If you have ruled out an injury and your knees still hurt when you do squats or climb stairs or go for a run the hidden cause of knee pain might not even be in your knee. The problem could be a group of muscles that is far away, from your knee joint and it is quietly affecting the way your knee moves and handles stress.

In this article we will find out what is really causing the knee pain we will look at what the latest research’s saying and we will show you seven ways to fix the problem that really work they do not just fix the symptoms they fix the root cause of the knee pain.

Dr. Renee Park, DPT – Doctor of Physical Therapy
Orthopedic & Sports Rehabilitation Specialist · 11 years clinical practice

The single most common pattern I see in my clinic is patients pointing at their knee, convinced something is wrong with the joint itself, when the actual driver is happening higher up the chain — in the hip. Research increasingly supports looking at the entire kinetic chain, not just the painful joint, when evaluating knee pain. Treating the knee alone in these cases is treating the symptom, not the cause.

The cause nobody checks first

Lots of people who have knee pain that just will not go away think it is because they used their knees much or because they are getting older or they have arthritis or their knees are just worn out. If you look up knee pain on the internet you will find thousands of websites talking about knee osteoarthritis and how the cartilage in your knees is breaking down and how you might need to have your knee joint replaced. These are all things that you should consider. There is another kind of knee pain that you hardly ever hear about. And it happens to a lot of people, under 50 who are active and healthy.

It is called dynamic knee valgus – When you do things like squat down go for a run or climb up the stairs your knee sometimes collapses inward. This is not usually because of something going on in your knee. The real problem is usually, in your hip. Your hip is what is causing your knee to collapse inward when you do these activities.

Your knee is often the victim, not the criminal. The real suspect is sitting one joint higher, in a muscle you’ve probably never trained directly.

How weak hips quietly destroy your knees

Here is how it all works and why it often goes unnoticed. Your gluteus medius muscle. A muscle on the side of your hip. Has one main job. It keeps your level and your thigh bone in the right position when you put weight on one leg like when you take a step, squat or run. When this muscle is weak or not working properly because you are not active your thigh turns inward every time you put weight on that leg.

That inward turn pulls your kneecap out of its position and puts extra pressure on the cartilage underneath it. This can lead to a condition called patellofemoral pain syndrome. People often call it runners knee even though many people who are not runners get it. A study used ultrasound imaging to look at people with this type of knee pain. It found that they had a difference, in how much their gluteus medius muscles were working on the painful side compared to the pain-free side. The more knee pain they had the bigger the imbalance was.

Gluteal amnesia – the muscle that “forgets” how to fire

Years of sitting and driving and not being very active can cause a problem that physical therapists call gluteal amnesia. This means your glutes do not get used much as they should when you move around every day. Other muscles like your hamstrings and IT band have to work hard to make up for it.

The thing is these other muscles are not supposed to do the job that your glutes are supposed to do. They are not good at keeping you stable. So when they try to do this job it causes problems.

This is why some people can have a MRI and no damage to their cartilage but they still get knee pain when they bend down or climb stairs. The problem is not really, with the joint itself. It is fine. The problem is that your hips are not stable and this puts forces on your knee. You will not see this problem on a standard imaging test because it only shows how your muscles are working.

Signs your knee pain might be hip-driven

7 fixes that target the real cause

These stretches are special. They focus on the hip and knee area. Physical therapists often suggest movements to help this area. These stretches are based on those movements. They target the hip and knee to help fix the problems.

1. Glute bridges

This is an exercise for getting your glutes to work properly. Physical therapists often start with it because it is easy, on the body. It helps to activate the glutes on their own without other muscles taking over.

How to do it
Lie on your back with your knees bent and your feet flat on the floor. Now squeeze your glutes. Lift your hips up high until your body is in a straight line from your knees, to your shoulders. You should hold this position for 2 seconds. Then you can lower your hips back down slowly. Do this exercise every day. You should do this exercise in sets of 12 to 15 repetitions. You should do 3 sets every day.

2. Clamshells

This is the single most commonly prescribed exercise for weak gluteus medius because it isolates exactly the muscle responsible for preventing the inward knee collapse described above.

How to do it
Lie on your side, knees bent at 45°, feet together. Keeping feet touching, lift your top knee like a clamshell opening. Avoid rolling your hip backward. 3 sets of 15 per side.

3. Lateral band walks

While clamshells build raw strength, lateral band walks train your glutes to actually fire during functional movement closing the gap between isolated strength and real-world stability during walking or running.

How to do it
Place a resistance band around your ankles or just above your knees. In a slight squat, step sideways maintaining tension on the band. 3 sets of 10 steps each direction.

4. Single-leg glute bridges

Since research shows the imbalance is often side-specific, this progression forces each hip to stabilize independently directly addressing the asymmetry studies have linked to patellofemoral pain syndrome.

How to do it
Same setup as a regular bridge, but extend one leg straight while lifting your hips using only the planted leg. 3 sets of 10 per side, keeping hips level throughout.

5. Terminal knee extensions (TKEs)

This exercise specifically targets the vastus medialis oblique (VMO) – a quad muscle that helps keep your kneecap tracking properly in its groove, complementing the hip work rather than replacing it.

How to do it
Anchor a resistance band at knee height. Loop it behind your knee, step back until tense, then straighten your leg fully by flexing your quad. 3 sets of 15 per leg.

6. Aerobic exercise (walking, cycling)

A sweeping 2025 review of over 200 studies found that aerobic exercise like walking and cycling offered the strongest evidence for pain relief and mobility improvement in knee osteoarthritis patients, outperforming many other intervention types studied.

How to do it
Start with 20–30 minutes of low-impact walking or stationary cycling, 4–5 times per week. Low resistance, comfortable pace consistency matters more than intensity here.

7. Movement screening with a professional

If pain persists past 2–3 weeks of consistent home exercise, a movement assessment from a physical therapist can identify exactly which part of the kinetic chain – hip, knee, ankle, or a combination is driving your specific pain pattern, rather than guessing.

How to do it
Book a session specifically requesting a lower-limb movement or gait assessment, not just a knee-focused exam this ensures the hip-knee chain gets evaluated together.

When to see a doctor instead of self-treating

If you have a lot of swelling all of a sudden or you cannot put weight on your knee or it looks like something is wrong with it or you felt something pop when you got hurt or your knee hurts after you fell down or got hit these are signs that you might have an injury, like a ligament tear or a fracture. You need to see a doctor away for these kinds of injuries. You should not try to do exercises at home for this.

The good news from the research

In the year 2025 a big study looked at one hundred and thirty nine trials. These trials had ten thousand people in them. The study found that things like knee braces and water therapy and special exercises were really good at helping people with knee pain. These things were often better than taking medicine. The good thing is, they do not have the bad side effects that people can get from taking anti-inflammatory medicine for a long time like stomach problems or heart problems. Knee braces and water therapy and special exercises, for knee pain are very helpful.

Research Citations

· Journal of Athletic Training, 2015. Hip plus core strengthening vs. quad-focused training in patellofemoral pain (n≈200), 6-week RCT. Referenced via Victory Performance PT clinical review.
· ScienceDaily. Scientists reveal the best exercise to ease knee arthritis pain. Oct 20, 2025 — review of 200+ studies on aerobic exercise for KOA: sciencedaily.com ↗