Knee Pain: Top Four Causes and What You can Do

Knee Diagram

Suffering from on/off knee pain that won’t go away?

If so – you’re not alone – it is the second most common complaint of musculoskeletal pain (back pain is number one) and it impacts one-third of all Americans at one time or another.

Most of our clients are in their 50’s and 60’s and love to ski, run, hike and bike – and they worry that knee pain could bring an end to their active lifestyles…

The good news is that eighty percent of all knee problems can be resolved without procedures or surgery.

But it starts with accurately identifying the cause.

Here are three of the most common causes of knee pain and what you can do about it…….

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, patellofemoral knee syndrome (PFS) is characterized by pain in the front of your knee, usually just below or behind your knee cap. With PFS – the source of the problem typically has to do with unwanted pressure in the front of your knee – that eventually results in pain.

It’s very tempting to just get a cortisone shot, or take pain pills, to reduce the inflammation caused by this wear and tear.

But then you’re only addressing the symptoms.

If you truly want to put an end to PFS – you’ll need to find the root cause of this problem.

Typically, it’s poor form and movement habits that are the result of an imbalance somewhere between your hips, quads (front of the thigh), and hamstrings (back of the thigh).

When you figure that out – you’ll restore healthy, balanced movement in your knee again – and reduce the aggravation happening at the front of your knee.

2. Iliotibial band syndrome

This is a very common problem that is similar to PFS except that you’ll experience pain on the side of your knee instead of the front.

Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called tensor fascia latae (TFL). When your TFL gets overworked, your ITB suffers, and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage – and while these are great modalities to relieve your symptoms – they do NOT address the root problem.

You MUST figure out why your TFL is being stressed and overworked if you really want to get rid of your pain.

Typically – it’s due to weak glute muscles – the deep ones designed to stabilize your pelvis.

Your TFL is neighbor to your glutes so when they decide to be lazy… your TFL loves to help out… and eventually overdoes it.

When you can get these two groups of muscles working properly together – you’ll put an end to ITB syndrome.

3.  Inner knee pain (which could be Meniscus injuries)

Inner knee pain can often occur because of Medial Meniscus injuries. These can sometimes happen suddenly such as after rising up from a squatted or crouched position in an awkward way, from lifting injuries or even jumping, running, skiing  OR they can happen in micro amounts in a “wear and tear” type of way which we call a “degenerative tear”. These type of tears are small and can occur over many months or years (can be seen in athletes who are very active or even in individuals with previous knee injuries like ACL tears and repairs)

Most people think they that as soon as a clinician mentions possible meniscus involvement, they will need surgery!

Not true!

Medial Meniscus injuries happen when the cushion like structure that provides shock absorption between your bones and cartilage, wears down over time or a sudden bruise or trauma occurs as described above

A lot of these tears can repair over time if a Physical Therapist can examine the “root problem” of YOUR PAIN and then  guide you step by step  how to treat it, using the right preventative measures ( do this but don’t do that) and corrective exercises.

Also it’s important for the PT to do extensive manual therapy and “hands -on” work to make sure all the structures around the knee are soothed, loosened up, NOT getting swollen and compromising the STABILITY of the knee further by becoming weaker.

It’s an intricate type of PT treatment that a specialist PT can assess and figure out a plan of care that will fix that particular meniscus injury – it can’t be a one size fits all approach as each meniscus injury can present differently in each person. Most people are able to avoid surgery with a proper examination by a PT, proper treatment and avoid future injuries again.

With this type of injury – it all comes down to building the muscles – around the knee and gluts, and building up the stability around your knees. Timing and balancing of the steps of treatment with an experienced PT (when to progress what and how it’s done…is key otherwise the meniscus will not heal) is important!

4. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get surgery to replace their knees.

Not true!

First of all, arthritis is normal and it happens to everyone as they age.

What is NOT normal is for you to think you’re helpless because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process, there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement…

The more mobility you have – and the more stability you have around your knees – the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core strength, and good flexibility in your hips and ankles. If anything is off in these areas – your knees will want to compensate – which could result in aggravation of arthritic symptoms.

“Motion is lotion” is not just a saying! It works… especially when it comes to arthritis.

If you’re currently suffering from knee pain…

REMEMBER – There is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills – or think that procedures and surgery are your only options.

As you can see – the TOP four causes of knee pain are due to movement and imbalance problems – three things that can be fixed by movement experts – NOT passive modalities.

If you’re currently suffering from knee pain that won’t seem to go away – perhaps you’ve missed the root cause and are treating symptoms instead of the imbalance or movement problem.

If you want help figuring this out…

Apply for a FREE Discovery Session with a specialist at my clinic.

We will speak with you about everything that’s going on, determine if you’re a good fit for what we do, and let you know if we can help you!



Trupti Mehta, PT, MS, OCS

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