Patellofemoral pain is a very common injury in running and jumping athletes. When creating a plan to treat this knee pain, it is natural to utilize knee exercises to fix the problem right at its source. But is that the best way? Multiple studies have shown that both knee-focused rehabilitation and hip and core-based rehabilitation are effective in the fight against knee pain. Canadian researcher Dr. Reed Ferber and his colleagues set out to pit the two methods against each other to determine which method would provide the most effective knee pain relief.

Knee vs. hip training for knee pain relief

The authors divided 199 subjects suffering from patellofemoral pain into either a hip or knee-focused six-week rehabilitation program.

They hypothesized greater improvements in:

  1. Pain and function in both groups?
  2. Hip strength and core endurance for patients with patellofemoral pain involved in the hip protocol
  3. Knee strength for patients involved in the knee protocol.


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Dr. Ferber’s protocol used TheraBand progressive resistance exercise bands in both the hip and knee groups. Download the exercise protocol here.


And the winner is…

The results of the study proved that, while both rehab programs were successful, the hip protocol yielded earlier pain relief and greater gains in strength:

Compliance was similar between groups. (Hip 80.3% Knee 81.7%)

  • Outcomes
    • Overall 78.9% were successful
    • Hip – 80.2%
    • Knee – 77%
  • Time to Success
    • Hip – Significant pain reduction at 3 weeks
    • Knee – Significant pain reduction at 4 weeks
  • Strength
    • Both increased, but patients in the hip group gained more in hip-abductor and -extensor strength and posterior core endurance.
  • Core Endurance
    • Patients in the hip program exhibited greater, but non-significant, changes in endurance for all muscle groups tested than did those in the KNEE group.

The results of this study suggest that either hip or knee strengthening exercises with TheraBand in patients with anterior knee pain is effective at reducing pain and improving function and strength. However, hip strengthening may be more beneficial, resulting in faster reduction in pain and greater improvements in strength.

What are your thoughts on training the hip to achieve knee pain relief? Comment below and share with colleagues!


Ferber R, et al. 2015. Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial. Journal of Athletic Training 50(4):366-77.

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