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Exercises for CP and OA
Hi all
My PT recommended the following exercises for Chondromalacia patella grade 2 and Osteoarthritis grade 1.
All the below exercises are to be done laying down-
1. IT band stretch (one leg over other leg knee)
2. Pillow squeeze between knees folded
3. Knee folded to chest
4. Quad stretch - Knee press on towel, knee press with forward and backward feet move, knee press with clockwise and anticlockwise feet move.
5. Quad stretch - Heel press on towel, heel press with forward and backward feet move, heel press with clockwise and anticlockwise feet move.
Out of the above, I am not able to do exercises 1 and 3 because of knee pain.
I want to know if the above exercises help or harm the knee diagnosis.
I am seeing on YouTube that quads are harmful for this situation. Instead glute exercises should be the focus.
Can anyone please share their valuable feedback.
My diagnosis was initially only mild Chondromalacia patella 7 months ago and now it's progressed due to stairs etc.
Answers (23)
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Get yourself checked vitamin B12 and vutamind3 level for faster recovery .
Which muscle to target is can't be generalised for that physical assesment needed .
Because we have find the chain .then only we get design the proper protocol .and yes treatment should be pain free .
Add hip flexor stretch if it's pain free
And hamstring strengthening .
Glutes exercise is must
Next Steps
change the physiotherapy who practice mulliagn technique and manual therapy for better recoevery .
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Exercise as a treatment is personalized and dose needs to be evaluated.
Get it peronalized in terms of dosage if general ex doesnt improve
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Hey there !
Treatment depends on the symptoms . Is there any weakness or discomfort . Kindly consult online.
Regards
Your physio
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The exercises prescribed by your physiotherapist are generally safe for Grade 2 Chondromalacia Patella and early OA, but exercises should be modified if they increase your knee pain. If exercises 1 and 3 are painful, inform your therapist rather than pushing through pain.
✔️ Quadriceps strengthening remains important
✔️ Glute and hip strengthening are equally important for patellar tracking
✔️ Low-impact activities like cycling and walking are usually beneficial
✔️ Avoid repeated stair climbing, deep squats and kneeling during flare-ups
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Recovery is best when exercises are individualized. The goal is not just stronger quads, but better overall knee mechanics and load management.
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Quadriceps strengthening is not harmful; in fact, it is a cornerstone of recovery. The quadriceps act as the primary shock absorbers for your knee. If they are weak, more impact is transferred directly into your joint cartilage, accelerating wear. The key is how they are worked. The isometric exercises your PT gave you (towel presses) are designed to activate the quads safely without grinding the kneecap.
Next Steps
Ask your physical therapist to safely incorporate hip-abductor and gluteal strengthening exercises (such as clamshells or straight-leg raises) into your routine to assist with your overall knee alignment.
Health Tips
Since your condition progressed due to stairs, try to minimize repetitive stair climbing, deep squatting, or kneeling until your thigh and hip muscles are strong enough to offload the joint.
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For grade 2 chondromalacia patella and early osteoarthritis, the exercises prescribed by the physiotherapist are generally intended to reduce muscle tightness, improve knee alignment, and strengthen the muscles supporting the knee. The pillow squeeze exercise can help strengthen the hip adductors, while the quad-setting exercises are commonly used to improve quadriceps activation without excessive knee movement.
However, exercises that significantly increase pain should not be forced. If the IT band stretch and knee-to-chest exercise consistently aggravate symptoms, they may need modification or replacement. Pain during exercise is a signal that the load or movement may not currently be tolerated.
It is also important to note that quadriceps strengthening is not harmful when performed appropriately. Current rehabilitation approaches usually focus on both quadriceps and hip/gluteal strengthening, as weakness in either muscle group can contribute to patellofemoral pain and abnormal knee mechanics.
Next Steps
Inform the physiotherapist that exercises 1 and 3 increase knee pain.
Request alternative stretches or modified versions that are pain-free.
Ask for an assessment of hip and glute strength, as these muscles are important for patellar tracking.
Progress exercises gradually and avoid activities that cause prolonged pain or swelling afterward.
Monitor stair climbing, squatting, and deep knee bending, as these often increase patellofemoral joint stress.
Seek a review if symptoms continue to worsen despite following the rehabilitation program.
Health Tips
Mild muscle discomfort is acceptable, but sharp knee pain is not.
Do not force stretches that significantly increase symptoms.
Improvement from rehabilitation often takes several weeks to months.
Focus on consistency rather than exercise intensity.
A balanced program including quadriceps, gluteal, core, and flexibility exercises usually produces better outcomes than focusing on only one muscle group.
If swelling, locking, giving way, or rapidly worsening pain occurs, consult the treating physiotherapist.
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⚠️ Disclaimer
This advice is based on the information provided and is for educational purposes only. It does not replace a physical examination or medical diagnosis.
Your exercise list is generally aimed at improving knee support, reducing patellar stress, and maintaining mobility.
✅ However, any exercise that increases your knee pain should be modified or temporarily avoided. For Chondromalacia Patella, both quadriceps and glute muscles are important—it’s not about choosing one over the other. Strong glutes help improve knee alignment, while correctly prescribed quad exercises help stabilize the kneecap.
Health Tips
✔️ Follow the “pain-monitoring rule”—mild discomfort is acceptable, but pain should not significantly increase during or after exercise.
✔️ Avoid excessive stair use, deep squats, and prolonged kneeling during flare-ups.
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Follow the rehabilitation plan advised by your therapist.
Avoid comparing your recovery protocol with videos on YouTube, as even patients with the same diagnosis may have different symptoms, severity levels, goals, and precautions.
Some exercises or activities that are beneficial for others may not be necessary or appropriate for your specific condition
Next Steps
YouTube and Google are forests of information, while they can be useful for general knowledge, your rehabilitation plan should be individualized.
If you are not able to do exercises that causing pain don't do them and also discuss with your physiotherapists
Health Tips
maintaining a healthy weight and include anti-inflammatory foods such as
fruits
vegetables
nuts
seeds
whole grains
omega-3-rich foods (fish, flaxseeds, walnuts).
Limit excessive processed foods, sugary drinks, and fried food
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Hi please take an online consultation for best diagnosis and treatment.
Next Steps
I need to know the present conditions
Health Tips
Follow the exercise and diet properly and postural care
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Exercises for knee strengthening is easy but as you are feeling pain while doing 1& 3, suggest you to stop and don't do that exercises.
Focus on strengthening exercises for now.
If you want to overcome the knee pain permanently consult back online.
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These exercises are generally helpful, not harmful, for knee osteoarthritis (OA) when done correctly. If an exercise causes significant pain (like exercises 1 and 3 for you), don't force it. Quad strengthening is usually beneficial, and glute exercises should be added—not replace quads completely
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You need knee strengthening exercises in particular where we strengthen the muscles specially quadriceps. The exercises you mentioned as 1 &3 is not for you.
Next Steps
Refrain the exc that you find difficult to do. Avoid sitting at floor
Health Tips
Calcium rich diet
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Pulling the knee to the chest and executing IT band stretches are generally not suggested and may be harmful to a patient with chondromalacia patella and grade one osteoarthritis. If these movements induce sharp discomfort or grinding, they should be avoided.
When you forcibly fold and pull your knee toward your chest, your kneecap compresses against your thigh bone (the patellofemoral joint). For someone with cartilage wear and arthritis, this grinding and crushing force can cause substantial pain and inflammation.
The iliotibial (IT) band is a thick band of tissue on the outside of the thigh. Many traditional IT band stretches include putting the knee in unnatural or twisted positions, which can twist the tibia and cause destructive shearing stress on already sensitive knee cartilage.
Next Steps
Switch to Swimming, Walking on flat surface.
Stationary bike
Modify your stretches, and focus on hip and gluteus exercises.
Avoid lunges and deep squats, leg extension.
If swelling is present use RICE protocol that is Rest, elevate your knee, use Cryo or ice and use crepe bandage or elastic bandage.
Health Tips
Avoid climbing stairs, squatting and kneeling.
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Dr. Steephan John (PT)
Physiotherapist
7 yrs exp
Bangalore
As you said, while doing the IT band stretch and knee bending, it is giving you pain because while doing these two, you are overstretching the muscle and putting stress on the patellar femoral area
Now focus on doing the ROM exercise without more load on the knee
and avoid knee-dominating stair climbing, instead train for hip-dominant stair climbing
Health Tips
for more information kindly contact THE RADIANT CLINIC, Indiranagar , Bangalore
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Dr. Neetu Rathi (PT)
Physiotherapist
17 yrs exp
Gurgaon
Greetings from Rid of Pain Physiotherapy
If you are feeling pain while doing specific exercises, stop doing that and consult the Physiotherapist. Exercises are advised according to the problem and the present symptoms. These are customized from person to person.
You tube can't explain the treatment of the problem. You can consider it only for reference.
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Ms. Kirtana Krishnan
Physiotherapist
3 yrs exp
Coimbatore
Hello,
The above exercises mentioned are not harmful but you should Know when to perform which particular exercises.
In case like condromalacia Patella, It gets worsen even if you follow certain exercises unless you rule out the main cause of the condition. A proper biomechanical diagnosis is essential to rule out Load Bearing on the Joint.
Patient even tend to develop pain in the opposite side of the condition due to even weight shifting.
Next Steps
Patient should focus on correct the alignment of the joint and strengthen the muscles to reduce the load and to stabilise the joint.
Health Tips
Avoid to much of stretching exercises and focus more on Strength Training.
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Dr. Jacob Roshan Mathew (PT)
Physiotherapist
22 yrs exp
Bangalore
There are multiple other factors like foot mobility, hip mobility, back mobility that also play a role with back pain.
Hence generic exercises could slightly help but you need to visit a physio for addressing other factors
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Dr. Shreya Humne (PT)
Physiotherapist
1 yrs exp
Jabalpur
Osteoarthritis and chondromalacia patella cause knee pain which increases during movement and stress the knee.
tightness of the IT band may be present,and stretching may provoke the pain around lateral knee.
Joint stiffness and cartilage degeneration can limit the knee flexion which make knee to chest more difficult.
Next Steps
if pain are aggregate while doing these exercises. exercise should modified. do streching in alternative days like once in a 2 days
Health Tips
consult the physiotherapist which help you with better assessment and better rehabilitation
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Ms. Jheel Shah (PT)
Physiotherapist
2 yrs exp
Mumbai
These excercises are not harmful for your case . you can continue with those . but what your program lacks is Vmo strengthening & mobilization glides which will offload the knee & also help in decresing the pain. mobilization glides in standing , walking & stairs are also helpful . let me know if you need any more assistance
Next Steps
distraction patella glide , medial MWM glide for knee flexion , medial MWM glide for knee flexion in stair climbing , pa glide to tibia ,vmo strengthening , eccentric quadricpes training
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Dr. Pranali Khatri (PT)
Physiotherapist
2 yrs exp
Mumbai
Please continue these exercises
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Dr. Afsa Rafiq (PT)
Physiotherapist
5 yrs exp
Srinagar
Take online consultation for better treatment and diagnosis
Health Tips
Avoid prolong standing
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Mr. Nalin Kumar
Physiotherapist
19 yrs exp
Ranchi
Well the above recommended exercises are rightly prescribed. However for ITB band strech you may need a support for this. Mostly active stretching exercises are also taught to patients.
For the pain management sympomatic management through the use of modality and further strethening exercises for Quadriceps and VMO is required. Moreover, I prefer prescribing a mix of dynamic and static exercises to the patients.
Next Steps
If you experice pain or discomfort during exercises you may discuss with your physio.
Health Tips
If the pain is intolerable stop the exercises, use icing and take rest. you may approach your physio for further guidance.
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