How to Manage a Knee Injury Without Stopping Training

One of the most frustrating parts of a knee injury is feeling like you have to stop everything. But complete rest is rarely the right answer — and often makes outcomes worse. The key is to load intelligently, not stop loading entirely. Here's how to continue training safely while your knee recovers.

**First: identify what you're dealing with.** The treatment approach differs significantly depending on the diagnosis. Common knee conditions include: - Patellofemoral pain syndrome (PFPS) — pain around or behind the kneecap - Iliotibial band syndrome (ITBS) — lateral knee pain - Patellar tendinopathy — pain below the kneecap - Meniscal irritation — usually medial or lateral joint line pain - Osteoarthritis — diffuse, often bilateral, worse with prolonged activity **General principles for training through knee pain:** 1. **The 0-2 pain rule.** Training with pain rated 0-2/10 during activity is generally safe and beneficial. Pain above 3/10, or pain that doesn't return to baseline within 24 hours, means you've overdone it. 2. **Modify, don't stop.** If running causes pain, switch to cycling or swimming. If squatting hurts, reduce the range. If stairs are painful, use a lift temporarily. Load management, not avoidance. 3. **Strengthen what's weak.** Most knee pain has a hip and foot component. Weak glutes are implicated in patellofemoral pain, ITBS, and tibial stress injuries. Single-leg strengthening — step-ups, Bulgarian split squats, hip thrusts — is often the most important intervention. 4. **Address the training error.** Most overuse knee injuries result from increasing load too quickly. Use the 10% rule — don't increase weekly training load by more than 10% in any given week.