Knee pain is very common – in fact, it’s one of the leading causes of musculoskeletal complaints, especially in adults over 45. Here are some key facts:
How Common Is Knee Pain?
- Around 1 in 4 adults experience chronic knee pain at some point.
- It’s most commonly caused by osteoarthritis, injury, overuse, or biomechanical issues.
- Women and people over 50 are more likely to develop knee issues due to hormonal, structural, and lifestyle factors.
- In fitness populations, knee pain can result from poor form, muscle imbalances, or tightness in the hips and ankles.
Good Exercises for Clients with Knee Pain
- Glute bridges – Strengthen hips and glutes with minimal knee pressure
- Clamshells / side-lying leg lifts – Target glutes medius for knee tracking
- Standing balance work – Improves proprioception and lower limb control
- Wall sits (short hold) – Strengthens quads in a static, controlled way
- Seated leg extensions (no weight) – Helps regain control through range
- Supine hamstring work (with ball or band) – Builds posterior chain strength
- Gentle stretching for quads, hamstrings, calves, and hip flexors
- Breathwork & pelvic stability – Supports overall posture and movement integrity
Exercises to Avoid or Modify
- Deep squats and lunges (especially unsupported)
- Repetitive jumping or hopping
- High-impact drills or HIIT-style transitions
- Fast-paced directional changes
- Prolonged kneeling – unless cushioned or supported
- Overly flexed knee positions – in clients with arthritis or meniscus issuesHigh-
- Fast-paced directional changes
- Prolonged kneeling – unless cushioned or supported
- Overly flexed knee positions – in clients with arthritis or meniscus issues
Knee Pain in Fitness Pilates: Causes, Challenges and Class Considerations
Common Causes of Knee Pain
- Muscle imbalances – Weak glutes, tight hamstrings or quads, or underactive inner thighs can all affect knee alignment.
- Poor movement mechanics – Overuse, poor squat technique, or misalignment in everyday activities can strain the joint.
- Lack of mobility – Stiff ankles or hips can force the knee to compensate, leading to pain.
- Injury or degeneration – Meniscus tears, ligament damage, arthritis, or previous trauma.
- Overload – Excessive jumping, repetitive high-impact exercise, or sudden changes in activity levels.
Fitness Pilates: What You Can Do
Fitness Pilates can be incredibly beneficial when taught with care and awareness of the knee joint. Focus on improving:
- Hip and ankle mobility
- Glute, hamstring, and core strength
- Knee tracking and alignment in movement
- Functional movement patterns
When Does Someone Need a Knee Replacement?
A knee replacement (total or partial) is typically recommended when:
- Severe arthritis or joint damage: Often due to osteoarthritis, rheumatoid arthritis, or trauma.
- Persistent pain: Pain that doesn’t improve with physiotherapy, medication,
or lifestyle changes. - Loss of function: Difficulty walking, climbing stairs, or standing for prolonged periods.
- Reduced quality of life: Pain interferes with sleep, mood, independence, or daily activities.
- Visible joint changes: Swelling, deformity, or restricted movement.
