Kelly had been having knee pain for roughly a year before she contacted me.

She had already worked with 4 physical therapists.

"They kept having me start with easy exercises, but as soon as we'd move on to the harder exercises, my knee would hurt more."

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Unfortunately, Kelly's situation is not unique.

Recommended exercises from well-intentioned trainers, physical therapists, and doctors often cause more knee pain, rather than less.


The exercises intended to increase knee strength actually increase knee pain.

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Many of these people are active.

In Kelly's case, she practiced yoga and enjoyed challenging hikes.

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Here's why this happens:

Anatomical illustration of a human knee joint showing bones, muscles, and ligaments.

Strength is a two-sided coin.

Muscles are one side of the coin.

Strengthening a muscle involves performing a challenging exercise.
An exercise that makes your muscle tired by completing it several times.
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For example, squatting 8 times with enough weight to feel tired in the front of your thighs may be a muscle strengthening exercise-- if the fatigue is strong enough that you could only perform a few more squats correctly.

Muscles are attached to bones by a tough cord called a tendon.

When your muscles work, they pull on tendons.

And tendons pull on bones.


This creates movement-- like straightening your leg, or standing up from a chair.

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Here is a tendon (highlighted in light blue):

This tendon ties one of the thigh muscles to the shin bone.)

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Working a muscle pulls the bones together.

In the case of the four muscles on the front of your thigh, they pull your thigh bone and your shin bone together.

And they press the back of your kneecap into the groove at the end of your thigh bone.

Everything in between these bones gets squished.

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This means the substance on the end of your bones, the cartilage (highlighted in light blue)-- get squished:

Alt text: Human knee joint model showing bones and cartilage on a white background.

So strengthening your muscles:

(1) pulls on tendons;

(2) pulls on bones; &

(3) squishes cartilage.

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If your joint -- your tendons, bones, and cartilage -- are strong, this is fine.

But you need a strong joint to withstand pressure from your muscles.

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Joint strength is the other side of the coin.

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If your joint is injured, broken, or even weak, working your muscles will put too much pressure on it.

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There are three cases where strengthening your joint needs to happen first (before strengthening your muscles):

(1) if you have a broken bone

(2) if you have a tendon injury

(3) if you have (osteo)arthritis, or weak cartilage (chondromalacia)

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In these cases, making your muscles work hard will pull and press, and will likely lead to pain.

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This is what was happening for Kelly before she worked with me.

When she performed harder exercises-- exercises to strengthen her muscles-- it put too much pressure on her knee joint.

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Instead, she met with me during online video sessions and strengthened her knee joint.

After she improved her knee joint, she could strengthen her muscles without pain.

(Watch this video to hear more from Kelly.)

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Successful muscle strengthening starts with a strong joint.

Learn more in this video:

More from Kelly:

"I had worked with four physical therapists previously. They kept having me start with easy exercises, but as soon as we'd move on to the harder exercises, my knee would hurt more. I was really fed up and looking for something that would actually work...

[After working with Laurie], walking on the sand is no problem, and I'm able to do shorter hikes. I used to experience random pains throughout the day or during activities that I didn't think were that intense, and now I find that I rarely experience any pain at all." --Kelly (client from Los Angeles, California)

Disclaimer: The information in this blog post is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose, treat, or prevent any health issue or disease without consulting with a qualified healthcare professional. The author of this blog and the website do not bear any responsibility for any actions taken based on the information provided in this blog.