Building leg muscle (hypertrophy) when you have knee arthritis is absolutely possible—but it requires a careful, joint-friendly approach. The goal is to strengthen the surrounding muscles without aggravating the joint. Here’s a breakdown of how to do it safely and effectively:
1. Focus on Low-Impact Strength Training
Avoid exercises that load the knee joint excessively or involve deep bending. Instead, use:
• Leg Press (short range of motion) – Press to about 60–70° knee bend, not deeper.
• Seated Leg Extension (light to moderate load) – Great for quadriceps if done with controlled tempo.
• Hamstring Curls (machine or lying) – Strengthens the back of the thigh to stabilize the knee.
• Glute Bridges or Hip Thrusts – Build strong glutes that take stress off the knees.
• Step-ups (low step) – Improve functional strength; start with body weight.
2. Prioritize Proper Load and Tempo
• Light to moderate weights (50–70% of your max) are enough to stimulate hypertrophy when done with slower reps (3–4 seconds atw down) and higher time under tension (10–12 reps).
• Avoid fast or jerky movements that create joint shear.
3. Train the Supporting Muscles
Knee stability depends not just on the quads and hamstrings, but also on:
• Glutes (medius and maximus) – Lateral stability
• Adductors – Inner thigh support
• Calves – Help absorb ground impact
Exercises like banded side walks, clamshells, and calf raises help reduce knee load during movement.
4. Include Mobility and Warm-Up Work
Before strength training:
• Warm up with stationary cycling (5–10 minutes) on low resistance.
• Include quadriceps, hamstring, and hip flexor stretches after training.
• Gentle foam rolling around, not directly on, the knee can help circulation.
5. Consider Water or Suspension Training
• Aquatic resistance training or pool workouts can build muscle while minimizing impact.
• TRX-assisted squats and lunges reduce knee load and improve control.
6. Manage Inflammation and Recovery
• Don’t train legs on back-to-back days.
• Apply ice post-workout if inflammation flares.
• Focus on anti-inflammatory nutrition (omega-3s, turmeric, leafy greens).
7. Progress Gradually
Track tolerance carefully. If pain lasts longer than 24–36 hours post-exercise or swells significantly, scale back intensity or range of motion.
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