Knee pain during pregnancy: causes, treatments, and exercises

Pregnancy is an exciting time filled with changes, including some new aches and discomforts. This can affect areas like your shoulders, hips, and knees. “Knee pain is pretty common during pregnancy because your body goes through so many changes that affect how you move and how your knees feel,” says Renee Bullis, PT, DPT, a physical therapist at Hinge Health.

But you don’t have to just deal with knee pain during pregnancy. Performing gentle knee strengthening exercises and stretches can help ease discomfort. 

Read on to learn why knee pain happens during pregnancy, plus how you can find relief with exercises recommended by our Hinge Health physical therapists.

Causes of knee pain during pregnancy

Here are some of the most common reasons you may experience knee pain during pregnancy:

• Increase in relaxin. Your body produces more of a hormone called relaxin during pregnancy, especially in the first trimester. This helps your body adapt and prepare for childbirth by loosening tissues, especially around your pelvis. But relaxin doesn’t just target the pelvis — it relaxes all ligaments, including the ones in your knees (ACL, MCL, PCL, and LCL). High relaxin levels can increase joint laxity, which can contribute to discomfort. 

• Changes in posture and gait. You might change how you stand as your belly grows. Some pregnant people lock their knees more than usual, which can lead to knee pain, Dr. Bullis says. “It’s common to take a wider stance and walk with more of a waddle, which can put extra pressure on your knees.” 

• Weight gain. The second and third trimester is often when you feel the most knee pain, says Dr. Bullis, likely due to typical pregnancy weight gain. 

• Flattening foot arches. “Research shows that your foot arches often flatten during pregnancy, especially in the third trimester, due to weight gain and shifts in your center of gravity. This can also affect your knees and hips,” Dr. Bullis says. 

• Sciatica. Sciatica and knee pain often go hand in hand. Changes in your spine and posture during pregnancy can irritate the sciatic nerve, which travels from your lower back down through your knee. This can cause discomfort that radiates from your back to your knee and further down your leg.

• Fluid retention. “Another reason for knee pain during pregnancy is increased fluid retention, which can make your knee joint feel achy, stiff, and swollen,” Dr. Bullis says.

Treatments for knee pain during pregnancy

There’s a lot you can do to relieve knee pain during pregnancy. Here’s what Hinge Health physical therapists (PTs) recommend:

• Try physical therapy and targeted exercises. Targeted exercises can help strengthen and alleviate muscle tightness in and around your knee. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Engaging in low-impact and low-intensity exercises (with your provider’s approval) such as walking, swimming, water aerobics, yoga, and elliptical workouts can all help increase blood flow to your knees, improve joint function, and reduce muscle soreness and tension.

• Apply ice and heat. Ice can help target inflammation and swelling; heat can help reduce muscle tightness and enhance blood flow. Alternate between the two or choose the method that brings you the most relief. 

• Elevate your legs. “If you’re on your feet all day, try taking breaks to rest and elevate your legs above heart level,” Dr. Bullis says. “This can help reduce swelling in your knees and feet.”

• Wear belly bands and pregnancy belts. There are different types of support belts, like sacroiliac (SI) joint belts and belly bands. “A belly band can help relieve knee pain by gently supporting your belly, making it easier to walk and stand comfortably,” Dr. Bullis says.

• Try over the counter pain relievers. Acetaminophen (Tylenol) has been shown to be safe to use during pregnancy. Always check with your provider before you use it.

• Take an Epsom salt bath. Epsom salt baths can help relax sore muscles, which can alleviate discomfort in and around your knees.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for knee pain relief during pregnancy, such as massage, acupuncture, or chiropractic care.

How physical therapy helps

“Physical therapy is a first-line treatment for knee pain during pregnancy, since so much of the discomfort is musculoskeletal,” says Dr. Bullis. “Our goal is to strengthen your lower body muscles to provide more support around the knees. Once we do that, pain should naturally decrease.”

A physical therapist can assess how you walk, lift, and carry things. This can help them identify any muscle imbalances that could be causing you to put more load on your knees. “When we get a sense of how your body’s moving and feeling, we can create a personalized plan of stretches and exercises for you to use at home,” Dr. Bullis says.

These exercises are recommended by Hinge Health physical therapists to help relieve knee pain during pregnancy. They help to stretch and strengthen a range of key lower body muscles which may feel overworked as your body adjusts to pregnancy-related changes.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Knee pain prevention in pregnancy

These tips can help your body stay healthy and strong during pregnancy and may help prevent knee pain:

• Try movement snacks. Sitting or lying down for extended periods can lead to muscle and joint stiffness. Try to get up and stretch or walk around once every hour or two. Do the above stretches daily to stay active and support your knee health.

• Choose supportive footwear. The right pair of shoes supports you from the ground up, says Dr. Bullis. “Wearing supportive shoes can help support your arches and relieve or even prevent discomfort higher up your leg, like in your knees.”

• Be mindful of how you walk. “When you can, try to focus on rolling from heel to toe as you walk,” says Dr. Bullis. “This natural walking pattern can help your knees feel more comfortable.”

• Strive for a healthy weight. Pregnancy of course comes with weight gain. And while this may look a little different for everyone, gaining too much weight can put strain on your knees. Talk to your doctor about a healthy weight gain range for you.

• Try a posture reset. During pregnancy, it’s common to shift your weight back toward your heels or forward onto your toes, says Dr. Bullis. A simple fix: “Stand upright and gently rock back and forth from your heels to the balls of your feet until you feel grounded and balanced,” Dr. Bullis says. “Once you’re settled, unlock your knees.” This small movement can help your body feel more supported and at ease. Rest your hand on a nearby counter or wall for extra support.

PT tip: Keep moving — and rest when you need to

Pregnant or not — when you have knee pain, it’s common to feel hesitant about physical activity. But gentle movements and strengthening exercises can help ease pregnancy discomforts. “Aim for a balance: If your knees or feet feel sore or swollen, elevate your legs and rest. Then take a gentle movement break. Change positions regularly throughout the day,” Dr. Bullis says. Mixing in different types of movement and postures throughout your day can ease knee pain and support your overall comfort during pregnancy.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Tanaka, M. J., Forman, J. M., Otwell, A. G., Frischmann, L. D., Jones, L. C., & Szymanski, L. M. (2021). Characterization of knee dysfunction and related risk factors during pregnancy. The Physician and Sportsmedicine, 50(1), 78–83. doi:10.1080/00913847.2021.1882277

3. Chu, S. R., Boyer, E. H., Beynnon, B., & Segal, N. A. (2019). Pregnancy Results in Lasting Changes in Knee Joint Laxity. PM&R, 11(2), 117–124. doi:10.1016/j.pmrj.2018.06.012

4. Dehghan, F., Haerian, B. S., Muniandy, S., Yusof, A., Dragoo, J. L., & Salleh, N. (2013). The effect of relaxin on the musculoskeletal system. Scandinavian Journal of Medicine & Science in Sports, 24(4), e220–e229. doi:10.1111/sms.12149

5. Segal, N. A., Boyer, E. R., Teran-Yengle, P., Glass, N. A., Hillstrom, H. J., & Yack, H. J. (2013). Pregnancy Leads to Lasting Changes in Foot Structure. American Journal of Physical Medicine & Rehabilitation, 92(3), 232–240. doi:10.1097/phm.0b013e31827443a9