Early Knee Pain Exercises

Physical Therapy First Demonstration of Early Knee Pain Exercises

🧾 What you’ll see
Setup — Gentle, early-phase drills performed in positions that unload the knee (supine, seated, or supported standing). Ribs stacked over pelvis, knee aligned over the second toe, and smooth, quiet breathing.
Sequence — A short circuit that prioritizes pain-free range, swelling control, and quad recruitment before progressing to light functional strength.
Reset — Between drills, shake out tension, re-check alignment, and continue with clean, controlled reps.

🎯 Coaching cues

“Knee over 2nd toe, ribs down, breathe.”

Work in a comfortable, pain-free range—no forcing end range.

Slow tempo; own the pause at the top of each contraction.

Light core brace to keep the pelvis level and the thigh from drifting.

If you feel sharp joint pain, scale the range/effort immediately.

💪 Why it helps

Reduces stiffness and swelling through gentle motion and muscle pumping.

Re-activates the quadriceps for better patellar tracking and gait control.

Improves tissue tolerance for daily activities (sit-to-stand, stairs, walking).

Sets the foundation for later loading (squats, lunges, step-ups) once symptoms settle.

📋 Step-by-step (typical flow)

Ankle pumps + heel slides (supine): 10–15 easy reps each to circulate fluid and restore flexion.

Quad sets (supine): Press the knee down into a towel, tighten the thigh, hold 3–5 sec, relax. 8–12 reps.

Short-arc quads (SAQ): Towel/foam under knee; straighten the knee to lift the heel, hold, lower slow. 8–12 reps.

Seated knee extension isometrics (pain-free angle): Kick into a strap/hand for 5–8 sec, 5–8 reps.

Standing terminal knee extension (TKE) with a light band: Tap the heel down as you straighten the knee and squeeze the quad/glute. 8–12 reps.

Supported mini sit-to-stand (high box or chair): Hip hinge first, knees track over toes, stand tall without a “plop.” 6–10 reps.

Optional hip support (side-lying clamshell or standing abduction): 10–12 reps to reduce valgus collapse and offload the knee.

⏱️ Dosage (general guidance)

2–3 sets per drill, 6–12 reps (isometrics: 5–8-sec holds)

Frequency: 3–5×/week for activation/mobility; daily for ankle pumps/heel slides if swelling is present

Tempo: 2–3 sec up → brief hold → 2–3 sec down—no bouncing

⚡ Progressions

Increase hold time (8–10 sec) on isometrics as tolerated.

Add light load (ankle weight for SAQ, mini-band for TKE, goblet for sit-to-stand).

Lower the seat height gradually for deeper functional range.

Introduce step-ups or split-stance sit-to-stand when pain remains ≤2/10.

⬇️ Regressions

Shorten range of motion; elevate the seat for sit-to-stand.

Switch to pure isometrics (quad set, strap extensions) on flare days.

Add hands/rails for extra support; reduce band tension on TKE.

Use a cold pack after the session (10–15 min, skin protected) if swelling increases.

❌ Common errors

Knees collapsing inward (valgus) during sit-to-stand.

Rushing reps; losing control on the way down.

Holding breath or tensing shoulders/neck.

Forcing painful end range or letting the knee drift past comfort.

Precautions

Modify/avoid during acute swelling, sharp joint-line pain, or locking/catching—seek evaluation.

Post-op or known conditions (e.g., meniscus, ligament, patellofemoral pain): follow your clinician’s timeline.

Stop and consult a professional if symptoms worsen, or you notice numbness/tingling or significant swelling after exercise.

Disclaimer
The exercise demonstration and information in this video are for general educational purposes only and are not a substitute for individualized evaluation, diagnosis, or treatment from a licensed healthcare professional. By following this exercise, you agree to:

Consult a qualified provider if you have or suspect an injury or medical condition.

Assume all risks associated with performing these movements.

Understand that viewing this video does not create a therapist–patient relationship with Physical Therapy First.

Stop immediately and seek medical advice if you experience pain, dizziness, shortness of breath, or other adverse symptoms.

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