7 Exercises to Prevent Knee Injuries: Strong and Healthy Knees

Preventing Knee Injuries

For a long time no one focused on training the knee. It was more or less considered a joint that you didn’t want to accrue wear and tear. We were taught to “sit back” into the squat and keep our shins vertical so that very little pressure was put on the knee. Yet somehow knee injuries have become very common. 

In this article, I will go over a few movements to help improve knee pain and to prevent future knee injuries. Many of these exercises can help improve joint pain in other areas as well so don’t be surprised if other body parts start feeling better too! 

Here are some easy to do exercises you can perform at home to start improving your knees and prevent knee injuries now. 

1. Band Resisted Knee Extensions 

Let’s start by waking up your VMO (vastus medialis oblique). This muscle is responsible for extending or locking out your knee. If this muscle isn’t working properly, you risk losing knee range of motion. 

Wrap a band around something solid and place the band right behind one of your knees. Start with your leg slightly bent then extend your knee to lockout slowly pressing against the resistance of the band. Hold the locked out position for a second or two before slowly bending the knee and returning to the start position. Make sure you keep your body weight equal on both legs. Continue for a set of 10-20 repetitions in order to drive blood flow to the joint and muscle. Keep your movements controlled. DON’T jam your knee into lockout forcefully. 

You may feel immediate improvement following just one set of this exercise. 

2. Knee Flexion Gapping

If you have no problem extending your knee, maybe your issue is that you are missing flexion. Grab a lacrosse ball and place it in the pit of your knee while kneeling down on the floor. You may want to use a pad or pillow to rest your knees on. 

With the lax ball wedged into the back of your knee, slowly sit back on your feet. You will feel the lacrosse ball press into some of the tissues behind the knee like the hamstring and calf muscle. Oscillate in and out of the bottom position to improve knee flexion. Spend 30-60 seconds on each leg. 

A gentler option is to place a rolled up towel behind your knee. You can then kneel on it as usual or you can lie back on your back and hug your bent knee to your chest. 

If no towel is available, cross your other leg over and behind your knee where the towel would normally go. Kneel down on your leg instead. 

3. VMO Squat

Now it’s time to train the VMO. Grab a set of weight plates or books or anything you can find to elevate your heels. Your feet should be hip width apart with your toes facing forward. SLOWLY sink down into the bottom of a squat. Try to keep your chest upright and sink low enough to let your hamstrings touch your calves. This may not be possible on the first few repetitions due to joint restrictions in the knee, low back and hips. Be patient and as you build strength you will be able to sink lower without problem. 

When you return to the top, push through the floor with your midfoot but don’t let your hips shoot backwards. Instead continue to “scoop” your hips under you and force your quadricep muscles to propel you upwards. 

I highly suggest you use something to hold onto during your first few attempts of this movement. You can place yourself between two chairs. Put your hands on the chairs to help take away some of your own body weight. You can also use a jump stretch band to help lower yourself. 

If you are still having trouble reaching optimal depth, try increasing the height of your heel elevation (more books/thicker plates). Make sure that you perform repetitions SLOWLY and with as much assistance as necessary. 

4. Poliquin Step Up 

Now it’s time to see how your legs work individually. If you have a set of stairs at your disposal then you can perform the Poliquin Step Up. 

Stand at the top of a step (you may elevate your heel if you want) on one leg with the other leg held out in front of you. Slowly bend the knee of the leg you are standing on forward and lower your opposite leg until it touches the next step. Slowly push through your back leg to return to the start position. Make sure to hold onto something for the first few times when performing this movement. 

Perform 10-20 repetitions on each leg with a controlled descent. 

5. Walk Backwards

We all know how walks can be beneficial for circulation, digestion and a ton more. Now your walks can benefit your knees too! 

Try walking backwards up a slight elevation if possible to improve the strength and circulation of the quad muscles. Reach back with each step and push through the toes. 

If you belong to a gym and have a sled or tank available to you then find a way to strap yourself to it and walk backwards. Pushing through your toes and slightly sitting back and staying low. 

What you should feel is the fronts of your legs fill up with blood or get a pump. 

6. ATG Split Squat

We’ve now arrived at the most difficult exercise of the group to achieve mastery. But the benefits of the ATG split squat are not just limited to the knees. Check out my article on the ATG split squat for back pain improvement here. 

Set up in a split squat or split stance position with your front foot around 2 feet in front of your back foot. Both feet should be pointed forwards. The challenge is keeping the back foot forward during the movement. 

With your weight predominantly on your front foot, sink down and forward until your front leg hamstring is touching your front leg calf. You should feel a stretch in your trailing leg hip flexor. 

Hold the bottom position for 2 seconds before pressing into the floor with the front foot and returning to the start position. Don’t let your hips shoot back or drop your chest. It’s helpful to have something to the side of you (like a chair) to help you with balance, especially if you are having trouble keeping your chest upright. 

When you are ready to add load you can hold dumbbells at your sides or put a barbell on your back. 

If you are struggling to get into this movement, continue working on your couch stretch to improve hip flexor length. 

If you want more information on the ATG split squat, you can go to our article here!

7. Nordic Curl

It’s so important to have strong hamstrings. I have tried so many different exercises but this one is one of the most effective but you must be patient and consistent in training. 

The Nordic Curl is incredible for improving low back health and athletic capacity because of its ability to target your hamstrings like no other movement. But as a side effect of having strong hamstrings, your knees will be further protected as well. 

Slow controlled eccentrics are key to help lengthen and strengthen the hamstring muscles! 

What you need is a pad for your knees (you will be kneeling during this exercise) and something to anchor your ankles to the ground. The pad is not hard to find. You can use a pillow or a blanket or a yoga mat or an Airex pad. 

Finding the anchor for your legs can be more challenging than actually performing the exercise. Here are a few ideas. You can have a partner hold your legs, you can tie a belt to a bench (this is what I’ve done for years), you can purchase a nordic bench and you can use the underside of a car. There are plenty of ways to anchor your legs down, get creative, but if it is your first time attempting this movement, make sure you have a safety net like a band or a wall close by to grab onto. 

The ACL is the most commonly injured tendon of the knee. Nordic curls will help strengthen your ACL. 

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Programming to Help Prevent Knee Injuries

I have programmed these movements from easiest to hardest in order. If you are not ready for a movement simply stick to the ones you are comfortable with and build strength. 

I consider these exercises to be a tonic for the body. These movements should make you feel better. Remember to perform the repetitions slowly to allow the knee to get stronger. Be patient and you will see improvements in pain symptoms and overall strength and stability. 

Movement	Sets/Reps	Frequency
Band Resisted Knee Ext	1×20	(1 per week or as needed)
Flexion Gapping	1x:30-60 each leg	(1 per week or as needed)
VMO Squat	3×10 (slow repetitions)	(2x per week)
Poliquin Step ups	3×10 each leg	(2x per week)
ATG Split Squats	3×5 each leg	(2x per week)
Nordic Curl	3×5-10 repetitions	(1x per week)

Key Takeaways

References:

1. Evans J, Nielson Jl. Anterior Cruciate Ligament Knee Injuries. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.