Guides · Training
Knee pain at the gym
What to swap, what to keep · Last checked November 2026
You usually don’t have to stop training. For pain around the kneecap, experts recommend exercise to reduce pain, and hip work plus knee work beats knee work alone. Swap the moves that hurt, keep training the muscles around the knee, and get it checked if any of the signs below show up.
Get it checked first if
- you can’t put weight on it or can’t move it
- it’s badly swollen or has changed shape
- it locks, gives way, or clicks painfully (painless clicking is normal)
- it’s red, hot, and you feel feverish
- it started with a pop or a twist
- it isn’t better after a few weeks
What the research says
- Exercise helps. A 2016 international consensus on pain around the kneecap recommends exercise to reduce pain in the short, medium and long term. Hip exercises combined with knee exercises work better than knee exercises alone.
- Some discomfort can be OK. A 2017 review of 7 trials in people with long-term joint and muscle pain found that exercise allowed to be a little painful worked slightly better in the short term than pain-free exercise, and the same in the long run. Pain during exercise “need not be a barrier” to improving.
- For knee arthritis, international guidelines (OARSI, 2019) list structured exercise as a core treatment.
What to swap
- Deep squats → leg press with a shorter range, or step-ups to a low box
- Lunges and split squats → leg extensions in a pain-free range
- Jumps → the bike
What to keep
- Hip thrusts and glute bridges
- Hamstring curls
- Calf raises
- Upper body, as normal
A simple rule
Mild discomfort is fine. Sharp pain isn’t: stop that exercise. If your knee feels worse the next morning, go lighter next time.
How BECOME does it
- Tell your coach. Write “my right knee hurts on deep squats” in your notes, and your plan leaves out exercises that load the knee hard. You still get quad work.
- “This hurt” button during a workout. Tap it and BECOME suggests a swap for that exercise everywhere it’s in your plan. If it hurts again, it tells you to get it checked.
- “Anything hurt?” at the end of every plan. Your next plan works around it.
Sources
- Crossley K.M. et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions. British Journal of Sports Medicine, 2016. PMC4975825
- Smith B.E. et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. British Journal of Sports Medicine, 2017. PMC5739826
- Bannuru R.R. et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage, 2019. doi:10.1016/j.joca.2019.06.011
- NHS. Knee pain. nhs.uk
General guidance, not medical advice. If you’re unsure, see a doctor or physio.
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