Exercises to Help with Kneecap Pain

You may think that if you have knee pain you would need to do knee exercises. Some physical therapists even have their clients do this. However, there is a smarter and less painful way to help relieve kneecap pain. Recent research and physical therapists have found that the problem is actually originating in the hips, not the knee.

How Your Hip Bone is Related to the Knee

“The hip bones connected to the…knee bone.”

Your kneecap is actually in a groove at the end of your leg bone (the femur). This grove is called a trochlear. When the kneecap doesn’t track evenly in this groove, it becomes painful and can wear away the cartilage on one side or the other.

Most commonly the kneecap will shift laterally, or to the outside. There is a muscle that can pull it toward the inside which is what physical therapists previously would try to strengthen to compensate for the lateral pull.

However, another reason the kneecap can track toward the outside has to do with the leg bone itself moving inward. This moves the kneecap’s groove out of place. This movement of your leg bone is controlled by your hip.

So, the question becomes whether you need to exercise your knee muscle or hip, or both?

diagram showing skeletal structure of hip and legs

Weakness of the Hip

The hip muscles do a lot of things, but one is to hold your hips externally rotated. When the hip muscles get weak, the body can cave inward. This results in the kneecap groove at the end of the femur moving inward. This is why hip physical therapy for knee pain is working external rotators – meaning exercises where you rotate the feet or hip outward. For example, clamshell exercises:

man doing clamshell exercises

Another hip problem that occurs is that the glutes and hamstrings get weak and the thigh muscles take over. Your butt muscles and hamstrings are meant to be active when walking or running, and if they aren’t working, they allow your quads (thigh muscles) to take over. This results in more force on the kneecap, since that is the bone at the base of these muscles. To resolve this issue, you should work on strengthening your glutes and hamstrings with exercises like bridges:

person doing a bridge exercise


If you have been experiencing kneecap pain, try these exercises. I hope they bring you some relief. Of course, you may not notice anything instantly, but keep at it.

At Nashville Regenerative Orthopedics we work to bring our patients the best results possible – whether it be helping patients with diet changes to handle the pain they are experiencing, with physical therapy or for musculoskeletal issues we have tissue matrix solutions that can help rejuvenate joints.

If you or a loved one are experiencing pain, please call our office to schedule a consultation and find out how we can help.

Here’s to your health and longevity!

Dr. Ethan Kellum, M.D.

Nashville Regenerative Orthopedics

dr ethan kellum



NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.