Knee Strengthening for runners

by Graeme Hilditch

Knee injuries in runners are incredibly common - and incredibly frustrating.

With the overwhelming majority of the running community having suffered a knee injury of some description during their running “career,” the knee is often seen as an area of weakness and one which is vulnerable to injury. The two questions many runners want to know the answer to is firstly, why is this the case and secondly, what can I do to prevent picking up a knee injury in the first place?

Although there are several answers to these questions, by far the best course of action any runner can take to reduce their chances of picking up a knee injury, is to incorporate strength training into their weekly regime.

The importance of strength training

By performing regular and specific strengthening exercises to the musculature surrounding the knee, you can help to ensure that the patella (knee cap) tracks properly through the gap in your thigh bone (known as your femoral condyle) thereby avoiding any rubbing, wearing and irritation of the knee cap or the femoral condyle. If certain surrounding muscles of the thigh are weak, it can cause tracking issues and overtime, lead to a chronic and painful injury.

When you consider that the loads placed on the end of the thigh bone and the knee-cap (known as the patello-femoral joint) can be as high as four times your bodyweight when walking and a massive nine times your bodyweight when walking downstairs, you can see just how important it is to make sure that your knee cap is tracking properly.

If your thigh muscles are weak and the knee isn’t tracking through the femoral condyle as smoothly as it should be, you can imagine what effect this will eventually have on those delicate structures after clocking up hundreds of running miles -

Injury, pain, frustration - meaning you will most definitely not be Running Happy!

Specific Knee Strengthening Exercises

They say a ”little knowledge can be a dangerous thing” and although no serious damage can be done if you perform incorrect or non-specific knee strengthening exercises, there are certain muscles which you need to target in order to ensure that you are actually strengthening the correct areas.

Lets take the thigh muscles for example.

As you can see in the image to the side, there are four main thigh muscles (hence the term QUADriceps) but there is one thigh muscle in particular which all runners should pay more attention to than the others.

Labelled is the thigh muscle known as VMO (vastus medialis oblique) also known as the “tear drop” muscle and it is an essential muscles for runners to keep strong if you have any chance of preventing a range of knee injuries. Although a herculean strong VMO can’t make you immune from picking up every knee injury, it can certainly help to protect you from some of the most common niggles.


In short, the VMO is responsible for ensuring that the knee cap tracks along the right line though the femoral condyle (click here to see a short animation of what happens to the knee cap as the knee flexes). If weak, it is unable to help the knee cap track as it should, causing poor alignment and rubbing on both the knee cap and the femoral condyle.

The trouble is, the VMO is a lazy muscle and it loses strength very quickly if you get injured or if your biomechanics are poor. Either way, it is essential that you keep the VMO strong - both to help prevent injury in the first place and as part of your re-hab if you are recovering from injury.

VMO Strengthening exercises

There are plenty of exercises you can do to strengthen the VMO without necessarily needing to have access to gym equipment.

Below are a handful of VMO exercises you can do to keep it strong and help prevent injury.

Straight leg raise

Straight leg raise

  • Lie on your back with the thigh you wish to exercise out straight and the other one bent at the knee.

  • Rotate your straight leg outwards from the hip ever so slightly so that your foot is rotated about 20-30 degrees.

  • From this position, slowly raise your leg 15-20 times to a height of around 12 inches and slowly lower it back to the floor.

  • Perform 3-5 sets.

A slight variation to this exercise and to change the type of musculature contraction, is to simply place a foam roller under your knee and straighten your leg - again ensuring that your foot is rotated outwards by 20-30 degrees.

Foot Drop

heel drop

Very simple yet very effective, the foot (or heel) drop exercise can be done in either a gym or home environment and it’ll do wonders to help fire up that VMO.

  • Stand on the edge of a step - the bottom step of the stairs is ideal.

  • Keeping the leg you wish to work on the step, slowly lower your other leg a few inches below the step.

  • By lowering your leg, the VMO of the other leg will automatically contract - provided your knee bends in line and does not deviate. Imagine there is a straight line leading from the centre of your knee through to your second toe (the one next to your big toe) and keep following that line as your other leg drops to the floor and back up again.

  • Perform 15-20 foot drops and then swap legs.

  • Start with 3 sets and work up to 5.

There are dozens of other exercises you can do to target the VMO and other surrounding muscles but these two are excellent to get you started and make sure that VMO muscle is fired up to help prevent injury and keep you Running Happy.

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