Knee Pain: Why Strengthening should be the first option (most of the time)
Knee pain is one of the most common issues people face — from young athletes to older adults. Whether it’s from running, squatting, or just going up the stairs, sore knees can make daily life harder. The good news? Exercise — especially strengthening — is one of the most effective treatments we have.
Quad Strengthening: The Foundation of Knee Rehab
When it comes to knee pain, the quadriceps (the muscles in the front of your thigh) play a central role.
Research consistently shows that quad weakness is linked to knee pain and conditions like patellofemoral pain and knee osteoarthritis. Why, is a little mixed as people with pain are likely going to test weaker so its kind of a chicken or the egg, but regardless quad strengthening seems to be beneficial in most cases.
Stronger quads help reduce load on painful areas of the knee, improve shock absorption, and restore function.
In fact, multiple studies suggest quad strengthening is as effective as many medical treatments — and for many people, it can delay or even prevent the need for surgery.
Hip Strengthening: Helpful, but Maybe for a Different Reason
Over the past decade, hip-focused programs (glute and hip abductor strengthening) have gained popularity for knee pain, especially in runners.
Evidence does support hip strengthening for reducing pain and improving function.
But why? One theory is that it changes knee alignment and reduces stress — but newer research suggests the real benefit may be simpler:
Exercise itself is beneficial, no matter the muscle group.
By working the hips, you stay active and strong while giving the knee a chance to calm down, then gradually reintroduce direct knee loading.
So yes, hip strength helps — but it may be more about keeping you moving while respecting the knee’s tolerance.
When Is Surgery Necessary?
For most people, conservative management should be the first choice:
Quad and hip strengthening
Activity modification
Pain education
Progressive exercise
But surgery may be considered if:
There’s a significant injury (like a torn ligament or meniscus) that clearly limits stability or function.
Pain and disability persist despite months of dedicated rehab.
Your activity goals (competitive sports, heavy physical work) demand more than rehab alone can restore.
Even in surgical cases, rehab before and after surgery can improve outcomes.
Beyond Strength: Plyometrics for Return to Sport
If your goal is to get back to running, sports, or higher-level activities, it’s not enough to just build strength.
Adding plyometrics (jumping, hopping, bounding drills) at the end of a rehab program helps retrain the tendon, muscle, and joint to absorb and release energy.
This prepares your knee for the real-world demands of sport and performance.
Bracing and Taping: Do They Help?
What about knee braces or kinesiology tape?
Bracing: Evidence is mixed. Some people feel more confident and stable with a brace, especially in activities. But long-term benefits are unclear.
Taping: Can provide short-term pain relief, especially in patellofemoral pain. But like bracing, it’s usually a short-term tool rather than a fix.
Bottom line: bracing and taping can be useful adjuncts — but they’re not substitutes for strengthening.
The Takeaway
For most types of knee pain, exercise is the first and best treatment.
Start with quad strengthening, add hip exercises to stay active, and progress gradually.
Surgery is reserved for specific injuries or when rehab fails.
Don’t forget plyometrics if your goals include running, jumping, or sports.
Bracing and taping may help short-term, but strength and consistency are the true game-changers.