How To Move More: Knee Flexion

Read Time: ~3 minutes
Time to perform exercises: ~10 minutes

Hey there! Dr. Matt here!

Do you struggle to kneel down comfortably? Have trouble sitting on your heels or notice stiffness after walking or working out? Limited knee flexion might be the cause.

Your knee should comfortably bend to at least 135 degrees, allowing you to squat, kneel, and move with ease. If you’re missing range of motion here, it places more strain on your hips, ankles, and even your lower back.

Today, I’ll walk you through a simple test to check your knee flexion and share the same exercises I give my patients to improve flexibility and comfort.

Why should you care?

Healthy knee flexion is essential for:

✅ Kneeling, squatting, and getting up from the floor. [1]
✅ Walking and running efficiently, without compensations. [3]
✅ Reducing unnecessary stress on your hips, ankles, and lower back. [3]
✅ Preventing long-term cartilage wear, stiffness, and chronic pain. [1][2]

If you ignore restricted knee flexion, you may develop:

• Increased stress on the kneecap (patellofemoral joint), leading to pain. [1][2]

• Higher risk of meniscus injuries, especially during twisting movements. [5]

• Reduced shock absorption, which can strain the hips and lower back. [3]

• Compensations that limit overall lower body mobility and balance. [3]

• Higher risk of knee replacement surgery.

Self-assessment:

How to Perform:

1. While laying face down on a firm surface, bend one knee and try to bring your heel as close to your butt as possible.

2. Use your hands to assist if you need to, but don’t force it.

3. Repeat for the other side.

Goal:

Your heel should be able to touch your glutes (or get very close) without sharp pain or compensations.

What to Watch Out For:

🚩 Pain in the front, back, or sides of your knee.
🚩 Stiffness or pinching in the front of the knee.
🚩 Feeling like the knee gets stuck before reaching full flexion.
🚩 Significant differences between the two sides.

These are signs that your knee flexion needs improvement.

Daily at-home exercises:

Here are three exercises I frequently recommend to improve knee flexion:

Mobility: 🎥 Quad Stretch (4 sets of 30 seconds per side)

• Lie face down on the floor or a mat.

• Grab your ankle with your hand, a strap, a towel, or a belt.

• Gently pull your heel toward your glute, keeping your hips flat on the floor.

• Hold the stretch for 30 seconds, breathing deeply.

• Switch sides.

Tip: If this is too intense, you can do the same stretch lying on your side instead.

Stability: 🎥 Heel Elevated Squat (3 sets of 10 reps)

• Place your heels on a rolled-up towel, dumbbells, books, or small weight plates, keeping your toes flat on the floor.

• Stand with your feet hip-width apart and slowly lower into a squat, as low as you can go.

• Focus on bending your knees fully while keeping your chest tall.

• Press back up to standing and repeat.

• Use a counter or sturdy surface for balance if needed.

Why this works: Elevating your heels shifts the focus to your knees and helps you access deeper knee flexion, especially if your ankles are stiff.

Tissue Quality: 🎥 Foam Roll Quads (4 spots, 30 seconds per spot, per side)

• Lie face down with a foam roller under the front of one thigh.

• Support yourself on your elbows and gently roll up and down from your hip to just above your knee.

• Pause and hold on any particularly tight or tender spots, taking slow, deep breaths.

• Spend 30 seconds per spot, or until pain decreases, before moving to the next area.

• Repeat on the other leg.

Tip: Bend your knee slightly while rolling to add an extra stretch to the muscle.

Do you need a foam roller? Check out my recommended products page here.

Even if your self-assessment was fine, these exercises are great for maintaining healthy knee flexion. Do them daily this week and see how much better your knees feel.

For more info on using this newsletter, click here: https://movemoreminute.com/c/howtouse

*Stop right away if you feel sharp pain, ongoing discomfort, or anything else that worries you during these exercises. This includes numbness, dizziness, or severe pain. Reach out to me or another healthcare professional so we can help you progress safely.

I hope this helps you in your movement journey. As always, don’t be afraid to reach out if you’re having any issues!

See you next week,

Dr. Matt Moreno, D.C., C.C.S.P.®
The Move More Minute

Disclaimer: The information provided in this newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, chiropractor, or other qualified healthcare provider with any questions you may have regarding a medical condition or before starting any new exercise program.

The exercises and suggestions provided are general recommendations and may not be suitable for everyone. If you experience pain, discomfort, or any concerning symptoms while performing these exercises (such as numbness, dizziness, or increased pain), stop immediately and consult a qualified healthcare professional.

Do not disregard professional medical advice or delay seeking it because of something you have read in this newsletter. The author, Move More Minute, and its affiliates assume no responsibility for injuries or issues that may arise from following the recommendations provided. By engaging with this content, you agree to do so at your own risk.

For personalized care or specific advice, please schedule an appointment with a qualified professional.

Sources:

1. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Frontiers in Physiology.
   https://www.frontiersin.org/articles/10.3389/fphys.2021.794062/full

2. Minimal Clinically Important Change of Knee Flexion in People with Knee Osteoarthritis. Systematic Reviews.
   https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02393-0

3. Isolating the Energetic and Mechanical Consequences of Imposed Ankle and Knee Motion Restrictions During Walking. Journal of NeuroEngineering and Rehabilitation.
   https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-021-00812-8

4. The Critical Role of Physical Activity and Weight Management in Knee Osteoarthritis. The Journal of Rheumatology.
   https://www.jrheum.org/content/51/3/224

5. Factors Affecting Range of Motion After Revision Total Knee Arthroplasty. The Journal of Arthroplasty.
   https://www.arthroplastyjournal.org/article/S0883-5403%2821%2900378-8/fulltext

   Note: Some claims are based on clinical observations and general orthopedic knowledge. For personalized advice, consult a healthcare professional.