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The question: I have very bad knees. I've been told that I have to strengthen my muscles around them, especially my thighs, in order to support them. But why do all the exercises have to be on the floor? Are there any good exercises that could be done sitting or standing?

The answer: For sure! Here are three great ones.

Quad/hamstring/glute-squeeze: Sit tall with a pillow in between your knees. Squeeze the pillow while simultaneously engaging the front and back of your thighs, your bum and your abdominal. Release and repeat 25 times.

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Seated leg extension: Sit tall with your right hand on the inside of your right knee. Engage the muscles around the knee, but especially the ones directly under your hand as you straighten your leg out in front of you. Repeat 15 to 25 times before switching legs.

Sit to stand: Only try this exercise after you have mastered the above ones. Find a chair that is relatively high. As you get stronger, try a lower chair. Start seated. Position your feet hip distance apart and parallel. Your knees should be in-line with your middle toes. Engage your core, bum and thighs to stand up, then sit back down slowly, muscles still engaged. Start with five reps. Progress to 10 reps as appropriate.

The trick to strengthening muscles around any "problem" joint is to find both the appropriate exercise and dosage. Your goal should be to increase muscular strength and promote synovial fluid (our natural joint lubricant) and blood flow without challenging the muscles so severely that you create negative joint pain (versus positive muscle exhaustion). Sometimes an exercise can be appropriate, but the repetition range too strenuous. If you feel negative pain, before abandoning the exercise, check your form and reduce your reps.

I also suggest you replace high-impact activities like running with low-impact activities like walking and water aerobics.

Trainer's tip: Since strong hip and core muscles will help decrease the torque placed on your knees, try the standing glute pulse: Stand on your left leg, engage your left bum muscle and make sure your left knee is in line with the middle toe of your left foot. Keep your right leg straight and pulse it backward on a 45-degree angle 15 times. Switch and repeat on the opposite side.

Kathleen Trotter has been a personal trainer and Pilates equipment specialist for 10 years. Her website is www.kathleentrotter.com.

Click here to submit your questions. Our Health Experts will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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