Many middle-aged and older people are affected by knee joint pain. This article presents three simple and effective knee rehabilitation exercises and addresses some frequently asked questions from patients with knee osteoarthritis.

First, it is essential to understand the structure of knee cartilage. Knee cartilage is a flexible, sponge-like cushion that protects the bones by reducing direct friction during movement. Knee cartilage is primarily made up of water, with a smaller proportion consisting of cartilage cells that regulate its metabolism and repair. The synovial fluid within the joint contains key components such as collagen, proteoglycans, and hyaluronic acid, forming a mesh-like framework that maintains the cartilage’s integrity and function.

Can Knee Cartilage Regenerate?

The body’s capacity for healing is often greater than we realize. While some believe that severe knee joint degeneration makes regeneration impossible, addressing the root causes of degeneration may support the gradual recovery of knee cartilage and help slow or prevent the progression of osteoarthritis.

One common cause of knee degeneration observed in clinical practice is leg-length discrepancy. When one leg is tighter than the other, it can cause tension or a knot to form in the back of the knee (the popliteal area). This tightness in the tendons behind the knee increases joint pressure and accelerates wear and tear. Performing targeted stretching exercises to release these tight tendons can improve knee flexibility and support better joint function.

A systematic review involving over 1,000 clinical trial participants found that stretching exercises are beneficial for relieving knee joint pain.

3 Simple Exercises to Improve Knee Health

Exercise 1: Leg Stretch on a Bench

Step 1: Lie flat on a firm surface with your hips positioned against a vertical post or wall.

Step 2: Extend one leg straight up along the vertical surface, keeping it perpendicular to the floor while the other leg hangs down naturally. Stretch your arms back over your head.

Step 3: Hold this position for 10 minutes, then switch legs and repeat.

At first, your raised leg may not straighten completely, but with regular practice and stretching, it will gradually become more flexible.

This exercise not only helps release tension in the tendons behind the knee but can also protect the spine and alleviate lower back pain, leg pain, and sciatica. While challenging, consistency is key to achieving the best results.

According to traditional Chinese medicine (TCM), meridians are the channels through which energy flows in the human body, connecting the internal organs to the body’s surface. When performing this exercise, the bladder meridian on the back of the leg and the spleen, liver, and kidney meridians on the inner side of the leg are stretched. This helps promote smooth energy flow throughout the body.

If you do not have a setup like a firm bed or bench near a wall, you can improvise using several chairs pushed together near a doorway. Lie flat on the chairs, raise one leg to rest against the door frame, and let the other leg hang down naturally.

Exercise 2: Back-of-Knee Tapping

Step 1: Sit on a firm surface like a bed or bench.

Step 2: Lift your knees slightly, keeping them relaxed and slightly bent.

Step 3: Make fists with your hands and gently tap the back of your knees with enough force to feel a penetrating effect.

This exercise helps release tension in the back of the knees, promoting relaxation and improving flexibility in the knee joints.

Exercise 3: Knee Joint Massage

Step 1: Sit with your feet hanging naturally and place your hands around your knees, shaping them like claws.

Step 2: Gently shake your knees while lightly massaging around the kneecap for 3 to 5 minutes.

Step 3: Keep your hands steady on your knees and let your feet dangle. Swing your lower legs gently back and forth and side to side. The gentle motion, combined with gravity, creates a light stretching and massaging effect on the knee joint.

When experiencing knee pain, you may notice a tender spot on the inner edge where the shinbone meets the thighbone, called the medial plica area. Gently massaging this area can help relieve discomfort.

For those dealing with persistent knee pain, we have previously explored its various causes and highlighted different rehabilitation exercises that may provide relief.

Can You Exercise With Joint Pain?

Cartilage works like a sponge that absorbs and releases water; exercise enhances this sponge-like function. When you walk, each step compresses the cartilage as your foot presses down, squeezing synovial fluid out. As your foot lifts and the pressure eases, the synovial fluid is reabsorbed into the cartilage, creating a dynamic balance. This cyclical process delivers essential nutrients from the synovial fluid into the cartilage, helping to maintain its health.

Appropriate exercise can help improve knee osteoarthritis by promoting joint mobility and circulation. However, overly intense or high-impact activities that excessively compress the joints may aggravate pain. People with joint pain should focus on exercises suited to their physical capabilities. Prolonged inactivity, on the other hand, can lead to stiffness in the knee joints, making movement and walking increasingly difficult over time.

A systematic review analyzing the results of 48 trials showed that patients with knee osteoarthritis achieved the best rehabilitation outcomes by participating in exercise sessions three times a week. Other studies suggest that walking and recreational running are safe for people with arthritis. However, sports such as basketball, soccer, volleyball, and high-intensity running may strain the joints excessively and should be minimized or avoided.

Which Foods Support Knee Joint Health?

According to TCM, foods with a naturally slippery or gelatinous texture can promote the production of synovial fluid, which helps lubricate and protect the joints. Examples include chicken cartilage, pig ears, sea cucumbers, eel, fish skin, pork skin, okra, natto, yam, and shiitake mushrooms.

Foods like chicken cartilage, bone broth, and pig ears contain chondroitin sulfate and type 2 collagen, both key components for maintaining cartilage health. Plant-based options like okra and yam, while lacking collagen, are believed to have moisturizing properties that support the body’s fluid balance.

Should You Use Cold or Heat Therapy for Knee Pain?

Heat therapy is effective for relieving chronic inflammation of the knee joint. In TCM, it is believed that stagnation of qi (energy) and blood can lead to pain. Heat therapy promotes blood circulation and thus supports joint repair. It is particularly useful when knee pain worsens due to wind or humidity exposure.

Cold therapy, on the other hand, is generally not recommended for people with osteoarthritis. While applying ice may temporarily reduce redness, swelling, and pain, it can impede blood circulation and lead to stiffness in joint tissues and ligaments.