A Simple Exercise for Knee Pain that Most People Do Wrong

“Yeah, I’ve done that before. Didn’t help my knee pain any,” said Jim.

“Well, let’s just double check what you did,” I replied.

Jim proceeds to show me the exercise often referred to as a “quad set”. He sits on the exam table, legs out in front of him. He then tightens the right thigh muscle – the quadriceps – and releases.

“Okay, now on a scale of 1 -10 where 10 is you couldn’t possible tighten that muscle any more, how much tightness do you produce in the contraction?” I asked.

“Oh, I guess maybe a 7 or so. Tight enough I guess because I can see the muscle change and could feel it,” said Jim.

“And how many of the contractions have you been doing over the course of a day?” I asked.

Jim paused. Then he said, “I do 3 sets of 10 repetitions but I don’t do it anymore because it didn’t help.”

Some of you might guess what’s going on here with Jim and his quad sets.

Insufficient stimulus.

When a physician prescribes a medication, you have to take a specific amount to achieve a therapeutic dose.

Same thing with exercise.

He’s not doing the exercise intensely enough, nor frequently enough to notice a change.

For quad sets to work, you have to go all in. Maximum effort contraction for 10 seconds and 10 repetitions is fine but you need to do closer to 100 per day, not 30.

If you give it your all on every contraction, you will, at first, struggle to get 30 a day. But your body will adapt quickly.

Why does this matter?

The benefit of the quad set is not a stronger muscle even though that’s what most people are told. Sure, you strengthen the muscle some but not enough to change your function.

The benefit is what happens inside your knee^[1]Miyaguchi, M., Kobayashi, A., Kadoya, Y., Ohashi, H., Yamano, Y., & Takaoka, K. (2003). Biochemical change in joint fluid after isometric quadriceps exercise for patients with osteoarthritis of … Continue reading.

Knee pain from arthritis (osteoarthritis) comes from, at least partially, a decrease in quality of the fluid inside your knee.

The fluid – synovial fluid – serves a couple of purposes. One – it lubricates your joint so movement is easy. And two – it serves as a cushion protecting the cartilage and underlying bone.

When the fluid gets thinner, watery, it does a poor job of lubricating and cushioning your knee. The result is your knee starts to hurt, ache.

The natural, non-invasive way to improve the quality of your synovial fluid in your knee is the quad set exercise.

But you have to execute the exercise correctly.

That’s all I have for now.

Thanks for reading.

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