Knee pain is one of the most common complaints we see, affecting people of all ages and activity levels. Understanding the cause of your knee pain is the first step toward effective treatment and prevention of future problems.
Common Causes of Knee Pain
Runner's Knee (Patellofemoral Pain Syndrome)
What It Is:
- Pain around or behind kneecap
- Most common knee complaint
- Often from overuse or biomechanical issues
Symptoms:
- Pain with stairs (especially down)
- Prolonged sitting
- Squatting or kneeling
- Grinding sensation
Causes:
- Weak hip/thigh muscles
- Poor foot mechanics
- Tight muscles
- Training errors
Treatment:
- Hip and quadriceps strengthening
- Activity modification
- Stretching program
- Proper footwear
IT Band Syndrome
What It Is:
- Inflammation where IT band crosses knee
- Common in runners and cyclists
- Sharp pain on outside of knee
Symptoms:
- Pain during activity (especially downhill)
- Worse at specific distance/time
- Swelling on outer knee
- Tenderness to touch
Causes:
- Tight IT band
- Weak hip abductors
- Training errors
- Poor biomechanics
Treatment:
- Hip strengthening
- IT band stretching
- Foam rolling
- Activity modification
- Gait retraining
Meniscus Tears
What It Is:
- Cartilage tear in knee joint
- Can be traumatic or degenerative
- May lock or catch
Symptoms:
- Pain on joint line
- Swelling
- Catching or locking
- Difficulty straightening
- Clicking sounds
Causes:
- Twisting injury
- Deep squatting
- Age-related degeneration
- Sports injuries
Treatment:
- Conservative first (physiotherapy)
- Rest and activity modification
- Strengthening program
- Surgery if mechanical symptoms persist
Osteoarthritis
What It Is:
- "Wear and tear" arthritis
- Cartilage breakdown
- Progressive condition
- Very common over 50
Symptoms:
- Aching pain
- Morning stiffness
- Worse with activity
- Better with rest initially
- Swelling and stiffness
Treatment:
- Exercise (most important!)
- Weight management
- Physiotherapy
- Pain management
- Joint replacement (severe cases)
Ligament Injuries
ACL/PCL (Cruciates):
- Major stability ligaments
- Often sports injuries
- May require surgery
MCL/LCL (Collateral):
- Side stability ligaments
- Usually heal conservatively
- Graded injuries (1-3)
Symptoms:
- Immediate pain
- Swelling
- Instability
- Limited motion
Tendinopathies
Patellar Tendinopathy (Jumper's Knee):
- Pain below kneecap
- Common in jumping sports
- Overuse injury
Quadriceps Tendinopathy:
- Pain above kneecap
- Similar to patellar
- Less common
Treatment:
- Load management
- Eccentric exercises
- Progressive strengthening
- Patience (12+ weeks)
Bursitis
What It Is:
- Inflammation of bursa (fluid sac)
- Cushions between tissues
- Can swell significantly
Types:
- Prepatellar (front of knee)
- Pes anserine (inside, below joint)
- Infrapatellar (below kneecap)
Treatment:
- Ice
- Activity modification
- Stretching
- Anti-inflammatory medication
- Rarely needs drainage
Diagnosis
Physical Examination
Assessment Includes:
- Observation (swelling, alignment)
- Range of motion testing
- Strength assessment
- Special tests (ligaments, meniscus)
- Functional movement analysis
- Gait evaluation
Imaging
When Needed:
- Severe pain or swelling
- Suspected fracture
- Mechanical symptoms (locking)
- No improvement with treatment
- Planning surgery
Types:
- X-rays: Bones, arthritis, alignment
- MRI: Soft tissues, ligaments, meniscus
- Ultrasound: Real-time assessment
- CT: Detailed bone imaging (rare)
Treatment Approaches
Conservative Management
First-Line Treatment (Works for Most):
- Physiotherapy
- Activity modification
- Strengthening exercises
- Pain management
- Education
Physiotherapy
What We Provide:
Manual Therapy:
- Joint mobilization
- Soft tissue massage
- Patellar mobilization
- Trigger point release
Exercise Therapy:
- Hip strengthening (crucial!)
- Quadriceps strengthening
- Hamstring work
- Calf strengthening
- Core stability
- Balance training
Biomechanical Analysis:
- Gait assessment
- Movement pattern evaluation
- Identify compensations
- Correct dysfunction
Education:
- Condition understanding
- Self-management strategies
- Activity modification
- Prevention techniques
Essential Exercises
For Most Knee Conditions:
Hip Strengthening:
Side-Lying Leg Raises:
- Strengthens hip abductors
- 3 sets of 15
- Essential for knee health
Clamshells:
- Hip external rotators
- 3 sets of 15
- Reduces knee stress
Bridges:
- Glutes and hamstrings
- 3 sets of 15
- Single-leg progression
Quad Strengthening:
Straight Leg Raises:
- Safe for most conditions
- 3 sets of 15
- Add weight as able
Terminal Knee Extension:
- With resistance band
- 3 sets of 15
- Targets VMO
Step-Ups:
- Functional strength
- Start low height
- 3 sets of 10 each leg
Balance:
Single Leg Stance:
- 30 seconds each leg
- Progress eyes closed
- Essential for stability
Pain Management
Non-Pharmacological:
- Ice (acute injuries/flare-ups)
- Heat (chronic pain, before activity)
- TENS
- Activity pacing
- Weight management
Medications:
- Acetaminophen (first-line)
- NSAIDs (short-term)
- Topical anti-inflammatories
- Prescription if needed
Injections:
- Corticosteroid (inflammation)
- Hyaluronic acid (arthritis)
- PRP (some conditions)
- Considered after conservative treatment fails
Bracing and Supports
When Helpful:
- Patellar tracking issues
- Ligament instability
- Arthritis support
- Return to sport
Types:
- Patellar stabilizing braces
- Hinged knee braces
- Compression sleeves
- Unloader braces (arthritis)
Footwear and Orthotics
Importance:
- Foot position affects knee
- Proper arch support
- Cushioning for impact
- Stability features
When Needed:
- Overpronation
- Flat feet or high arches
- Leg length discrepancy
- Biomechanical issues
Surgical Options
Arthroscopy
Minimally Invasive:
- Small incisions
- Camera and instruments
- Outpatient usually
- Faster recovery
Used For:
- Meniscus repair/removal
- Cartilage procedures
- Loose body removal
- Ligament reconstruction
Joint Replacement
Total or Partial:
- For severe arthritis
- Failed conservative treatment
- Significant function loss
- Excellent pain relief
Recovery:
- Hospital 1-3 days
- Physiotherapy essential
- Progressive rehabilitation
- Full recovery 6-12 months
Other Procedures
- Realignment surgeries
- Cartilage restoration
- Ligament reconstruction
- Tibial osteotomy
Prevention Strategies
Maintain Healthy Weight
Why It Matters:
- Each pound = 3-4 pounds knee stress
- Reduces arthritis risk
- Lessens pain
- Improves function
Regular Exercise
Best For Knees:
- Walking
- Swimming/aqua exercise
- Cycling
- Elliptical
- Strength training
- Yoga/Pilates
Avoid:
- High-impact if painful
- Deep squats (if problematic)
- Excessive stairs
- Kneeling (bursitis)
Strength Training
Essential Muscles:
- Quadriceps
- Hamstrings
- Hip abductors and rotators
- Glutes
- Core
- Calves
Frequency:
- 2-3 times per week
- All year round
- Progressive resistance
Proper Form
Activities:
- Squat with knees over toes
- Land softly from jumps
- Avoid excessive inward knee collapse
- Use proper running technique
- Gradual training progression
Footwear
Good Shoes:
- Appropriate for activity
- Replace every 300-500 miles (running)
- Proper arch support
- Adequate cushioning
- Good fit
Activity Modification
During Pain
REDUCE:
- High-impact activities
- Excessive stairs
- Deep squats/lunges
- Running (temporarily)
- Activities causing pain
MAINTAIN Fitness:
- Swimming
- Cycling (if tolerable)
- Upper body work
- Core exercises
- Walking (pain-free)
Return to Activity
Progressive Approach:
- Pain-free daily activities
- Low-impact exercise
- Gradual intensity increase
- Sport-specific training
- Full return
Criteria:
- Minimal pain
- Good strength
- Normal movement patterns
- Confidence in knee
When to See a Physiotherapist
Early Is Better:
- New knee pain (>2 weeks)
- Recurrent problems
- Limiting activities
- Unsure of cause
- Want to prevent worsening
- Optimize performance
Benefits:
- Accurate diagnosis
- Personalized treatment
- Expert guidance
- Prevent chronic issues
- Faster recovery
- Avoid unnecessary interventions
Red Flags
Seek Immediate Medical Care:
- Unable to bear weight
- Severe swelling
- Obvious deformity
- Locked knee
- Severe pain
- Signs of infection (fever, warmth, redness)
- Sudden giving way with injury
Living with Knee Pain
Management Strategies
Daily Habits:
- Morning stretching
- Regular strengthening
- Activity pacing
- Good posture
- Appropriate footwear
Flare-Up Management:
- Rest from aggravating activities
- Ice application
- Elevation
- Compression
- Gentle movement
- Return gradually
Long-Term Success
Key Factors:
- Consistent exercise
- Weight management
- Listen to body
- Address problems early
- Maintain strength
- Stay active
Prognosis
Most Knee Pain:
- Improves with proper treatment
- 6-12 weeks typical
- Full recovery common
- Prevention key to avoiding recurrence
Chronic Conditions:
- Manageable with proper care
- Focus on function
- Stay active safely
- Quality of life maintained
Experiencing knee pain? Our orthopedic physiotherapy specialists at M.O. Therapy provide comprehensive assessment and treatment for all types of knee pain. We'll identify the cause, create a personalized treatment plan, and guide you back to pain-free activity.
Book your knee assessment today. Don't let knee pain limit your life. Whether you're an athlete or simply want to walk without discomfort, we're here to help you achieve your goals and maintain healthy, strong knees.