Training Around Knee Pain: What You Can and Can't Do

Disclaimer: This is general information, not medical advice. Consult a physiotherapist or doctor before starting any rehab programme.

”Just Don’t Squat” Is Bad Advice

If someone told you to stop squatting because your knees hurt, they probably meant well — but they were wrong. In most cases of knee pain, the answer isn’t to avoid loading the joint. It’s to load it differently and more intelligently. Controlled loading actually helps your knees recover.

Here’s how to keep training without making things worse.

Common Causes of Knee Pain

Patellofemoral syndrome (runner’s knee) — pain around or behind the kneecap. The most common cause in active people. Often caused by weak quads or poor tracking of the kneecap.
IT band syndrome — pain on the outside of the knee, especially during running or cycling. Tight IT band, weak glutes, or both.
Meniscus issues — pain with twisting movements, sometimes with clicking or locking. Can range from mild irritation to tears that need attention.
General wear and tear — sometimes knees just hurt after years of use, and that doesn’t necessarily mean something is broken.

What Usually Helps

Quad Strengthening

This is the single most important thing for most knee pain. Strong quads support and stabilise the knee joint. Leg extensions at partial range of motion (avoid the last 30 degrees of extension if it hurts) are surprisingly effective. Start light — 3 sets of 15.

Hip Strengthening

Weak hips let your knees collapse inward, which causes pain over time. Clamshells, banded side walks, and single-leg glute bridges all help. Your knee pain might actually be a hip problem in disguise.

Wall Sits

Isometric holds build quad strength without repeated joint movement. Start with 20-30 seconds, back against the wall, thighs at about 45 degrees (not 90 — that’s too deep for most people with knee pain). Work up to 60 seconds over a few weeks.

Step-Ups

A controlled, single-leg movement that strengthens the quad and glute while teaching proper knee tracking. Use a low step (15-20cm) and focus on keeping your knee in line with your toes.

Smart Modifications

Exercise	Modification
Barbell back squat	Box squat (controls depth, reduces bounce at the bottom)
Deep lunges	Reverse lunges with shorter stride
Leg press	Limited range of motion (don’t go past 90 degrees)
Running	Cycling or rowing (lower impact)
Jump squats	Bodyweight squats with slow eccentrics

The key is controlling the depth and the speed. Fast, bouncy movements at the bottom of a squat are what cause most knee flare-ups, not the squat itself.

The Nuance People Miss

“If it hurts, don’t do it” is the most common advice, and it’s oversimplified. Some discomfort during rehab is normal and even expected. The difference matters:

Dull ache during or after exercise that settles within 24 hours — generally fine, keep going
Sharp pain during a movement — stop that specific movement, try a modification
Swelling after training — you’ve done too much, scale back next session
Pain that gets progressively worse week on week — see a physiotherapist

Track What Works

Knee rehab is a process of finding what your joint tolerates and gradually expanding that. PT Tracker’s injury log lets you record which exercises cause pain, which ones help, and how your symptoms change over time. Patterns become obvious after a few weeks of tracking — and that data is gold when you take it to a physio appointment.

Your knees might not feel like they used to, but they can absolutely get stronger. It just takes the right approach and a bit of patience.