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Physical Therapy for "Bad Knees"

Jul 18, 2019

Author: Yves Gege

“I have bad knees” is something we hear all the time.

It usually comes up during some sort of physical activity like hiking, running, or tennis or during something as simple as getting up off of floor or going down stairs. You tell yourself, and unfortunately you have been told, that because you have “bad knees” we shouldn’t do certain things.

You’ll see a doctor or health professional who tells you that because of your arthritis or tendinitis or chondromalacia (big word) that we should avoid certain activities. Unfortunately, or FORTUNATELY, the newest medical research is simply not backing these claims.

We’ve now seen multiple studies showing improved cartilage thickness with weighted squats, as well as in runners. Also increased ligament size within olympic lifters as well. Most rehabilitative research shows that movement and exercise produces the best results for long term function better than any other modality.

Do you have knee tendinitis? Slow controlled eccentric and concentric exercise are the gold standard. Have knee arthritis? Flexibility, walking, and strength training has the most backing from medical evidence. The list goes on and on.

We are not saying that when you have an acute injury or in some circumstances, with certain red flags, (here is a great resource to determine if you knee injury is serious here), you shouldn’t rest and go see a trusted health care professional right away. But in many cases, getting moving quickly, often and under load is the right call.

Ok, now that we got past that. Let’s talk about how to keep your knees healthy and some of our favorite tests and exercises we use in our clinic every day.



#1 Are your hips strong and flexy?

The knee is sandwiched in between the ankle and hip. The hips are a big driver in a lot of our activities and we see a lot of people with weakness and tightness in this area. Here are great ways to improve your hip function:

Here are great ways to improve your hip function:

Side Plank 

Crossed Leg Stretch


#2 Do you have adequate ankle ROM?

If your ankle can’t move the way it's intended, you can put undue stress on the knee. Here is a great way to test and improve your ankle ROM:

Here is a great way to test and improve your ankle ROM:

Ankle Half Kneel Test

Ankle Kettlebell Rock


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#3 Finally and most important do you have FULL knee ROM and stability?

Most books will say we should have 135 degrees of knee ROM. I say hogwash! Let’s look at it this way, within certain exceptions we should all be capable of sitting on our heels in what we call the hero stretch.

We should all be capable of sitting on our heels in what we call the hero stretch

Hero Stretch

We should also be able to stabilize and control the knee joint. 

Step Down


Don’t get us wrong, the knee and the human body is way more complicated than this, and the rehabilitative process takes a lot of time, energy, and coaching. But I hope this gets the ball rolling and changes your thought process a little. Moving more and getting stronger is the right direction more often that not! If you have questions seek help. We all need a coach!

One of my favorite things I learned in PT school was: Wolfe’s Law which states “….that bone grows and remodels in response to the forces that are placed upon it.” Put your body under the right kind of stress and it will react positively. A lot of times we are hindered by pain and that’s a whole other discussion.

Remember pain is not necessarily an indicator of damage, in reality it rarely is! So find a health care professional that will get you off the couch and moving early, often, and under load, because that’s where the magic happens!


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