My Knee Hurts!

How many people do you know who’ve had knee replacement surgery… and were shocked when it didn’t fix the pain or restore their mobility? The truth is, your knee may be screaming — but your hip might be the one whispering the root cause.

In this episode, I’m breaking down what no one tells you in standard rehab: why working your hips might just be the smartest thing you can do for your knees — before or after surgery. If you or someone you love is dealing with chronic knee pain, don’t skip this one.

Welcome to the Midlife Reset podcast, episode 21. I’m your host, Cheryl Gordon. I educate midlife women on losing weight, feeling stronger and sleeping better using the tools of yoga and mindfulness.

When Mary Lou came to me, she had been told her knee was “bone on bone”. The only real option her medical team discussed was replacement. This is an invasive surgery with a tremendous amount of pain during recovery. If you’ve had knee replacement or a loved one has been through it, you know what Mary Lou was facing.

Mary Lou wanted to do what she could to cope with her mobility restrictions because there was still quite a wait before surgery. Her friend had recommended my approach… yoga therapy. It’s crazy that the doctors made her feel guilty for holding a few extra pounds (“so much more pressure on the knee joint!”) But there was no guidance on how to move more comfortably now.

After working with hundreds of clients like Mary Lou, I have developed an evidence based protocol that addresses most of the needs for sore knees and hips. We start with gentle, relaxation based practices that help calm the pain response.

For Mary Lou, her knee had been progressively getting worse for over a decade. This reduced the amount she wanted to move which made moving more and more painful. What a vicious circle!

Research explains how sensations from the body are transmitted to the brain via chemical messengers called neurons. These are nerve cells. There is no pain until the brain gets these signals and decides that something is wrong. The brain is super efficient at keeping you safe. If it perceives danger, it’s going to give you a jolt to wake you up. Pay attention! Something is horribly wrong! When the knee joint is out of alignment, maybe bone is rubbing on bone… maybe there is an erosion of cartilage… the brain just knows to stop doing whatever you’re doing that created that danger signal.

It’s at the level of the brain that us humans have the potential to create a mindset that isn’t as reactionary. We can train ourselves to not be quite so nervous.

One of my teachers was involved in the classic research study where people reported their levels of pain after a paper cut at work. Then the researchers compared reported pain levels when people got the same paper cut reading the weekend funnies at home. Totally different experience because of the mindset. At work, we’re stressed… distracted… on a deadline… tired. At home, laughing with Peanuts, we’re less stressed. The brain receives the sensation under a different pretence and reacts differently.

For Mary Lou, she would step down on a stair and feel a jolt in her knee. Her brain panicked that the knee was going to give out on the stairs… She’d fall… She wouldn’t be able to manage simple household tasks anymore… her daughter would be angry with her for climbing stairs… you get it. Stressed, right?

So our first job was to calm the stress.

Now we went to work on how to get some mobility into the knee without aggravating the joint. In the protocol, there are several poses that do not weight bear heavily on the joint but help muscles to engage and strengthen. I love isometric work for the muscles. This means you make the muscle fire but it doesn’t change shape. Which means, it doesn’t pull on tendons which are often inflamed and angry in these situations. The effect is the muscles around the joint get stronger with pulling or pushing on it.

The real “secret sauce” to my protocol, and what made Mary Lou’s recovery from replacement surgery so much different, was our whole body focus. The knee didn’t get to this stage all on its own. It’s part of a kinetic chain. Just one member of the team. Everyone has to be reminded to do their parts.

Here's why exercising the hip joint helps knee pain:

1. The hip controls the leg

The hip joint is the major weight-bearing joint above the knee. If it’s weak, tight, or not moving well, the knee often ends up compensating, leading to pain.

Of the 11 muscles that move the knee joint, 7 cross the to the hip. You just can’t talk knees without looking at hip function.

(Share screen) Muscles like the glutes, hip rotators, and hip abductors (especially gluteus medius) are key stabilizers. When these are weak, the knee may collapse inward (valgus), twist, or become misaligned during walking or standing — aggravating pain.

Stiff hips force the body to twist or overuse the knees during everyday movements like squatting, walking, or climbing stairs. Restoring hip range of motion helps distribute movement more evenly.

The body works as a chain. If one joint isn't working well (like a stiff or weak hip), the joints above and below (low back, knee) try to make up for it. That’s often how knee pain develops even though the knee isn’t the real problem.

In Mary Lou’s case, she had knee pain when walking, and we determined her glutes were weak. So her thigh internally rotated and the knee was caving in with each step. Strengthening the glutes and improving hip control reduced that misalignment and eased pressure on the knee. This is a very common pattern.

You can tell that the glute med might be the culprit, at least in part, if you press around this area of the buttocks and feel a sore spot. It can be quite tender to touch. One thing we did with Mary Lou was get her into a program of using a tennis or massage ball against a wall. This really helped work out the tension. (Demonstrate)

While we’re talking brass tacks, here’s my favourite way to work knees without putting too much pressure on them. (Demo chair with tie, knee pumps)

1. Supine Bridge (Glute Bridge) can be done in bed if getting to the floor is tough right now.

What it does: Strengthens glutes and hamstrings.

2. Standing Abduction at wall with resistance OR seated in chair with glute band or just hands

What it does: Targets glute medius (important for knee alignment). Supports knee tracking during walking and stairs.

5. Mini Squats (with hips in focus)

What it does: Builds coordination between hips and knees.

How to do it: Stand with feet hip-width apart, do a small squat (no more than 30° knee bend). Focus on pressing through the heels and sending hips back.

Why it helps: Trains safe movement patterns without deep knee bend.

6. Wall Sit with Glute Activation

What it does: Static strength for glutes and thighs.

How to do it: Slide your back down a wall until knees are at 45–60° (not 90° if knee pain is present). Press knees out slightly to activate glutes.

🧠 Tips for Success:

Form matters more than reps — go slow and controlled.

No pain rule: If the knee hurts during an exercise, stop or modify.

Focus on hips and glutes, not quads. Avoid exercises that overload the knee (e.g., deep lunges, stairs too early).

Props like yoga blocks, bands, or chairs can make exercises safer and more accessible.

Exercising the hip can address the root causes of knee pain and when you get that new hardware, the most important part of rehab is already done!

Mary Lou still had her surgery. But during the wait, she had something productive to work on. When her physio talked to her about rehab, she was primed. She understood why she was doing what she was doing and made great strides. She told me the best part of the protocol for her though was learning the relaxation piece. There is a tremendous shock to the whole system with surgery. She found the calming practices really helpful for recouping from that.

I have this whole protocol available online now. It’s 11 videos that are all under 20 minutes. The Hip and Knee Release and Strengthen series is helpful for those waiting for knee replacement, like Mary Lou, and those recovering. I’ve also had great success with hip surgeries.

You can find this on my website or by clicking on the link in the show notes. It costs $19 and you can use the videos as often as you like. Please be sure to share this information with someone you care about who is suffering with knee pain.

I’m so happy to share this information with you each week. The more people who learn these things, the happier I’ll be. Subscribe to the podcast too so you don’t miss an episode.