Pilates for Knee Pain and Diagnosed Knee Problems

Knee pain can be frustrating, whether it’s a dull ache, a sharp twinge or a general feeling of weakness. It can affect your walking, your sleep, and your confidence to move.

But here’s the good news: you don’t have to avoid exercise – you just need the right type of movement. Pilates can help strengthen the muscles around the knee, improve mobility, and support the joint, without making the pain worse.

In this blog, we’ll explain the most common diagnosed knee problems and how Pilates can help.

Common Knee Conditions

1. Osteoarthritis

This is the most common knee issue, especially in people over 50. It’s the “wear and tear” type of arthritis.

Symptoms:

• Pain during or after activity

• Stiffness (especially in the morning or after sitting)

• Swelling

• Reduced movement

• A grating feeling or sound when you move

Pilates Tips:

✔ Choose low-impact movements

✔ Focus on improving mobility and joint strength

✘ Avoid deep squats or high-impact moves

2. Patellofemoral Pain Syndrome (PFPS)

Pain around or behind the kneecap, often caused by muscle imbalance or poor tracking.

Symptoms:

• Pain when using stairs (especially going down)

• Discomfort when squatting or kneeling

• Ache after sitting for long periods

Pilates Tips:

✔ Focus on strengthening the hips and glutes

✔ Keep knee movements small and controlled

✘ Avoid deep lunges and kneeling unless supported

3. Meniscal Tear

The meniscus is cartilage inside your knee that can tear due to twisting or degeneration.

Symptoms:

• Pain with twisting

• Swelling

• A feeling like the knee locks or gives way

• Limited ability to straighten the leg

Pilates Tips:

✔ Build strength in the quads and glutes

✔ Stick to straight, controlled leg movements

✘ Avoid twisting or deep bends

4. Ligament Injuries (ACL, MCL, etc.)

These usually happen during sport or a fall, and recovery involves a structured rehab programme.

Symptoms:

• Swelling

• Instability

• Pain when putting weight on the leg

Pilates Tips:

✔ Stick to controlled, closed-chain movements (feet stay grounded)

✔ Focus on alignment and balance

✘ Avoid side-to-side or fast movements early on

5. Bursitis or Tendonitis

Inflammation around the knee joint, often due to overuse or pressure.

Symptoms:

• Pain during movement or when pressing on the joint

• Swelling

• Tenderness

Pilates Tips:

✔ Use padding under the knees

✔ Focus on mobility without irritating the area

✘ Avoid repetitive kneeling or pressure on the joint

6. Post-Surgical Knees (e.g. Knee Replacement)

After surgery, it’s essential to build strength, mobility, and confidence without overdoing it.

Symptoms:

• Limited movement

• Swelling or discomfort

• Reduced strength and control

Pilates Tips:

✔ Stick to exercises within your pain-free range

✔ Use props and support

✘ Don’t rush into high-impact or full-weight-bearing movements

General Tips for Exercising with Knee Pain

✅ Build strength in your hips, glutes and core

These muscles help support and protect the knee.

✅ Use closed-chain exercises

This means your feet stay in contact with the mat or floor – such as bridges, squats, or leg presses.

✅ Go slowly and focus on control

Don’t rush the moves – it’s about precision and form, not speed.

✅ Modify where needed

We often use blocks, bands, cushions or extra mats in class to support sensitive knees.

✅ Stretch gently

Tight calves, hamstrings and quads can pull on the knee and make things worse.

Exercises That Can Help

✔ Clamshells, bridges, side-lying leg lifts

✔ Supine heel slides and leg raises

✔ Gentle squats or wall sits (small range)

✔ Standing hip abductions

✔ Seated leg extensions

✔ Calf and hamstring stretches

✔ Functional sit-to-stand or step-ups (low step)

Exercises to Avoid or Adapt

✘ Deep squats and lunges

✘ Jumping or fast changes of direction

✘ Kneeling on a hard surface

✘ Uncontrolled twisting movements

✘ Single-leg balance (unless supported)

Final Thoughts

Living with knee pain doesn’t mean you need to stop moving. In fact, gentle, targeted movement can help you feel better and stay active for longer. Pilates gives you a way to move that supports your joints, builds confidence, and strengthens your whole body – without flaring up your knees.

Contact us for details of the Pilates, Gentle Pilates face-to-face classes in Oxfordshire or online classes to do live or on demand.