Why You Shouldn’t Just Focus on Your Knee When It Hurts

Jessica Bento, Physical Therapist (Don’t Miss Her Upcoming 2-week Knee Pain Coach’s Corner HERE)

Recently, I had the opportunity to present at a major fitness summit where I was speaking on the topic of knee pain. One question I heard over and over was: “Why don’t you just focus on strengthening the knee itself? Why not isolate the quads or hamstrings to fix knee pain?”

It’s an understandable question. After all, many therapists, trainers, and influencers emphasize specific muscle weaknesses—especially in the quadriceps or hamstrings as the main reason behind knee problems. If your knee hurts, the instinct is to target those muscles directly, right?

But here’s the thing: Current research is painting a much more complex picture. Isolated strength deficits in the quads or hamstrings don’t reliably predict who will get injured or suffer knee pain. Instead, the bigger factors often lie elsewhere—and that changes how we should approach knee pain rehabilitation and prevention.

What Really Matters Beyond Isolated Muscle Strength?
Multiple studies now highlight that deficiencies in core endurance and trunk stability, combined with poor mobility and stability in the foot and ankle, have a far greater impact on lower limb function and injury risk than just weak quads or hamstrings alone.

This makes sense when you think about how the body operates. The knee is a hinge joint sandwiched between two powerful and complex structures: the hip above and the foot and ankle below. Both these joints affect how forces are absorbed and distributed through the knee.
If your core isn’t able to stabilize your pelvis, your hip mechanics will suffer, placing more stress on the knee. If your foot and ankle lack proper control or mobility, your knee may compensate in unhealthy ways, leading to pain or injury over time.

Why This Can Be Confusing
I get it — it’s confusing! We’re bombarded with messaging like:

“ You need to strengthen your quads to fix your knee.”
“Your glutes are weak, that’s why your knee hurts.”
“You need to work on your tibialis anterior to get your knee better.”

While there’s truth that these muscles are important, the problem is often how we approach training them. Instead of isolating one muscle at a time, we need to train them as part of an integrated system  a team that works together.

 

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The Knee is Part of a Movement Chain
Think of your knee like a link in a chain. If there is a lack of mobility, stability, or control in the joints above or below the knee, the knee will have to compensate   leading to abnormal stress and, over time, breakdown.

So rather than “training the knee” alone, it’s more effective to look at the whole body’s movement patterns and loading strategies. We need to build:

-Integrated strength throughout the entire lower limb and core
-Core endurance and trunk stability to maintain control
-Dynamic control and mobility at the hip, knee, foot, and ankle

 

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What Does the Research Say?
There’s some fascinating research comparing integrated vs. isolated training that supports this approach.
One study divided participants into two groups: one did integrated training with full-body, multi-directional movements, and the other did isolated training focusing on single muscles in a single plane.
The results? The integrated training group showed significant improvements in:

-Movement quality
-Speed
-Strength
-Endurance
-Flexibility
-Power

Meanwhile, the isolated training group only improved in power and flexibility. Movement quality, speed, endurance, and overall function lagged behind.

This highlights that training the whole body through varied and functional movement patterns is much more effective for improving performance and reducing injury risk than just targeting one muscle at a time.

 

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What This Means for Your Knee Rehab or Training
If you’re struggling with knee pain, or just want to strengthen and protect your knees, here’s what I recommend focusing on:

1. Core Endurance and Stability
Your core stabilizes your pelvis and spine, which directly influences hip and knee mechanics. The inability to stabilize the core muscles can lead to inefficient movement and increased stress on your knees.

2. Hip Strength and Control
A strong and well-controlled posterolateral chain helps keep the knee aligned during movement, reducing risky valgus (inward collapse) stress.

3. Foot and Ankle Mobility and Stability
The foot and ankle act as your foundation. Poor control or stiffness here can cascade upward, affecting knee alignment and loading.

4. Integrated Functional Movement
Rather than isolated exercises, work on multi-joint, multi-directional movements that mimic real-life activities. This improves coordination and neuromuscular control.

Knee pain is rarely about just one muscle or joint. It’s about the way your entire body moves, stabilizes, and loads through daily life and exercise. By focusing on the whole system  core, hips, foot, and ankle  you give your knees the best chance to stay healthy and pain-free.

Discover more with Jessica Bento’s upcoming 2-week Coach’s Corner where she will present the science and solutions that are MOST meaningful to improve knee pain. Check it out HERE and this week only save 25% with code “coach”