. Muscles are strongest while they lengthen under load, which in a knee means the three seconds on the way down rather than the flick on the way up. It is unglamorous and it is where the work lives.
Working hard, and working sore
Some discomfort while strengthening a painful joint is expected, and it is worth having that said plainly rather than discovered. NICE's osteoarthritis guidance specifically tells clinicians to warn people that joint pain may increase when therapeutic exercise starts, and to explain that regular consistent exercise is beneficial for the joint even when it is initially uncomfortable. Knowing that in advance is often the difference between a programme that continues and one that stops in week two.
What is not expected: pain that keeps climbing during a session, a knee that swells afterwards, giving way, or a joint that locks. Those are reasons to stop and get it looked at, not to push through.
The sequence
- 1
Terminal knee extension · 30 to 60 seconds of slow repetitions per side
Trains the last few degrees of straightening, which is the range the quadriceps most often lose and the one a knee needs to feel solid in standing.
- 2
Clamshell · 30 to 60 seconds per side
Side-lying, no weight through the joint, aimed at the gluteus medius. This is the hip muscle that stops the knee falling inward, trained before you ask it to do that job standing up.
- 3
Standing hip abduction · 30 to 60 seconds per side
The same muscle, now in the position it actually works in. It is lateral hip strength, and it shows up at the knee.
- 4
Heel raise · 30 to 60 seconds of slow repetitions
Calf strength decides how much force from each step ever reaches the knee. Lower over about three seconds; the slow part is the exercise.
- 5
Chair pose, shallow · 30 to 60 seconds
A held squat with the depth turned right down. Loads the quadriceps through a small controlled range, which is how knees build without being provoked.
- 6
Mini squat, one leg · 30 to 60 seconds per side
The step up in difficulty, and the first movement that tests knee tracking under real single-leg load. Keep a hand on a chair and keep the depth small.
- 7
Sit to stand · 8 to 10 repetitions
The most functional strength movement in the set. It is the movement you do dozens of times a day, and it is a fair test of whether the rest of the work is transferring.
Around fifteen minutes, two or three days a week, which is the strengthening frequency the WHO guidance describes for adults. Work through the list in order: the first three ask little of the joint, the last three ask more. If the single-leg work is too much today, do the shallow chair pose twice instead and come back to it.
What the research says
The reference guidance here is NICE NG226 on osteoarthritis in over 16s. It names therapeutic exercise as a core treatment, and its first recommendation is direct: for all people with osteoarthritis, offer therapeutic exercise tailored to their needs, giving local muscle strengthening and general aerobic fitness as the examples. It also asks clinicians to advise people that joint pain may increase when exercise starts, and that doing regular and consistent exercise will be beneficial for their joints long term even if it is initially uncomfortable.
The size of that benefit has been measured. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis pooled forty-four trials and found exercise reduced pain by about twelve points on a hundred-point scale and improved physical function by about ten points immediately after treatment. Benefit was still present two to six months after formal treatment ended, at roughly half the size. Both halves of that are worth stating: the effect is real and moderate, and it fades when the exercise does.
For how often, the World Health Organization's 2020 guidance sets the general floor. Adults should do muscle-strengthening activities at moderate or greater intensity involving all major muscle groups on two or more days a week, in addition to their aerobic activity. None of these sources is about Vinys, and none of them endorses it. They describe what strengthening is recommended to look like; the sequence below is one way of doing it at home.
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)
Land-based therapeutic exercise reduced knee pain by 12 points per 100 and improved physical function by 10 points per 100 immediately after treatment, with benefit sustained for at least 2 to 6 months after formal treatment ended.
- 3WHO 2020 guidelines on physical activity and sedentary behaviour
Adults should do muscle-strengthening activities at moderate or greater intensity involving all major muscle groups on two or more days a week.
Common questions
Should I exercise a knee that hurts?
Often yes, and the guidance says so directly. NICE advises clinicians to warn people that joint pain may increase when therapeutic exercise starts, and to explain that regular consistent exercise is beneficial for the joint even when it is initially uncomfortable. The exceptions are worth knowing: a knee that swells after sessions, gives way, locks, or hurts more each session rather than settling needs assessing rather than loading.
How often should I do these?
The WHO guidance for adults asks for muscle strengthening involving all major muscle groups on two or more days a week. Two or three sessions a week is the shape of a programme, and a rest day between sessions is not lost time.
Why are there hip and calf exercises on a knee page?
Because the knee is largely governed from above and below. The gluteus medius controls which way the knee travels when you stand on one leg, and the calf determines how much load from each step arrives at the joint. Training only the quadriceps trains a third of the problem.
Do I need weights or bands?
Not for this sequence. A resistance band makes the terminal knee extension and the clamshell more adjustable, and a chair to hold makes the single-leg work available sooner. Everything else is bodyweight.
Is squatting bad for the knees?
Depth is the variable, not the squat. A shallow, controlled squat loads the quadriceps in a range most knees tolerate well, which is why the shallow version is in the sequence and the deep one is not. If your heels lift or your knees collapse inward, the answer is less depth rather than no squatting.
How long do the benefits last if I stop?
The Cochrane review measured this. Benefit was still present two to six months after formal treatment ended, at roughly half its original size. That is the honest picture: strengthening is something to keep rather than something to complete.
This page is general movement information, not medical advice, and it is not a diagnosis. Stop and get the knee assessed if it swells after sessions, gives way, locks, or is sharply painful rather than working hard. Get clearance first if you have had knee surgery, a recent injury, or a joint replacement.
Also called knee strengthening exercises, exercises to strengthen knees, knee strengthening exercises at home, best exercises for knee pain, quad strengthening exercises, knee exercises for seniors. 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.