Why Do My Knees Hurt In The Gym?


You may have always been active, but as you’ve gotten older, your knees may have started to hurt during or following your weightlifting activities. What’s causing this pain? Is there anything you can do to prevent it? How can you keep doing the activities that you love without hurting yourself?

You may be lifting too much weight.

If you’re lifting weights, your knees may be hurting. It can be from one of two things: either the weight you are using is too heavy for your body and/or your form is off. If this is the case, taking a break from working out or lowering the amount of weight that you lift may help reduce your knee pain. Remember, the muscles may be coping okay, but the cartilage, tendons and bones also need to adjust and recover from the workouts. It’s great to progress the weight, and progressive overload enhances muscular growth, but it needs to be done at a pace that allows all the loaded tissues to adapt, not just the muscles. Bone related pain is notoriously slow to recover, and may take some months. Aiming for a 5 to 10% increase in weight lifted per fortnight or even month may be most appropriate for knee pain.

If it’s more of a nagging pain than anything else, consider seeing your trusted Physiotherapist before returning to lifting weights again. They may be able to determine what exactly is causing this discomfort and give suggestions on how best to avoid injury when lifting weights again in future workouts.

You might have an undiagnosed injury.

If you’re new to lifting weights and are experiencing knee pain, it’s possible that your injury was caused by using improper form for your specific anatomy. The human anatomy differs slightly from person to person. However, there are other causes of pain in the knees that may not be as obvious.

Some common injuries / pathologies include:

  • Torn meniscus (cartilage)
  • Torn anterior cruciate ligament (ACL) in one or both knees (the ligament that stabilises the knee joint)
  • Patellar tendon tear or patellar tendinopathy (the tendon that joins the kneecap to the tibia)
  • Overloaded bone tissue, or even bruising of the bone

You may already have osteoarthritis in your knee/s.

Osteoarthritis is a common cause of knee pain. It’s caused by damage to the cartilage that cushions your joints, which allows bones to glide smoothly past each other. Over time, this can lead to bony deposits that grind away at the joint surface and cause pain. It is inflammatory in nature as well, so it may be the actual inflammatory chemicals that are initiating the pain. Osteoarthritis is really on a continuum though – it starts with weakening of the hyaline cartilage (the white and shiny bone covering) and perhaps some degeneration of the menisci (the cup-shaped cartilage that sits atop the tibia). The bony deposits that replace the hyaline cartilage happen at a much later stage of the condition, and this is a very common condition – so it’s not so much to be feared as it is to be understood.

Osteoarthritis may be prevented or managed through weight management and regular exercise. In fact, strength training exercises like squats and deadlifts (which strengthen muscles around the knees) may be very suitable for you. It is likely a matter of finding the best exercises and form for YOUR body, YOUR individual anatomy and YOUR stage of the condition.

The muscles around your knee may need strengthening.

If you’re experiencing knee pain, it’s possible that your muscles around the knees could be weak, or at least not strong enough. Weak muscles can also cause pain in other parts of the body, including the lower back and glutes.

To strengthen these muscles, exercises like step-ups, leg presses, hamstring curls, calf raises and seated knee extensions MAY be appropriate. Exercises like lunges and step ups may also not be ideal for you at this point in time, depending on your symptoms, medical history and ability to recover.

Seated Knee Extensions may be a safe way for for you to strengthen your quadriceps without aggravating tibio-femoral pain.

You may be moving sub-optimally or not using ideal form for YOUR body.

Remember that everyone has their own unique musculoskeletal profile. We each have unique muscular origins and insertions (locations of muscular attachments on the bones). Our bones and joints are often shaped uniquely as well. For example, some people have greater joint flexibility than others due to the shape of their bones. No amount of stretching or mobility work can change bone structure.

Good form means using your muscles in ways that allow you to lift heavy weights whilst minimising excessive shearing forces on the joints, and maximising tension on the targeted muscles.

You may not be warming up properly.

There are many ways to warm up, but here are some examples: light cardio exercise (eg. elliptical machine), dynamic stretches (stretching while moving), mobility drills (exercises meant to improve your range of motion), and warm up sets. Warm up sets are particularly important, as they get the blood flowing to the targeted muscles, warm up the brain’s coordination pathways and increase joint lubrication.

If you are using good form, warming up properly, and pacing your increases in the weight lifted, you can usually prevent pain in your knees when lifting weights. However, if you feel pain, seeing your trusted Physiotherapist could save you time, reduce injury risk and reduce the frustration.


If you’re not sure whether your knees are hurting because of lifting weights, it’s best to talk to your trusted Physiotherapist. They can check for any underlying injuries / pathology, order any imaging if needed and make sure that you’re doing the right exercises for your specific anatomy. If your knees do hurt when lifting weights or doing any other activity, you may need to keep trying different approaches until you find something that works for you.

At Destiny Health, our Assessment is Free. You only pay if you choose a service option.

Book your appointment today, online or in-person!

1300 GYM DOC

13 William Street, Raymond Terrace NSW 2324