How to exercise with knee pain without making the knee worse
Get cleared by your doctor or physical therapist, then strengthen the muscles around the knee with movements which cause no pain. Swap or shorten anything which hurts, and keep training the rest of your body.
Book a free Baseline SessionWork around the pain, keep the strength
A sore knee tends to end a routine. Runners stop running. Class regulars sit out half the moves. One woman in her early 40s wrote about hurting her knee in a jogging group she loved and wondering which exercise would leave the knee alone. Another, in her mid 50s, said constant small injuries kept her from lifting at all. Stopping everything feels safe. The knee still needs strong muscles around the joint.
Step one is a diagnosis. The NHS says to get urgent advice if a knee is badly swollen, changes shape, locks, gives way, or won't take your weight, or if you run a high temperature with redness or heat around the joint. Knee pain lasting more than a few weeks belongs with a doctor. A doctor or physical therapist tells you what the knee needs and what to avoid. A coach works from those instructions.
Once you're cleared, strength is the goal. The American Academy of Orthopaedic Surgeons says strengthening the muscles which support your knee reduces stress on the joint. Their knee program has one rule worth keeping: you should not feel pain during an exercise. If a movement hurts, change the movement.
In a gym, working around pain looks like this. A deep squat hurts, so you squat to a box at a height you control. Lunges hurt, so you swap to a step-up or a hip bridge. Hamstrings, hips, and calves still get trained, and the upper body keeps working at full effort. The sore joint gets a smaller job while the rest of you keeps getting stronger.
A sore lower back or shoulder follows the same approach. A 2021 Cochrane review of 249 trials found moderate-certainty evidence exercise reduces chronic low back pain compared with no treatment or usual care, with a modest effect. For shoulders, the AAOS rotator cuff program carries the same rule as the knee program: no pain during the exercise, and a call to your doctor or physical therapist if pain shows up.
Pain during a set means stop and change the exercise. Pain which lingers afterward goes to your doctor or physical therapist.
How we do this at Sessions. Our coaches are not physical therapists, and we don't treat injuries. Your free Baseline Session starts with a movement assessment, so the knee, back, or shoulder comes up before your first workout. If you're under a doctor's or physical therapist's care, bring their guidance, and your coach writes the program inside those limits.
Every member follows their own written program, with two coaches on the floor every session and six people per coach. Coaches watch form on every set and adjust weights and exercises as you go. Every set and weight is logged, so when the knee settles, the load climbs from where you left off. Nobody asks you to modify a class workout built for someone else. More on the difference at Sessions vs group fitness.
Three things to ask a coach before training with an injury
- Do you assess movement first?A coach should see how you squat, hinge, and reach before choosing a single exercise.
- Will you follow my clinician's limits?Your doctor or physical therapist sets the boundaries, and the coach writes the program inside them.
- How do you swap exercises?A good coach has a pain-free option for each movement and changes the plan the moment you say something hurts.
Common questions
Should you exercise with knee pain?
Often yes, after a doctor or physical therapist has checked the knee. The AAOS says strengthening the muscles which support the knee reduces stress on the joint. Choose movements which cause no pain during the exercise, and get urgent advice for swelling, locking, giving way, or a knee which won't take your weight.
What exercises should I avoid with knee pain?
Avoid any movement which hurts during the set. For many people this means deep squats, lunges, jumping, or running for a while, though the list depends on the cause, so get specifics from your doctor or physical therapist. Pain-free options often include box squats, bridges, and upper body work.
Is strength training safe with lower back pain?
For chronic low back pain, a 2021 Cochrane review found exercise reduces pain compared with no treatment or usual care, with a modest effect. Get a diagnosis first. Then start light, keep every rep pain-free, and build up slowly.
How do I work out with a shoulder injury?
Start with your doctor or physical therapist's guidance on which movements are safe. The AAOS shoulder program says you should not feel pain during an exercise. Lower body and core training usually continue while the shoulder recovers, with pressing and overhead work brought back gradually.
Are personal trainers the same as physical therapists?
No. A physical therapist diagnoses and treats injuries. A coach builds your strength inside the limits your clinician sets. At Sessions, coaches are not physical therapists and do not treat injuries.
Sources: AAOS OrthoInfo: Knee conditioning program · NHS: Knee pain · Cochrane 2021: Exercise therapy for chronic low back pain · AAOS OrthoInfo: Rotator cuff and shoulder conditioning · NIA: Three types of exercise