Struggling with knee pain? For relief, consider aiming higher. Rehab routines that incorporate the hip—as opposed to the knee alone—appear to work better for combating runner’s knee, according to a new research review published online in the British Journal of Sports Medicine.

British and Australian scientists analyzed 14 previous studies of people with patellofemoral pain, the official name for the ache in the front of the knee that strikes many runners. Participants whose programs included moves to build strength, endurance, and activation in the muscles around the hip had less knee pain and improved joint function when compared with those whose therapy focused on the quadriceps muscles alone.

What’s more, programs that strengthened hip and glute muscles with heavy weights—using a load of at least 70 percent of what a person could lift for just one rep—showed promise after a year follow-up.

Given how often runner’s knee returns, incorporating these types of exercises could be key to staying pain-free for the long term, according to lead study author Dylan Morrissey, Ph.D., of the Queen Mary University of London.

Hip-focused rehab routines likely work by altering movement patterns and shifting the load of running back onto the appropriate muscle groups, Morrissey said. “For example, if rehabilitation helps stop a female runner’s knee from drifting in and keeps it pointing forward while her gluteal muscles do more work, then the knee will need to cope with less load in a better position,” he told Runner’s World Newswire in an email. “These changes seem to be associated with reduced pain and improved function.”

Not every runner will benefit from the same approach, so if you’re coping with chronic knee pain, Morrissey advises seeking treatment from a physical therapist or other sports-medicine professional. “There are lots of other things that can be done to help runner’s knee pain, and we are learning more about them all the time,” Morrissey said.

Meanwhile, consult our "Hip Check!" routine to help you identify—and correct—weakness and imbalance in this area before you get hurt.

Cindy Kuzma Contributing Writer Cindy is a freelance health and fitness writer, author, and podcaster who’s contributed regularly to Runner’s World since 2013.

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