Sometimes our knee sneaks out of its balanced alignment without our noticing. I'm always surprised to find I have a pain in my knee and wonder, “How did that get there?”

Commonly, knee problems come down to a misalignment at the knee joint itself: a combination of weak supporting and overtight leg muscles. There is a lot you can do to help your knees, and the three S's are a good place to start. This set of three simple exercises helps by targeting the muscles that can guide the knee joint back to a healthier line of movement: by strengthening the muscles that support the knee and by bringing relief to the overtight muscles that are adversely pulling on it.

The Three S's: Strengthen, Support and Stretch

1. Begin with a set of inside thigh strengtheners.
2. Follow with front thigh extensions (supports healthy kneecap tracking).
3. Finish with a good thigh stretch.

Exercise 1: Inner Thigh Squeezes

Why? Strengthening the inner thigh helps counter-balance the outer thigh muscles that are often tight and can pull adversely on the knee joint. This move also helps “open-up” tightness in the lower back.

Equipment: a cushion, plump pillow or a rolled-up towel.

Setup: Natural curve of the lower back and neck. Feet together. Tailbone heavy.
a. Begin: Inhale to prepare - no movement – let the breath widen your back.
b. Exhale: Scooping your tummy deeply; squeeze the cushion with your knees. Countslowly — 5 - 4 - 3 - 2 - 1 — and release. Repeat 5 to 8 times.

Teachers tip: Imagine your low abs and your inner thighs as long one muscle as you squeeze. Itʼs important to not let your pelvis tilt, but to keep its natural curve throughout.
Watch out for: These other muscles will want to join in: glutes, hip flexors, back, neck — but donʼt let them. Focus on using the inside thighs and low abs only, no other muscles allowed to play.

Exercise 2 - Leg Extensions
This exercise focuses on strengthening the usual weak-knee culprit: Itʼs a quad muscle called the Vastus Medialis. It lies just above the kneecap on the inner-front thigh. This muscle supports the healthy tracking-balance needed for pain free knee-joints.

Setup: Sit toward the front edge of a chair, with your spine tall and both feet flat on the floor. Raise one knee slightly and interlock your fingers underneath the knee. Let your arms lengthen and allow your leg to feel heavy in your hands.

To a slow waltz rhythm, counting “1 - 2 - 3 ” ...
a. Extend the leg fully on count 1.
b. Hold the leg still, on count 2: knee straight and the flexed foot extends through the heel.
c. Slowly lower down for count 3. Relax the foot and ankle.

Repeat: Start with 10 extensions and build up to three sets of 20 with each leg.
Teachers Tip: Think of moving slowly through heavy air and take any swing out of the action. On the extension, itʼs important to straighten the knee completely to engage the targeted quad muscle. The most benefit comes during the last 25 percent of the extension just as the leg is fully straightened, and then during the first 25 percent when re-bending the knee.

Exercise 3: A Good Thigh Stretch.
Stretching out the strong quads at the front of the thigh releases tension, sometimes immediately, from around the knee. When your thigh muscles are tight, they can affect your kneecap or patella and can weaken the knee joint. There are many thigh stretches to choose from. Here is a gentle place to start:

Hold the stretch for 5 to 8 long deep breaths. Repeat two or three times with each leg. An easy way into this stretch (to stretch your right thigh):

Standing tall - rest your left hand on a strong support, chair or ledge in front of you. Prepare by lifting your right knee directly on front of your right hip, shin dangling down, foot relaxed. Take your right hand and slide the palm down the front of the right shin — from the knee down to your right ankle. Hold onto your ankle or wherever feels comfortable and ease the knee downward and back to the stretch position; this can avoid possible hamstring cramps.

• Scoop in your low abdominals to keep your pelvis from tilting forward.

• By relaxing you can bring the bent knee back in line with the supporting leg and then draw your heel closer to your buttock with the strength of your arm.

• Aim to feel the stretch in the middle of the thigh.

• Imagine helium balloons attached to the front of your hip bones, lifting them higher, but a heavy weight attached to your tailbone that lengthens your lower back.

• Keep the knees close together.

Watch-points: Keep breathing and stay long enough in the stretch to let the muscles release.

Working out advice:
If you have knee pain and want to keep exercising, proper walking or running shoes can help. Avoid the physical pounding aspect of your workout for a few days. If you run, try the elliptical; if thatʼs still painful, do Pilates, swim, stretch or walk — with the focus on healthy hip-knee-foot alignment. When freedom returns to your knee again, ease your way back to your workout. Lastly, have a look at your feet; you may need insoles to support the arch and heel. MBTʼs (soft-heeled shoes) can help realign shins and thigh rotations, and Birkenstocks are beneficial for opening up the feet.

When my knee hurts, on occasion now thankfully, I wear my MBTs more and they really do seem to help. With a little investigative hunting on your part, a pain in the knee wonʼt be such a mystery, and youʼll find the keys that work for you. The 3 Sʼs and good shoes are a great anti-knee-pain recipe. Remember: Itʼs “No Pain, All Gain.”

Amanda Musker studied classical ballet at the Royal Ballet School in London. She went on to enjoy 14 enormously successful years working in London’s West End, starring in productions such as “Cats,” “Joseph and the Amazing Technicolor Dream Coat” and “Oklahoma.” In 2000 Amanda decided to pursue her other great passions, Pilates and yoga. This led her to an equally successful career as one of the most sought-after teachers of these disciplines. Having experienced 30 years of career-related injuries, as well as working with hundreds of yoga and Pilates students, Amanda is uniquely qualified to bring a deeper understanding of our bodies and what helps to make us flourish in them. Send your questions to Amanda@smartnow.com.