Strength training can be one of the best treatments for chronic knee pain. Here’s how to do it safely.

Caitlin Berzok used to be scared of strength training. She occasionally exercised with ankle weights but worried that heavy lifting might slow her down or lead to injury.

In 2015, she got serious about running, progressing from shorter races to marathons, and just a year later she started having chronic knee pain. Soon, she could barely run a mile. Ms. Berzok, then 29, tried resting, stretching and working with a physical therapist, but nothing helped.

Then a new physical therapist had her try weight lifting with a kettlebell, starting light and eventually working up to 40 pounds. She’d leave a session drenched in sweat after wide-legged squats, curtsy squats, Bulgarian split squats, Romanian deadlifts and lunges. “I never knew there were so many different types of squats,” Ms. Berzok said.

Within a year she was back to running marathons pain-free, and over the years she has kept lifting.

Frequent knee pain affects about 25 percent of adults. While a generation ago experts often recommended rest and ice to alleviate knee pain, evidence now suggests that strength training can reduce pain and increase range of motion.

“Stronger muscles help distribute the load more evenly across the knee,” said Dr. Nima Mehran, an orthopedic surgeon in Los Angeles, Calif., who specializes in the knee. Building muscles reduces the amount of stress on the joint, he said, and it can also improve alignment, which in turn helps prevent injury.

“People think that strength training will hurt their knees or cause further damage,” said Leada Malek, a physical therapist in San Francisco who specializes in sports medicine and the author of “Science of Stretch.” But that’s not actually the case, she said.

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