Knee & Hip Conditions

Knee and hip conditions are among the most common reasons people stop doing what they love. Whether it’s osteoarthritis, a tendinopathy, patellofemoral pain, or post-injury weakness, exercise physiology has a proven and specific role in treatment.

What Are Knee & Hip Conditions?

The knee and hip are the body’s primary load-bearing joints, and between them they’re responsible for walking, climbing, squatting, running, and almost every other lower-limb movement pattern. When either joint is compromised — by injury, degeneration, or dysfunction — the effects ripple outward quickly: movement compensations develop, surrounding musculature weakens, and what began as a local problem becomes a whole-limb issue.

Common presentations include osteoarthritis of the knee or hip (cartilage degeneration with associated pain, stiffness, and reduced range of motion), patellofemoral pain syndrome (pain at or around the kneecap, often aggravated by stairs, squatting, and prolonged sitting), gluteal tendinopathy and greater trochanteric pain syndrome (lateral hip pain, often worse with sitting cross-legged, stairs, or lying on the affected side), patellar tendinopathy, femoroacetabular impingement (FAI), acetabular labral tears, and residual weakness or dysfunction following ligament injuries such as ACL tears.

What these presentations share is a response to appropriately applied load. Cartilage, tendon, and muscle all adapt to mechanical stress — they become more robust when loaded correctly. The clinical challenge is identifying what “correctly” looks like for each individual, each structure, and each stage of the condition.

How Exercise Physiology Helps

For knee osteoarthritis, the evidence for exercise is unambiguous. Progressive strengthening of the quadriceps, hamstrings, and surrounding hip musculature reduces compressive joint load, improves shock absorption, and consistently reduces pain and improves function. The joint is not protected by avoiding load — it is protected by building the muscular capacity to absorb it.

For tendinopathies, heavy slow resistance training has emerged as the gold standard — it stimulates tendon remodelling and builds load-bearing capacity more effectively than rest, stretching, or passive treatment. The progression from isometric loading through isotonic strengthening to heavy slow resistance is a clinically established pathway that requires careful management but produces reliable outcomes.

For hip conditions including FAI and gluteal tendinopathy, targeted strengthening of the hip abductors, external rotators, and glute medius — alongside load management strategies — changes the mechanical environment around the joint and reduces impingement forces. Hip strength is consistently underestimated as a driver of both hip and knee pain; addressing it is frequently the most impactful intervention available.

What to Expect

The initial assessment includes objective strength testing of the hip and knee musculature, a movement analysis to identify compensatory patterns and asymmetries, and a thorough history of the condition including imaging, previous treatment, and what activities are currently affected. From that baseline, a targeted resistance program is built around the specific joint, the specific tissue, and your specific goals.

Functional training is integrated from early in the program — the goal is not just to get stronger in a clinical setting, but to be able to climb stairs, squat, walk further, return to sport, or do whatever it is the condition has been limiting. Load is managed carefully and progressed consistently as capacity builds.

• Objective strength testing of hip, knee, and supporting musculature
• Progressive resistance program targeting the specific joint and surrounding muscles
• Load management — controlling how much force is put through the joint over time
• Functional training: stairs, squatting, sport-specific movement patterns
• Education on loading vs. rest (and why most people underload)

Is Exercise Physiology Right for You?

If pain is limiting your movement, your daily life, or your sport — whether that’s been going on for weeks or years — exercise physiology is the evidence-based starting point before considering more invasive options. No referral is needed. Book a consultation to discuss your presentation and what a targeted program would look like for you.