How familiar does this sound: You’ve made the fantastic decision to take control of your health and start working out more regularly. Maybe you decide to start running, maybe you join a recreational soccer team, start going to the group classes at the gym, or found a weights routine online you decide to try.
Fast forward a couple of weeks. Regularly moving your body and getting your sweat on is starting to feel really good and you’re just starting to hit your workout stride, when you feel a twinge in your knee mid-session. Before you know it, your knee (or knees) are stiff, creaky, and chronically in pain. You don’t want to quit exercising (again), but you know if you keep going the way you are, you’re going to have a big problem. So what do you do?
Here’s the thing: You are not alone. Millions of people around the world suffer from chronic knee pain.  The problem with knee pain is it has become a chicken-and-the-egg scenario: Was it the activity that caused it, or the lack of prior activity that put you on the pain-train? The key to preventing pain is understanding its source, and following up with a series of knee strengthening exercises and knee stretches.
Causes of Chronic Knee Pain
Knee pain can be caused by a variety of things. In acute cases, it is fairly obvious and has to do with an actual traumatic injury to the knee joint, such as a tear of the MCL or ACL, or a broken knee cap. 
Chronic knee pain can be less obvious and more difficult to narrow down the cause, as it typically builds slowly overtime until it finally becomes too great to work through. Common causes of knee pain are: 
- Overweight and obesity
- Jumping into an advanced workout routine after a period of inactivity
- Iliotibial band syndrome
- Certain sports (acute injuries are more common with sports such as soccer or basketball, overuse, chronic injuries are commonly associated with repetitive sports like long distance running)
- Lack of flexibility and muscle strength
Unfortunately, our North American lifestyle is highly conducive to developing chronic knee pain. Most of us are carrying around extra weight, are inactive (aka sitting!) for most of the day, and have the bad habit of starting and stopping exercise routines without much thought or preparation. 
When presented with knee pain, most doctors will tell you to stop doing anything that hurts it until it goes away. The problem with this is that it never addresses the actual problem: You will continue to suffer on and off with knee pain until you do so.
How to Find Knee Pain Relief
Though it’s easiest to prevent knee pain from developing in the first place, if you’re already in pain it doesn’t have to be permanent! This is how to treat knee pain for fast and long lasting relief.
Determine the cause
If you have chronic knee pain, chances are you are dealing with weak and tight muscles, or arthritis. These can usually be solved with specific knee exercises and stretches for knee pain relief, however there are cases where doing so could damage your knees further. Go see your doctor if you: 
- can’t put weight on one or both of your knees
- have a large amount of swelling around the knee
- cannot fully flex or extend your knee
- there is an obvious deformity in the area of the knee
- you have a fever and redness or swelling in the knee
- you feel like the inside of your knee “gives out”
In those cases, your doctor can assess you and send you to the appropriate specialist.
Strengthen and Stretch
Most of us all have the same problems: Our quads (front of leg) are overdeveloped and tight, our glutes (butt) and hamstrings (back of leg) are weak, and our hips and ankles/calf muscles (bottom of leg) are tight and have restricted movement. You should be able to squat perfectly to the ground, with your back up and straight and heels firmly on the ground, no-problem. You should also be able to sit cross-legged for a period of time without discomfort. You lack of ability to properly perform those (and many other) basic movements is indicative of how immobile you are and how likely you are to experience joint pain and eventually degeneration of those joints.
Most of us assume that we need to stretch and “loosen up” before we start strengthening, however it is actually the opposite. Often the muscles that feel tight feel that way because their antagonist muscles are overworked (example: Your hamstrings may feel tight, but it’s actually the quad that’s causing the problem). If you just start stretching, you end up making the weak muscles weaker and the tight muscles get even more worked up.
5 Exercises for Knee Pain Relief
Whether you are a seasoned exerciser, a beginner, or just want to get rid of your chronic knee pain, do these five things to strengthen your knees and get solve the real problems causing your knee pain.
1. Hip Exercises
A weak, immobile hip causes many of our knee pain problems.  Leg lifts are a fantastic way to fix this problem, and they are great because you can scale them to ability using number of reps and ankle weights. Channel your inner Jane-Fonda and feel the burn!
The key to these are to go slowly and not let your leg or hip wobble around. We suggest finding a line you can follow on the wall and keeping your heel in line with it as you slowly move your leg up and down.
Other variations on this include moving your leg forwards and backwards, and making medium-sized circles with your heel, both clockwise and counterclockwise.
2. Vastus Medialis Oblique (VMO)
This is the teardrop shaped muscle on the inside of the knee. For the majority of the population, this muscle is underdeveloped, both in inactive people, and highly active people, such as marathon runners. When the VMO is weak, our knee tracks in over the big toe instead of straight out over the third toe, causing friction, inflammation, and pain.  To strengthen and stabilize the VMO, the progression of exercises are:
Peterson Step Up
3. Front Foot Elevated Split Squats:
These are a precursor to a full squat, and target all of the classic troubles spots for anyone who spends a large amount of time sitting at a desk, in a car, etc. FFE Split Squats stretch your hip flexors and calves, increase ankle mobility, and strengthen your VMO and your glutes. The lower your front foot is to the ground, the more challenging, and once you are able to perform these without your front foot raised up at all, feel free to add weights to challenge yourself.
– Full squats: These are only to be performed when knee pain is minimal or nonexistent! It is a commonly believed myth that squatting with your knees past your toes is bad for your knees, however your knees are actually under the most strain at the 90 degree angle. Past-parallel squatting is critical for knee, hip, and ankle strength, mobility, and health.  Check out this video for proper squat form:
4. Glute Exercises
Though front foot elevated split squats and full double legged squats are great for your butt, those exercises might be too advanced for you. That doesn’t mean you can’t still strengthen your glutes!
Clam Shells: These can be performed anywhere and don’t require any pressure on your knees, perfect if you are just starting out. When performing clam shells, you should be squeezing your glutes to open your knees, not using your quad. If you can open your knees really wide, you are doing it incorrectly. We suggest actually putting your hand on your butt to make sure that you are flexing the right muscle.
Glute bridges: These are fantastic for your core, glutes, and hamstrings. Be sure to tighten your core before each rep, squeeze your glutes together, and pretend like you are dragging your heels back towards your butt in the top position. If you have trouble with your knees caving inwards, put a band around your knees and press out on the band while pushing hips upwards. Watch this tutorial for proper form.
When you are ready, try the single leg version. With this exercise, it is VERY important that your hips stay even in the top position. If you were to lay a yardstick across your hips, it should remain even (no tilting). Be sure to squeeze both glutes and keep your core tight. Watch this tutorial for proper form.
5. Knee Stretches
Finally, now that you are strengthening the supporting muscles of your knees, you can stretch. These are the stretches you should be performing, provided they do not cause pain in your knee:
Glutes and IT Band:
As always with an exercise routine, start easier than you think you should and progress to the harder movements slowly, only adding intensity when you are ready. Many of the reasons we have knee pain is because of muscles that have been unused for many years, so a little will go a long way in the beginning.
Everyone’s knee pain is different, so always monitor how you are feeling throughout each exercise. Some of these exercises may not work for you at the beginning, and that’s ok. Do what you can, and as your knee pain goes away you will be able to do more.
If your pain does not decrease or go away after a few weeks of regularly performing these exercises, book an appointment with your doctor to ensure there isn’t a larger problem.
 Mayo Clinic. (2017, January 12). Knee pain. Retrieved from http://www.mayoclinic.org/diseases-conditions/knee-pain/home/ovc-20190111
 Cigna Health and Life Insurance Company. (2016, May 27). Knee Problems and Injuries. Retrieved from https://www.cigna.com/healthwellness/hw/medical-topics/knee-problems-and-injuries-kneep
 Hutchinson, A. (2014, June 2). Hip Weakness and Knee Pain. Retrieved from http://www.runnersworld.com/sweat-science/hip-weakness-and-knee-pain
 Sports Injury Clinic. (n.d.). Vastus Medialis Oblique Rehab. Retrieved from http://www.sportsinjuryclinic.net/rehabilitation-exercises/knee-hamstring-thigh-exercises/vmo-rehab
 Women’s Health Magazine. (2013, October 17). 7 Squat Variations You NEED to Try. Retrieved from http://www.womenshealthmag.com/fitness/types-of-squats