Ask the expert: My knees hurt when I exercise. What should I do?

Matt Kan is the founder and CEO of Chiropractic First Group of Clinics, and founder of KlaritySG, a Singapore-based company specialising in medical- grade collagen supplements for joint, bone and ligament health.

Over the past few years, I’ve observed a noticeable increase in patients coming in with knee-related complaints, particularly runners, gym-goers, and individuals who have recently become more active. I actually see this as a positive shift – more people are prioritising their health and fitness. The issue here is not exercise itself.

Too much, too soon

I see this all the time: Many people spend most of the week sitting at a desk, then suddenly ask their bodies to perform at a very high level during the weekend. The body loves consistency, so these big swings in activity can be challenging.

When muscles around the hips, glutes and core aren’t doing their job efficiently, the knees often end up taking on extra workload. That’s why the knees tend to complain first. You don’t need to train every day, but even small amounts of movement throughout the week can make a big difference.

Now let’s talk about running in particular. When someone overdoes running, the tissues around the knee – including cartilage, tendons, muscles and ligaments – may not get sufficient time to recover between sessions. Over time, this can lead to irritation, inflammation and pain.

The knee also functions as a key shock absorber with every step. During running, it is exposed to forces several times your body weight, repeated thousands of times in a single session. When load exceeds recovery capacity, stress accumulates in the joint structures.

What women need to watch out for

Women tend to experience certain knee conditions more frequently due to a combination of factors such as anatomy, movement patterns, muscle strength and hormonal changes.

That said, I don’t think women should see knee pain as something that’s bound to happen with age. Many women remain incredibly active well into their 40s, 50s and beyond without significant knee issues. The key is being proactive with strength training, mobility and recovery, rather than waiting until pain develops.

Early signs of knee issues can be surprisingly subtle. Maybe your knees feel stiff when you get up after sitting for a while. Maybe stairs are starting to feel uncomfortable. Or perhaps your knees ache after a run when they never used to.

If the pain keeps coming back, lasts more than a few days, affects your workouts, or starts impacting everyday activities, it’s a good idea to get it checked.

How to protect your knees during exercise

• Firstly, don’t skip strength training. Strong muscles around the hips and legs help support the knees and improve how forces are absorbed during movement.
• Secondly, build up gradually. A lot of injuries happen when people suddenly increase their running distance, class frequency or workout intensity.
• Thirdly, listen to your body. Pain isn’t something you should constantly push through. Small aches and niggles are often your body’s way of asking for a little attention before they become bigger problems.

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