Pilates for Knee Pain: A Gentle, Practical Guide
Living with general knee aches can make daily movement feel difficult, but gentle exercise is often a helpful way to support your joints. When a doctor has ruled out an injury that requires specific treatment, a careful movement practice can help build strength in the muscles that surround and support the knee.
Pilates focuses on alignment and controlled movement, making it an accessible option for those with knee discomfort. By strengthening the hips, glutes, and thighs, you can encourage better mechanics throughout your lower body without putting unnecessary stress on the knees themselves.
Editor note. A swollen, locked or unstable knee, or pain after a twisting injury, needs assessment before exercise.
What the general evidence says
General exercise is widely recommended to help manage non-specific knee pain by strengthening the supporting muscles. While research specifically looking at Pilates for knee aches is somewhat limited, its focus on low-impact strengthening of the hips and legs aligns well with standard physical therapy approaches. It is not a complete solution, but it can be a supportive part of your routine once you have clearance from your clinician.
Principles that help
- Focus on strengthening the hips and glutes, which help control the alignment of the knee.
- Move slowly and with control, avoiding any sudden or jerky motions that might irritate the joint.
- Keep your range of motion small at first, only increasing it if the movement feels entirely comfortable.
- Pay attention to how your knees feel during and after exercise, stopping if you notice sharp pain.
- Breathe naturally and avoid holding your breath while completing each repetition.
A gentle starting sequence
Each exercise links to a full page with steps, common mistakes and easier options.
| # | Exercise | Level | Main muscles | Why it is here |
|---|---|---|---|---|
| 1 | Clam | Beginner | gluteus medius, deep hip rotators | This movement targets the outer hips to help stabilize your leg alignment, and you can keep it gentle by making the opening very small. |
| 2 | Side-Lying Leg Lifts | Beginner | gluteus medius, tensor fasciae latae | Strengthening the side of the hip supports the knee from above, and you can keep it mild by lifting the leg only a few inches. |
| 3 | Inner Thigh Lifts | Beginner | hip adductors | This exercise engages the inner leg muscles to balance thigh strength, and it remains gentle as long as you avoid lifting too high. |
| 4 | Pelvic Curl | Beginner | gluteus maximus, hamstrings | Building strength in the back of the legs and glutes supports the knee joint, and you can keep it safe by pressing evenly through your feet. |
| 5 | Single Leg Circle | Beginner | hip flexors, adductors | This motion encourages mobility and strength around the hip, and you can keep it gentle for the knee by keeping the working leg slightly bent. |
| 6 | Prone Hamstring Curl | Beginner | hamstrings | Strengthening the hamstrings directly supports the back of the knee, and you can keep it mild by bending the knee only halfway. |
What to avoid or modify
- Avoid kneeling exercises if they cause discomfort, or use a thick folded towel for extra padding under the knees.
- Choose lying or seated variations of exercises to keep your body weight off the knees entirely.
- Skip movements that require deep knee bends if they irritate your joints.
- Keep your range of motion small during leg circles and curls to avoid stressing the joint.
Movement types to treat with care
- Kneeling can be uncomfortable with knee pain; use extra padding or choose a version that keeps you off the knees.
Related pages
When to see a doctor or physical therapist
- A swollen, locked, or unstable knee.
- Pain that begins after a twisting injury.
- A feeling that the knee is giving way.
- Any knee condition that has not been assessed by a clinician.
This page is general education, not a diagnosis or treatment plan. If you have a health condition, are pregnant or are recovering from an injury or surgery, check with your own clinician before trying new exercises.
How we put this page together. Exercise choices and cautions were selected by our editors from the exercises in our library, using widely published general guidance on exercise and safety. Text drafted with AI assistance and checked by the Editorial Team. See our editorial policy. Last checked October 2026.