Knee injuries are amongst some of the most common orthopaedic injuries. These can be associated with trauma, overuse, degradation or misalignment. Knee pain can be related to running, previous injury, imbalances and prolonged periods of sitting. When the muscles around the knee joint become weakened and unbalanced, the joint is forced to work harder and may contribute to discomfort or reduced mobility.
Pilates is a highly effective conditioning approach to strengthening the supporting muscles around the knee joint and correcting imbalances or misalignments. The method focuses on controlling movements, increasing joint stability and correcting biomechanics and habitual movement patterns. For people recovering from knee injuries or looking to prevent knee pain, the emphasis placed on proper form and correct muscle activation helps to transfer stability and control to functional strength.
Why does Pilates help knee strength?
- Improves alignment
Improper alignment can often cause or contribute to additional stress on the knee joint. Pilates looks at the overall picture – did you know strengthening your hips, glutes, core and overall posture can help to reduce stress on the knee?
- Stability and control
Pilates is designed to slow down movements to encourage neuromuscular control. By taking down the pace, coordination and specific movements are practiced, improving awareness and reducing the likelihood of injury.
- Balance
Targeting quadriceps, hamstrings, glutes and calf muscles are all essential for knee health and proper function. Pilates works to strengthen these muscles to help balance knee strength and prevent overworking a particular muscle group. Balance and proprioception are not only important for lower leg strength, but are especially important for knee strength.
- Core strength
The core is the foundation! A strong core helps to keep the pelvis stable, which in turn promotes correct knee alignment and improves the biomechanics of the knee joint. In Pilates, core activation is at the foundation of every exercise.
Pilates exercises for knee strength
- Pelvic curls or glute bridges – A simple exercise that can be used to establish proper knee tracking and activation of hamstrings.
- Footwork on the Reformer – The use of springs provide resistance to a series of double and single leg press movements, focusing on alignment and stability.
- Lunges on the Reformer – An effective exercise for quad, glute and hamstring strength and even ankle stability, all important for overall knee function.
- VMO activation with the small Pilates ball – The Vastus Medialis Oblique helps to stabilise the knee’s patella. Strengthening the muscle can help to prevent knee injuries and track the knee correctly.
Tips and Tricks for Practicing Pilates safely with knee pain
- Focus on the form – less is more! Start smaller and work on precision of the movement. Pilates is all about recruiting the correct muscle groups.
- Core engagement is important when practicing Pilates safely. This is to support your pelvis and reduce compensatory movements.
- Try to avoid ‘locking’ or ‘snapping’ into your knees. Work within your own range and keep a protected position.
- Work with a certified Pilates Instructor if you have a history of knee injuries or surgery.
- Pilates is not about “no pain, no gain”. You should not feel joint discomfort. Always let your instructor know if something does not feel right. There is always another way to activate the correct muscles in a pain free way!
Why should you start Pilates?
Incorporating Pilates into your rehabilitation programme could help in a number of ways, like reducing pain, improving strength or preventing injury. It’s also fun! At Physio on the Green, we offer 1:1 Pilates to help you achieve your goals and different group class options. If you are new to Pilates or have practiced Pilates previously, we can answer any questions you may have.
Written by By Norah Jeffery | Pilates Instructor
References:
- Wood, S. (2019). Pilates for Rehabilitation. Champaign, Il: Human Kinetics.
- Isacowitz, R. and Clippinger, K.S. (2020). Pilates Anatomy. Champaign, Il: Human Kinetics.
- Maida, A. (2021). How Pilates Helps Keep Knees Healthy. [online] Pilates Anytime. Available at: https://www.pilatesanytime.com/blog/restorative/pilates-for-healthy-knees [Accessed 27 Nov. 2025].
- Garlick, K. (2024). The Pilates Journal. [online] The Pilates Journal. Available at: https://pilatesjournal.com/articles/knees [Accessed 27 Nov. 2025].
- Physiopedia (n.d.). Vastus Medialis Oblique. [online] Physiopedia. Available at: https://www.physio-pedia.com/Vastus_Medialis_Oblique [Accessed 27 Nov. 2025].