Joints and bones
Knee pain usually starts at the hip
For the most common kind of knee pain, the guideline recommends training the hip as well as the knee, and prefers the combination to knee work alone.
Created by Lee Albert, NMT · 8 August 2026
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
“Vinys started smaller than I thought possible and built up from there.” Michael T. · Knee osteoarthritis
Before you start
Get it assessed if the knee locked, gave way, or swelled quickly after an injury, or if it is hot and swollen without an obvious cause.
Ready to stop guessing? Let your answers narrow the choices and shape your first session.
Start your first sessionWhat it is
A great deal of non-traumatic knee pain is patellofemoral pain: pain around or behind the kneecap, without damage to a specific structure. The kneecap runs in a groove at the end of the thigh bone, and how it tracks depends less on the knee than on what is happening above and below it. If the muscles at the side and back of the hip are not controlling the thigh well, the knee absorbs the difference.
How it behaves day to day
Stairs, especially going down, are the classic complaint. So is sitting for a long time with the knee bent, which people often call the cinema sign, and squatting or kneeling. It usually builds gradually rather than starting with an event, and it often tracks a change in activity rather than an injury.
What tends to feed it
- A sudden increase in running, walking or stairs
- Long periods sitting with the knee bent
- Deep squatting and kneeling while it is irritable
- Doing knee exercises only, and skipping the hip
What the research recommends
The reference document is the patellofemoral pain clinical practice guideline from the Academy of Orthopaedic Physical Therapy, published in JOSPT in 2019 after review of around 4,500 articles. Its central recommendation is exercise therapy that is appropriately progressed and targets the hip as well as the knee. It is specific about the combination: hip-targeted and knee-targeted exercise together is preferred over knee-targeted exercise alone, and hip-targeted work may be given preference in the early stages. The hip work it describes targets the posterolateral musculature, meaning the muscles at the side and back of the hip. Knee-targeted work can be weight-bearing or non-weight-bearing; both are supported. Taping is a short-term adjunct alongside exercise, not a substitute for it.
Sources
- 1Patellofemoral Pain, clinical practice guideline, Academy of Orthopaedic Physical Therapy (JOSPT 49(9), 2019)
Progressed exercise therapy targeting both hip and knee is recommended, and the combination is preferred over knee-targeted exercise alone, with hip-targeted work potentially favoured early.
- 2NICE NG226, osteoarthritis in over 16s (2022)
Where knee pain is osteoarthritis, therapeutic exercise tailored to the person, including local muscle strengthening, is offered to everyone.
Where Vinys is different
- A Vinys knee session includes hip work by design, because the guideline prefers the combination and hip work is the part most home routines leave out.
- Load is graded rather than avoided. Sessions start where the knee is today and build, instead of removing everything that bends the knee.
- Easier and harder mid-session means an irritable day gets a smaller version rather than a skipped one.
- Every movement explains why it was chosen, so the hip work does not look like a mistake to someone whose knee hurts.
- Where yoga meets physiotherapy: the strengthening the guideline asks for, in a session you can do at home without equipment.
A short session to try
- 1
Clamshell · 10 to 12 each side
Targets the muscles at the side and back of the hip, which is exactly the posterolateral work the guideline names.
- 2
Glute bridge · 10 slow lifts
Builds the back of the hip, which changes how the thigh sits over the knee when you walk and climb.
- 3
Shallow chair pose · 5 slow reps
Weight-bearing knee strengthening at a depth that stays comfortable, which is the knee half of the combination.
- 4
Heel raise · 10 to 12 reps
Calf strength supports the whole leg and changes how load arrives at the knee.
- 5
Figure 4 stretch · 30 seconds each side
Eases the deep hip muscles that tend to grip when the hip has been working hard.
Keep the squatting shallow enough that the knee stays comfortable. Depth is something to earn later, not the thing that makes this work.
That session was written for everyone with this condition. Yours would be built around your answers.
Start your first sessionMovements often used for this
Hips · 30–60 seconds of controlled repetitions per side
Clamshell
A small movement aimed at a muscle that keeps your pelvis level every time you take a step.
Hips and lower back · 30–60 seconds, or slow repetitions with a short hold
Glute bridge
Anyone can lift their hips. Doing it with the glutes, not the back, is the exercise.
Stability / Core · 30 to 60 seconds
Chair Pose: Shallow
A shallower version that reduces demand on your knees and back while still building functional leg strength: accessible for bodies still building capacity.
Ankles and calves · 30–60 seconds of slow repetitions
Heel raise
The calf is the engine of every step, and it is trained by going slowly down, not quickly up.
Hips and lower back · 60–180 seconds per side
Figure 4 stretch
The muscles under your glutes are hard to reach standing up. Lying down, they are straightforward.
Restorative · 60 to 300 seconds
Child's Pose: Chair Facing Back
A fully seated rest: sit facing the back of a chair, fold forward, and rest your arms and forehead on the backrest. No floor needed; all the calming benefits of Child's Pose from a chair.
Upper Limb Weight Bearing · 60 to 90 seconds
Downward Dog: Chair Supported
The most accessible version: a chair supports your hands, removing deep flexion demands and making this stretch gentle enough for sensitive knees, ankles, and shoulders.
Upper Limb Weight Bearing · 60 to 90 seconds
Downward Dog: Hands on Wall
Hands on the wall create a gentler angle that reduces load on your spine and shoulders, making the decompressive benefits of this pose accessible for almost everyone.
Stability / Core · 20 to 60 seconds
Bridge: Mini
The most accessible bridge: minimal range makes this gentle enough for almost everyone, introducing posterior chain activation without placing excessive demand on your spine.
Stability / Core · 30 to 60 seconds
Chair Pose: Dynamic Sit-to-Stand
The most accessible chair pose equivalent: the dynamic sit-to-stand movement builds functional strength without sustained holds, making it gentle on sensitive backs.
Spinal Mobility · 30 to 60 seconds
Gate Pose: Seated Chair
The most accessible lateral stretch: a seated side bend that gently opens your side body with no kneeling demand, suitable for everyone.
Hip Mobility · 30 to 60 seconds
Low Lunge: Supported Chair
The most accessible lunge: chair support creates an upright position that opens your hip flexors with minimal demand on your spine, suitable for almost everyone.
These are movements the clinical library marks as especially beneficial for this movement pattern, with anything it flags as a caution for the same pattern removed. A pattern is not a diagnosis, and your own session is built from your answers on the day.
Common questions
Why are you giving me hip exercises for a knee problem?
Because the 2019 guideline prefers hip and knee work together over knee work alone, and suggests hip work may take priority early on. The knee often absorbs what the hip is not controlling.
Should I stop squatting?
Not permanently. Depth is usually the variable to adjust rather than the movement itself, and weight-bearing knee work is supported in the guideline.
Is knee pain always arthritis?
No. A large share of non-traumatic knee pain is patellofemoral pain, which is not a wear-and-tear diagnosis and follows different guidance.
How do I strengthen my knees?
The 2019 patellofemoral pain guideline prefers hip and knee work together over knee work alone, and suggests hip-targeted work may take priority early. So the answer includes the muscles at the side and back of the hip, not only the thigh. Shallow chair pose, clamshells and glute bridges cover that combination.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called patellofemoral pain, runner's knee, anterior knee pain, kneecap pain. Movements are drawn from the clinically authored Vinys library, and the guidance above is sourced to the publications listed. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.