Your Knee Pain Probably Isn't a Knee Problem
You’re doing your favorite lower body workout, when out of nowhere your knee gets a little achy. “No problem,” you think, “I’ll just stretch it out.” So you finish your workout and do your favorite quad stretch before you leave. But it’s still achy your next workout, so this time you add some knee exercises you saw on Instagram.
Now it’s been 4 weeks of quad stretches, TKEs, and backward sled drags. You’ve cut out the leg extension machine, squats, and lunges. But the knee pain? It’s still there.
Want to know why?
It was never your knee.
You see, the knee sits beautifully between 2 joints responsible for creating nearly all the stability from our lower body: the ankle and the hip.
When the ankle can’t stabilize well, it passes the work to the hip.
When the hip can’t stabilize well, it passes the work to the ankle.
The guy stuck between them? The knee, a hinge joint not built for stability demands, weeblin’ and wobblin’ until the hip and knee decides who gets the role of main stabilizer.
When I see clients for knee pain, the only time it’s actually the knee is
A) you have a knee specific mechanism of injury and we find some actual sprain or tear of a ligament or the meniscus
B) you’ve been hammering the legs a bit too hard and the volume has lead to muscle strain or tendinopathy.
If you don’t recall a recent fall and you’ve cut back knee-specific exercises without relief, I’d bet hip and ankle stability are involved.
So let's go through a check list together. Do you:
have an ankle or hip that's always stiff?
have an old injury to a hip or ankle that sometimes acts up?
have a "weak side" on calf raises or single leg exercises?
have a hip shift in your squat?
If you answered "yes" to any of these questions, it's time to do the real work:
Ankle:
That ankle sprain you had in high school, you know- the one that had you in an ankle brace anytime you played sports all 4 years? It’s still haunting you, my dear. And unfortunately, there’s no spells or witchcraft you can do to rid yourself of this ghost (though I’d argue intentional movement to improve a pain point is the most powerful self-love ritual you could do).
After years of neglect and atrophy from relying on a brace for stability, it’s time to finally rebuild the strength and stability here (even if it’s been 15yrs since the original sprain).
Now, I’d love to give you a playbook here that will fix all of your problems, but the foot and ankle have so many little joints here that there’s hardly a “standard” presentation here, and certainly no one-size fits all program. But, here’s the advice I can offer:
I would start with taking a look at your shoes and making sure they’re not restrictive and let your muscles WORK (take a look at my guide to wearing barefoot shoes for more information).
Find where you struggle most with balance and/or strength and train it HARD (calf raises and single leg exercises are a good start here)
If you want a little more guidance or help finding your weak points, let’s chat!
Hip:
This is the weak point I probably see most. If you have a job where you sit at a desk most of or all of the day, there’s probably a hip restriction somewhere in your body.
This can be poor mobility and stiffness, weakness in rotator muscles and stabilizing muscles, or a combination of both. Take it from someone who ping pongs from busy days standing up in the clinic to days mostly sitting to write these articles and do admin work:
If you are sitting 8+ hours a day, your hips are paying the price.
I feel the difference on my admin/ writing days. Hips are stiffer, gym warm ups take longer, and nothing moves quite as smooth. If this is what you do every day, you need to be working on it.
The hips are an incredible joint because they do SO much, but that does mean that most people miss a lot when they’re trying to work them on their own. We of course have our 6 basic movements: flexion, extension, internal rotation, external rotation, abduction, and adduction, all of which need training in their own regards. But where I see people miss the most is in the combination of those movements.
For example, if you have tightness in your squat, you need to be able to internally and externally rotate the hip while moving into hip flexion, and no amount of stretching will help your stiff hips if you’re not training it in the positions it’s stiff in.
This can be difficult and confusing, so I made a hip mobility program specific to hip issues I see in the gym to help you make sure you’re training every position you need in the gym. This program progresses every week so you can actually improve your mobility and stability (and it’s currently on sale for 50% off with code THANKYOU2026 through 11/30/2026).
If you’ve been trying any knee exercise the algorithm throws your way and nothing is getting better, I think you know it’s time to try something new. The lack of mobility and stability in the hips and ankles are the biggest culprits here. I want to help you figure out your weak points and get rid of this once and for all, so book a visit if you’re ready to get to work!
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