Pain guide · Knee pain

Knee pain in pregnancy: the kneecap, weight and looser joints, swelling, exercise by trimester

Knee pain in pregnancy is fairly common, especially in the third trimester, though less common than back, hip or foot pain, and it is rarely a sign of anything serious. Most of it is an ache around the kneecap that is worse getting up from low seats, on stairs and squatting, as the bump grows and the load on the front of the knee rises; women who had knee trouble before are the most likely to get it. Pregnancy loosens the joints a little, but that doesn't explain knee pain and isn't a reason to stop exercising.

A few signs need a call. A swollen, throbbing calf or thigh needs help the same day, as clots are more likely in pregnancy and after the birth; a hot, red, swollen knee with a high temperature needs the National Health Service's 111 line (NHS 111) now; and sudden swelling of the face, hands or feet, a severe headache or vision problems can be pre-eclampsia, which needs urgent help from your maternity unit. This guide covers how to tell the causes apart, what to change at home and at work, what the evidence says about relaxin, exercise and painkillers, and a four-stage plan with 3D demos through pregnancy and after the birth.

4-stage exercise plan When to get help 52 sourcesUpdated 27 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or contraception or hormone replacement therapy (HRT) that contains oestrogen.
Leg pain or swelling with breathlessness or chest pain: call 999 or go to A&E, and do not drive yourself. It can be a blood clot that has reached the lungs.
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. These are the NHS's signs of a blood clot in the lungs (a pulmonary embolism) or another serious condition. Don't drive yourself.
Get advice from NHS 111 now: a hot, red or swollen knee with sudden severe pain, a very high temperature, or feeling hot, cold or shivery. This can be a joint infection.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape.
Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
You hurt your knee and cannot take 4 steps, or you are 55 or over and have injured it: get it checked the same day for a broken bone.
Ask for an urgent GP appointment or get help from NHS 111 for pain or swelling in your leg that suddenly gets worse; swelling, bruising and warm skin on your leg; red or darkened skin on your leg; or swelling in your leg that gets harder or softer. These can be a burst Baker's cyst or a blood clot.
Get urgent medical help: you're pregnant or have given birth in the last few weeks and have symptoms of pre-eclampsia, such as pain below the ribs, a severe headache that does not go away with simple painkillers, vision problems such as blurred vision or seeing flashing lights, sudden swelling of the face, hands or feet, heartburn that does not go away with heartburn medicines, being sick, or feeling very unwell. If you're pregnant, call your maternity unit if you have the number; if you've recently given birth or cannot call your maternity unit, call 111.
Call your midwife or maternity unit straight away for vaginal bleeding, fluid leaking from the vagina, regular painful tightenings, a change in your baby's movements, a high temperature, a severe headache, problems with your vision, or sudden swelling of your face, hands or feet.
After a fall or a knock to your bump, even if you feel fine, call your maternity unit: they may want to check you and your baby. If you hit your head, call your GP or NHS 111 as well. This is our suggestion, from NHS Greater Glasgow and Clyde's and NHS Wales's maternity advice: the NHS website gives no tier for a fall in pregnancy.
Sudden, severe knee pain with no injury that gets worse, or not being able to put weight on a leg, especially late in pregnancy: get help the same day. A rare thinning of the bone in pregnancy (transient osteoporosis) or a fracture needs a scan (our suggestion, from case reports).
Call 999 or go to A&E: back or leg symptoms with numbness around the genitals or bottom, new trouble controlling your bladder or bowels, or severe or worsening weakness or numbness in both legs.

See a doctor or physiotherapist if

Knee pain that has not improved within a few weeks of looking after it at home. Many areas offer NHS physiotherapy without a GP referral.
Numbness, tingling or weakness that travels down the leg from the back. That points to a nerve (sciatica) rather than the knee.
Call your midwife or GP if you have pelvic pain and it's hard for you to move around, it hurts to get out of a car or turn over in bed, or it's painful going up or down stairs.
Swelling in several joints, or morning stiffness that lasts more than 30 minutes: see a GP. It can be an inflammatory arthritis such as rheumatoid arthritis rather than osteoarthritis.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

A dull ache around or behind the kneecap, worse getting up from low seats, on stairs, squatting or kneeling

Usually kneecap (patellofemoral) pain, the commonest knee pain in pregnancy. This guide's plan covers it; our runner's knee guide covers it outside pregnancy.

Read: Runner's knee →Knee pain on stairs, especially coming down

Usually the kneecap. Our stairs guide covers it, and this guide's written steps cover stairs in pregnancy.

Read: Knee pain on stairs →Pain at the front of the pelvis, groin or inner thighs on stairs, turning in bed or getting out of a car

Usually pelvic girdle pain rather than the knee, which affects up to 1 in 5 pregnant women.

Read: Pelvic girdle pain (SPD) →Puffy legs, ankles and feet, both sides, worse at the end of the day

Normal swelling in pregnancy. Our foot pain in pregnancy guide covers what helps and when swelling is a warning sign.

Read: Foot pain in pregnancy →

One calf or thigh swollen and throbbing, with red or darker skin

Possibly a blood clot, which is more likely in pregnancy and the weeks after the birth: get help the same day, as the warning signs say.

A sudden cramp in the calf at night, felt behind the knee

Common later in pregnancy, and it passes within minutes. Our leg cramps guide covers what helps.

Read: Leg cramps →A lump behind the knee, or pain behind the knee

Often a Baker's cyst, which shares urgent signs with a clot if the calf suddenly swells. Our guide to pain behind the knee maps it.

Read: Pain behind the knee →A hot, red, swollen knee, especially with a high temperature

A swollen knee joint isn't normal pregnancy swelling: get advice from NHS 111 now, as the warning signs say.

Read: Swollen knee →The knee locks, gives way, or swelled within hours of a twist or a fall

Possibly a ligament or cartilage injury: get advice from NHS 111.

Read: Meniscus tear →

Sudden, severe knee pain with no injury, getting worse, late in pregnancy

Very rarely, a thinning of the bone in pregnancy (transient osteoporosis): get help the same day.

Knee pain while running in pregnancy

Our running guide covers knee pain when you run; in pregnancy, keep to running you already did, as this guide says.

Read: Knee pain when running →Knee pain in women at other times of life

Our knee pain in women guide sorts the causes by age and life stage.

Read: Knee pain in women →

Several swollen, stiff joints, with morning stiffness of more than 30 minutes

Possibly an inflammatory arthritis: see a GP.

Understand it

Less common than back, hip or foot pain, and commonest late in pregnancyEmerging evidence

In one Turkish hospital, 184 women were asked at each trimester visit which parts of their body hurt. Knee pain affected 4.9% in the first trimester, 8.2% in the second and 13.0% in the third, against 29.9% for the hip and 19.6% for the ankle and foot in the third. In 310 women at US pregnancy clinics, knee function scores fell through pregnancy, and a lower score was linked with earlier knee problems, being very active, being under 25 and a higher body mass index (BMI).

Front-of-knee pain was reported by 20% of 215 pregnant women in Nigeria, and by 19.1% of 3,102 women who ran in pregnancy, less often than pelvic, back and hip pain. These are surveys, and their figures differ with how they asked.

Sources 1, 2, 3, 4

Earlier knee trouble predicts it better than pregnancy doesEmerging evidence

In a US clinic, 22% of 107 women at their 6-week postnatal check had had knee pain, against 41% of 91 women who had never been pregnant; once earlier knee pain was counted, pregnancy made no difference, while earlier knee pain was the strongest link. Nearly half of the pregnancy-related knee pain began in the third trimester. In an Israeli survey, pregnancy wasn't linked with musculoskeletal pain on its own once other factors were counted.

Sources 5, 2, 6

The load rises late in pregnancy, especially getting up and on stairsEmerging evidence

Most women gain 10 to 12.5 kg in pregnancy, mostly after week 20, and the American College of Obstetricians and Gynecologists (ACOG) says the weight gain and a shifted centre of gravity "increase the forces across joints". In a laboratory study of 24 women, rising from a chair produced larger forces at the knee in the third trimester than the first, especially from low chairs, and an older study, as one paper reports it, found much higher kneecap forces getting up at 36 weeks. Going downstairs loaded the legs faster in pregnancy.

Walking changes less than people expect: there was no "waddling gait" in one study, the hip and ankle take more of the extra load, and the changes ease after the birth. Studies disagree on what happens at the knee when walking, so the clearest message is about low seats and stairs.

Sources 7, 8, 9, 5, 10, 11, 12, 13

Looser joints: real, small, and not the explanation for knee painStrong evidence

Joints do loosen a little in pregnancy: laxity rose in most peripheral joints measured, and front-to-back knee laxity was higher in late pregnancy than 4 months after the birth. But it didn't track levels of relaxin, the hormone usually blamed, joint pain wasn't linked with joint laxity in 35 women, and a moderate exercise class didn't make knees looser. Small changes in knee laxity were still measurable about 19 weeks after the birth, mostly less laxity than early in pregnancy, of unknown importance.

ACOG says concerns that exercise in pregnancy causes musculoskeletal injury "have not been substantiated" in uncomplicated pregnancies.

Sources 14, 15, 16, 17, 18, 19, 8

The causes that aren't the knee, and how rare they areStrong evidence

Gradual swelling of the legs, ankles and feet is normal in pregnancy, but "a sudden increase in swelling can be a sign of pre-eclampsia or a type of blood clot called deep vein thrombosis (DVT) and needs to be checked immediately", the NHS says. Clots affect about 1 to 2 in 1,000 pregnancies and the weeks after the birth, the Royal College of Obstetricians and Gynaecologists (RCOG) says, with the risk highest just after delivery.

A hot, red, swollen knee with a high temperature can be a joint infection. A burst Baker's cyst and a clot share urgent signs. Transient osteoporosis of the knee, a thinning of the bone in late pregnancy, is very rare (case reports only). Pelvic girdle pain can spread to the thighs and is worse on stairs, and leg cramps affected 75% of women in the Turkish study, mostly at night late in pregnancy.

Sources 20, 21, 22, 23, 24, 25, 26, 27, 28, 1

When a scan or test helpsStrong evidence

Most knee pain in pregnancy needs no tests. After an injury, an X-ray can be done in pregnancy when it's needed: UK guidance says the dose from diagnostic X-rays "should present no risk" of harming the baby and asks about pregnancy for X-rays between the diaphragm and the knees, so tell the radiographer you're pregnant.

A suspected clot needs an ultrasound within 24 hours, which also shows a Baker's cyst. Magnetic resonance imaging (MRI) uses no X-rays and shows transient osteoporosis, which X-rays often miss early. Blood pressure and urine checks for pre-eclampsia are part of every antenatal appointment.

Sources 29, 30, 23, 26, 27, 31, 32

How it usually goesEmerging evidence

Knee pain tends to build towards the third trimester. After the birth, knee laxity and walking return towards how they were before pregnancy. No study has measured how many women still have knee pain months after the birth, so this guide gives no recovery time. No one can promise a timescale.

Sources 1, 2, 15, 12, 5

What helps, and how strong the evidence is

Exercise is safe and recommended in pregnancyStrong evidence

The UK Chief Medical Officers advise at least 150 minutes of moderate activity a week and muscle strengthening twice a week: "There is no evidence of harm" and "Listen to your body and adapt". The NHS says start gently if you're new to exercise (about 10 minutes a day), don't start a new vigorous activity such as running, avoid sports with a risk of falling or bumping your tummy, and in later pregnancy avoid lying flat on your back for more than a few minutes (NHS Best Start in Life says "particularly after 16 weeks"). Canadian and US guidelines agree.

Sources 33, 34, 35, 36, 8

No exercise trial in pregnancy has measured knee pain; the kneecap trials are borrowedEmerging evidence

No trial has tested exercise for knee pain in pregnancy. Outside pregnancy, a Cochrane review of 31 trials (1,690 people with kneecap pain) found exercise cut pain during activity by about 1.5 points out of 10 in the short term, with hip and knee exercises together doing better than knee exercises alone, though the evidence was very low quality. An international consensus supports hip and knee exercises and foot orthoses. A specialist team suggests trimester-adapted programmes for pregnant athletes, and a moderate exercise class didn't loosen the knees in pregnancy. This guide's plan borrows that approach and says so.

Sources 37, 38, 39, 15

Knee supports, tape, shoes and painkillersMixed evidence

The kneecap pain consensus is uncertain about tape and braces, and there are no pregnancy trials. High heels raised kneecap forces by about 23% in non-pregnant women, and the NHS advises supportive shoes for pelvic pain in pregnancy. Paracetamol is usually the best painkiller in pregnancy and "does not harm your baby", the NHS says; avoid ibuprofen, including gels, unless a doctor or pharmacist advises it. The NHS knee page's ice advice (up to 20 minutes every 2 to 3 hours) is general advice that fits pregnancy.

Sources 38, 40, 28, 41, 42, 24

After the birth: squats from the first weeks, running from about 3 monthsEmerging evidence

UK return-to-running guidance, written by physiotherapists and graded as expert opinion, suggests squats, lunges and bridges from about 2 to 4 weeks after the birth in line with everyday tasks, and no running before about 3 months; its checks first include walking for 30 minutes, 10 single-leg squats each side and jogging on the spot for a minute, all without pain, heaviness, dragging or leaking. The pelvic health physiotherapists' leaflet (POGP) advises kneeling at the bath or using a waist-height changing surface, and the Chief Medical Officers say restart gradually.

Sources 43, 44, 45

Having babies and knee arthritis later: a small linkEmerging evidence

In 1.3 million UK women, the risk of a knee replacement rose 8% for each birth; in a US cohort, 5 or more children went with about 2.6 times the risk of knee osteoarthritis compared with 1. These are associations, mostly with many births, and their causes aren't known; nothing shows that exercising in pregnancy changes them.

Sources 46, 47

How much pain is OK while you exercise?

For the knee, up to about 5 out of 10 and settled by the next morning; for the pelvis and back, stop if it hurtsEmerging evidence

For knee pain itself (the rule our knee guides use, from NHS inform): rate it from 0 to 10, aim to keep it within 0 to 5, with 0 to 3 most of the time, and your knee should be no worse the next morning. If it is, drop back a step next time, such as a shallower range, a higher seat or fewer sets, not nothing. In 7 trials of long-lasting pain, exercise that allowed some pain did no worse than pain-free exercise.

In pregnancy, the rule is stricter for the pelvis and back. POGP says "Stop any activity that produces pain, especially in the back or pelvis", and the Chief Medical Officers say "Listen to your body and adapt". The NHS says stop if you feel uncomfortable, too hot or unwell. Stop and call your midwife or maternity unit for bleeding, fluid leaking, regular painful tightenings, chest pain, dizziness, or calf pain or swelling (ACOG's list, which our exercise in pregnancy page uses).

After the birth, some discomfort up to about 5 out of 10 that settles by the next morning is fine, and stop for heaviness, dragging or leaking, as the UK return-to-running guidance says. No trial has tested a pain rule in pregnancy.

Sources 48, 49, 50, 33, 34, 8, 43

The exercise plan: 4 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep moving, and settle the knee

Any trimester, most days. Stay active within the pain rule, use the everyday changes in the written steps below, and start gentle thigh and hip work in comfortable ranges. With pelvic girdle pain or a known knee injury, that guide's plan comes first. No trial has tested this plan as a whole.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

About 10 minutes a day if you're new to exercise, building towards 150 minutes a week · The NHS's starting point and its 150 minutes; walking outdoors counts, and swimming can replace it

Harder: Treadmill jogging

Quad set (static quads) demonstrated on the 3D figure

3D demoQuad set (static quads)Beginner · No equipment

Tighten the thigh and press the back of the knee down, hold 10 s; 2 to 3 at a time, every hour if you can, building to 2 sets of 8 · NHS inform's static quads and pacing. Do it sitting with the leg out on a bed, or propped up on pillows after the first trimester, not flat on your back

Harder: Straight-leg raise

Seated knee extension (chair) demonstrated on the 3D figure

3D demoSeated knee extension (chair)Beginner · A bench or box + Something with weight

3 sets of 10 to 15 each leg, 2 to 3 days a week; from 90° to about 45° only if the full range hurts · The move page's dose, an editorial starting point, with its half-range advice

Easier: Quad set (static quads) · Harder: Leg extension

Stationary cycling demonstrated on the 3D figure

3D demoStationary cyclingBeginner · Cardio machine

10 to 20 minutes easy, seat high · Editorial, as in our runner's knee guide; cycling is on the Chief Medical Officers' list

Easier: Recumbent exercise bike · Harder: Air bike intervals

3D demoClamshellBeginner · No equipment

2 sets of 10 to 15 each side, small range, with a pillow under your bump · As on our exercise in pregnancy page (editorial). Leave it out if opening the knee brings on pain at the pubic bone

Easier: Supine isometric hip abduction (belt press) · Harder: Lateral band walk

Move on when: Stairs and getting up from a chair are within the pain rule, and your knee is no worse the next morning (as our runner's knee guide checks). Stages 1 and 2 can run side by side.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Strength for low chairs, stairs and a growing bump

Two or three times a week until the birth: thigh and hip strength for getting up, stairs and lifting, within the pain rule. After the first trimester, keep any move on your back to a few minutes.

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

2 to 3 sets of 8 to 12, feet hip-width apart, from a higher seat first and lowering it over weeks · As on our exercise in pregnancy page (editorial); a higher seat because low chairs load the knee more late in pregnancy. Use a firm chair that can't slide, as the move page says

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

3D demoWall sitBeginner · A wall

2 to 3 holds of 20 to 30 s at a shallow, comfortable depth, breathing throughout · As on our exercise in pregnancy page (editorial). Never strain against a held breath, as the move page says

Easier: Straight-leg raise · Harder: Spanish squat (band squat hold)

3D demoStep-upBeginner · A step

2 to 3 sets of 8 to 10 each leg on a low step, holding a rail · Editorial, as in our knee pain in women guide. Skip it with pelvic girdle pain if stairs hurt, as the move page says

Easier: Low step-up · Harder: Dumbbell step-up

Sit squat (partial squat) demonstrated on the 3D figure

3D demoSit squat (partial squat)Beginner · No equipment

2 to 3 sets of 10, to about 45° of knee bend · Editorial, as in our runner's knee guide

Harder: Bodyweight squat

Side-lying leg raise demonstrated on the 3D figure

3D demoSide-lying leg raiseBeginner · No equipment

2 sets of 10 to 15 each side, with a pillow under your bump · As on our exercise in pregnancy page (editorial)

Easier: Lateral band walk · Harder: Lateral band walk, band at the feet

Tandem stance and heel-to-toe walk demonstrated on the 3D figure

3D demoTandem stance and heel-to-toe walkBeginner · A wall

Next to a counter: 2 holds of 20 to 30 s, then a few slow lengths · Balance as on our exercise in pregnancy page (editorial); it suits pelvic girdle pain better than standing on one leg

Easier: Semi-tandem stance · Harder: Single-leg stand

Move on when: Carry on until the birth within the pain rule. Drop back to the first stage during a flare, and stop for any warning sign.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

After the birth: the first weeks

From the first days, as you feel able: pelvic floor and deep tummy muscles first, with walking, as POGP and the NHS teach, and gentle thigh work for the knee. After a caesarean or a complicated birth, follow your team's advice; our caesarean guide has the timings.

Pelvic floor exercise (Kegel) demonstrated on the 3D figure

3D demoPelvic floor exercise (Kegel)Beginner · No equipment

10 long squeezes held for up to 10 s, with 10 s rest, then 10 quick squeezes, at least 3 times a day · POGP's dose after the birth; the move page starts at 8 of each. With a catheter, start once it's out, as the move page says

Side-lying tummy draw-in demonstrated on the 3D figure

3D demoSide-lying tummy draw-inBeginner · No equipment

Hold for up to 10 s, breathing normally, up to 10 times · The move page's dose, which is the NHS's after the birth

Harder: Bird dog, one limb at a time

3D demoQuad set (static quads)Beginner · No equipment

As before, now lying down if you like · NHS inform's static quads and pacing

Harder: Straight-leg raise

3D demoSeated knee extension (chair)Beginner · A bench or box + Something with weight

2 to 3 sets of 10 each leg · Sets editorial; the half-range advice is the move page's

Easier: Quad set (static quads) · Harder: Leg extension

3D demoTreadmill walkingBeginner · Cardio machine

A walk every day, gradually increasing the time and pace over the first 6 weeks · POGP's advice; a buggy walk counts

Harder: Treadmill jogging

Move on when: Daily life with your baby is comfortable, and nothing brings on heaviness, leaking or more bleeding: often from about 6 weeks after a straightforward birth, later after a caesarean (our suggestion, as in our hip pain in pregnancy guide).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 4

Lifting, kneeling, stairs and your usual exercise

From about 6 weeks, 2 or 3 sessions a week, then keep going; squats can start earlier in line with everyday tasks. Lifting a car seat and a growing baby, kneeling for baby care, stairs and your usual sport come back one at a time, by the written steps below.

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

2 sets of 8 to 12, to a chair at first, a light weight held close to your chest · As on our postpartum page (editorial). After a caesarean, lift nothing heavier than your baby for about 6 weeks, as the move page says

Easier: Bodyweight squat · Harder: Barbell front squat

3D demoStep-upBeginner · A step

3 sets of 8 to 10 each leg, raising the step over weeks · Editorial, as in our knee pain in women guide

Easier: Low step-up · Harder: Dumbbell step-up

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

6 to 8 each leg, holding a support, with a narrow stance · As on our postpartum page (editorial). Pad the back knee, as the move page says

Easier: Bodyweight squat · Harder: Reverse lunge

Lateral band walk demonstrated on the 3D figure

3D demoLateral band walkBeginner · A band

10 steps each way with no band, then 10 to 15 with a light band · Editorial, as in our hip pain in pregnancy guide. Skip it or keep the stance narrow if pelvic girdle pain lingers, as the move page says

Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet

3D demoSit to stand from a chairBeginner · A bench or box

Slowly on one leg each side, building towards 10 and then 20 · The UK return-to-running guidance's single-leg sit-to-stand target

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

From about 3 months, walk-jog intervals, only once the readiness checks pass · The UK return-to-running guidance (expert opinion), whose checks include walking for 30 minutes, 10 single-leg squats a side and jogging on the spot for a minute, without pain, heaviness, dragging or leaking

Easier: Treadmill walking · Harder: Sprint intervals

Move on when: Our suggestion: stairs, kneeling, lifting your baby and your usual exercise pass the pain rule for 2 weeks. Keep two strength sessions a week: knee pain is more likely in a later pregnancy if you've had it before.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Low seats, stairs and getting up (written steps)

Our 3D figure can't show these. No trial has tested them; each step names its source or is our suggestion.

1. In later pregnancy, choose a higher seat or one with arms. Shuffle to the edge and push up with your arms (our suggestion, from a laboratory study of getting up from chairs).
2. Getting into a car: sit down first, then bring your legs in; to get out, put both feet out and push up with your arms (POGP).
3. Stairs: one at a time with a hand on the rail while the knee is sore; going down loads it more (our suggestion, from a study of stairs in pregnancy).
4. Sit rather than stand for jobs such as ironing or preparing food, at a work surface of the right height (POGP).

Sources 9, 10, 50

Swelling, shoes, sleep and work (written steps)

These come from the NHS, POGP and the Health and Safety Executive (HSE).

1. Swelling: avoid standing for long periods, wear comfortable shoes and socks without tight straps, and rest with your feet up when you can (the NHS).
2. Shoes: supportive shoes rather than high heels (the NHS's pelvic pain advice).
3. Sleep: from 28 weeks, go to sleep on your side, either side; try supporting your bump with pillows and putting a pillow between your knees. If you wake on your back, turn onto your side and go back to sleep (the NHS). Rest on your side with your legs slightly bent (POGP).
4. Work: your employer should make sure you aren't sitting or standing for long periods or lifting heavy loads (the HSE).

Sources 20, 28, 51, 50, 52

Ice and painkillers (written steps)

These come from the NHS.

1. An ice pack or a bag of frozen peas wrapped in a tea towel on your knee for up to 20 minutes every 2 to 3 hours.
2. Paracetamol is usually the best painkiller in pregnancy; take it unless your GP or midwife says not to, following the packet.
3. Avoid ibuprofen, including gels and sprays, unless a doctor or pharmacist advises it. While breastfeeding, paracetamol is usually best, though ibuprofen can often be used.

Sources 24, 41, 42

After the birth: kneeling, lifting and baby care (written steps)

These come from POGP and the UK return-to-running guidance, except where a step is our suggestion.

1. Get to your baby's level: kneel at the bath, or use a changing surface at waist height (POGP). With a sore kneecap, kneel on a cushion (our suggestion).
2. Lift a car seat, a buggy or a toddler close in front of you, bending your knees and breathing out as you lift (POGP).
3. After a caesarean, lift nothing heavier than your baby for at least 6 weeks, and let older children climb up to you when you're sitting (POGP).
4. Running waits until about 3 months, and until the readiness checks pass without pain, heaviness, dragging or leaking (the UK guidance, expert opinion).

Sources 44, 43

Positions to swap, and why

Habit or position	Why it matters	Instead
Getting up from low sofas and seats with no help from your arms, late in pregnancy	Knee forces rising from low chairs are larger in the third trimester.	A higher seat or one with arms; shuffle forward and push up.Try: Sit to stand from a chair
Deep squats held for long while the kneecap hurts	Deep squatting and long bent-knee positions are the usual kneecap triggers.	Shallow sit squats, to about 45° of knee bend.Try: Sit squat (partial squat)
Rushing down stairs	Going down loads the legs faster in pregnancy, and stairs are where many falls happen.	One step at a time with a hand on the rail.
High heels	They raised kneecap forces by about 23% in non-pregnant women.	Supportive, low-heeled shoes.
Starting running for the first time in pregnancy	The NHS says don't start a new vigorous activity such as running.	Brisk walking, swimming or a static bike.Try: Stationary cycling
Leg raises flat on your back in later pregnancy	The NHS says avoid lying flat on your back for more than a few minutes in later pregnancy.	Sitting knee extensions, or propped-up quad sets.Try: Seated knee extension (chair)
Resting the knee completely	Exercise is safe and recommended, and strengthening eased kneecap pain in trials outside pregnancy.	Gentle thigh work and daily walks.Try: Quad set (static quads)
A knee brace or tape instead of exercise	The kneecap pain consensus is uncertain about tape and braces.	Hip and knee strength.Try: Clamshell
Ibuprofen tablets or gel in pregnancy	The NHS says avoid it unless a doctor or pharmacist advises it.	Paracetamol, unless your GP or midwife says not to.
Waiting to see whether a swollen, throbbing calf or a hot, swollen knee settles	It can be a clot or an infection.	Get help the same day: an urgent GP appointment or NHS 111.
Kneeling on a hard floor at bath time after the birth	It loads a sore kneecap.	A cushion, or a changing surface at waist height.

Routines to follow

Pregnancy strength workout (no lying on your back)

A 30-minute strength workout for any trimester with dumbbells and a band: squats, rows, hinges, presses and side-lying hip work, none on your back.

30 minBeginner14 movesA dumbbell, A bench or box

Pregnancy Pilates workout (no lying on your back)

A 20-minute Pilates workout for any trimester: seated, standing, all-fours and side-lying moves, with no lying on your back or front and no jumping.

20 minBeginner15 movesA wall, A bench or box

Prenatal yoga workout (no lying on your back)

A 20-minute prenatal yoga workout for any trimester: seated breathing, all-fours and kneeling poses, supported standing poses and rest, none flat on your back.

20 minBeginner15 movesA step, A wall

Knee strengthening workout: from first steps to full range

A 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.

25 minBeginner13 movesA bench or box, A wall

Postnatal exercises

A gentle 25-minute routine for the first weeks after birth: pelvic floor, breathing, tummy and hip exercises on the floor, sit-to-stands and a walk.

25 minBeginner12 movesA bench or box, Cardio machine

Postnatal strength workout (from about 6 weeks)

A 25-minute strength workout from about 6 weeks after birth: sit-to-stands, deadlift practice, push-ups, rows, bridges and tummy work, with the knack.

25 minBeginner14 movesA bench or box, A kettlebell

Easy cardio workout

A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.

40 minBeginner3 movesCardio machine, A wall

More moves for this area

Questions people ask

Is knee pain normal in pregnancy?

It's fairly common, especially late on: in one Turkish hospital, about 1 in 8 women had it in the third trimester, fewer than had back or hip pain. It's usually an ache around the kneecap rather than anything serious. A swollen, throbbing calf or a hot, swollen knee needs checking the same day; in the US, call 911 where this page says 999.

Which trimester is knee pain worst?

Usually the third: 4.9%, 8.2% and 13.0% by trimester in one Turkish hospital, where women were asked at each visit, and knee function scores fell through pregnancy in a US study. Getting up from low seats loads the knee more late in pregnancy.

Is knee pain a sign of early pregnancy?

No study we found links knee pain with early pregnancy; it's least common in the first trimester. If you might be pregnant, a pregnancy test is the way to find out.

Does relaxin cause knee pain in pregnancy?

Probably not on its own. Joints loosen a little in pregnancy, but that didn't match relaxin levels or joint pain in studies, and knee pain rises late in pregnancy, when relaxin is lower than early on, as one study reports. It isn't a reason to stop exercising.

Why do my knees hurt getting up from a chair or on stairs?

Late in pregnancy, rising from a low chair puts more force through the front of the knee, and going downstairs loads it faster. Use higher seats, push up with your arms, and take stairs one at a time with a rail while it's sore. Strengthening the thighs and hips eases kneecap pain in trials outside pregnancy.

Is a swollen knee normal in pregnancy?

Gradual puffiness of the legs, ankles and feet is normal, but a swollen knee joint isn't that kind of swelling. A hot, red, swollen knee with a high temperature needs NHS 111 now, and sudden swelling of the face, hands or feet needs urgent help from your maternity unit.

Why do I have pain behind my knee in pregnancy?

Often a calf cramp, which is common later in pregnancy and passes within minutes. Throbbing pain with swelling in one calf or thigh can be a clot, which is more likely in pregnancy and the weeks after the birth: get help the same day. A lump behind the knee can be a Baker's cyst.

What can I take for knee pain when pregnant?

Paracetamol is usually the best painkiller in pregnancy and doesn't harm your baby; avoid ibuprofen, including gels, unless a doctor or pharmacist advises it. An ice pack wrapped in a tea towel for up to 20 minutes can help too.

Which exercises help knee pain in pregnancy, and can I still squat?

Yes, squats and sit-to-stands are fine within the pain rule: keep them shallow, use a higher seat, and build thigh and hip strength. After the first trimester, do knee exercises sitting or propped up rather than flat on your back.

How should I sleep with knee pain in pregnancy?

From 28 weeks, go to sleep on your side, either side, with pillows under your bump and a pillow between your knees. No study has tested positions for knee pain; the pillow stops one knee pressing on the other.

Why do my knees hurt after giving birth?

Lifting, kneeling at the bath and getting up from the floor load the knee while your strength comes back. Kneel on a cushion or use a waist-height changing surface, and build up squats and step-ups from the first weeks. Knee pain that hasn't eased after a few weeks of home care is a reason to see a GP or physiotherapist.

Can I keep running in pregnancy with sore knees?

If you were already running, you can usually carry on, perhaps more gently; don't start running in pregnancy. After the birth, wait until about 3 months and pass the readiness checks first.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.