Updated August 13th, 2022
Introduction
Knee pain...my grandmother Olga has knee pain, my friend Mike has knee pain, my barber Angelo has knee pain, my 1st grade teacher Ms. Malvin has knee pain, my Uncle Alejandro's nephew has knee pain! Wait, that's me…I have knee pain. Why is this happening?! Seems like this whole knee pain debacle is more common than we think. Well let me spit a couple statistics at you: nearly 25% of adults are affected by knee pain and its prevalence has increased by 65% in the past 20 years, which accounts for nearly 4 million primary care doctor visits a year! (1)(2) That's a lot of knee pain!
With that being said, there are many causes for knee pain and it is in fact one of the most common diagnoses I see as a physical therapist. Within this article I will break down some of the most common causes of knee pain, as well as exercises that I have found to be successful.
Brief (kind of) Anatomy
The knee is quite complex so it is important to highlight some key features and what they are responsible for. I will break down the major muscles, bones, ligaments, tendons, and cartilage. I apologize in advance for the boredom but the good news is you are in complete control of your computer so you can scroll right past all of this if you like! I won't be offended.
Muscles:
The muscle group directly above the knee in the front of your thigh are the quadriceps, which purpose is to extend the knee. The muscles behind the thigh and above the knee are the hamstrings and are responsible for helping bend the knee. Below the knee and behind the leg are the calf muscles, which help point your foot down towards the ground and below the knee in front is the tibialis anterior which helps point your foot up towards your head.
Bones:
The bone directly over the knee which is most commonly known as the kneecap is called the patella, which protects the knee joint and allows the knee to move smoothly when you bend and straighten it. The bone directly above the knee is the femur and below the knee you have two bones: the tibia which is the larger bone and fibula which is towards the outside of your leg.
Ligaments:
A ligament connects a bone to another bone and within the knee you have 4 main ligaments. The most common ligament you may of heard is the ACL (anterior cruciate ligament) which controls forward movement of the tibia, the PCL (posterior cruciate ligament) controls backward movement of the tibia, the LCL (lateral collateral ligament) gives stability of the outer knee and the MCL (medial collateral ligament) gives stability to the inner knee (3).
Tendons:
A tendon connects a muscle to a bone and within the knee there are two main tendons. As described before, the muscle above your knee is the quadricep and you have the quadricep tendon which connects to the patella. Soooo ready for a plot twist that no one has yet to give me a thorough explanation about?! Below the kneecap you have the patellar tendon which connects the kneecap to the tibia however those are two bones! Why is this called a tendon? Who knows, I guess the person who named it was actually kind of dumb. It's whatever though, we have all just accepted it at this point.
Cartilage:
Cartilage is a shock absorber which acts as a cushion between two bones. In the case of the knee the cartilage is called the meniscus.
Okay this was a tough one, believe me I am fully aware, but you made it to the end of the “brief” anatomy and I am sorry if I bored you! It's just very important to understand the structures and many of my patients find it helpful to visualize why their knee is actually hurting!
Why Does My Knee Hurt?!
So my honest answer to this question is…it's complicated. I know, I know. I apologize that you made it all through my anatomy lesson with such a horrible answer to your question but it's true. The knee is a very complicated structure with a wide spectrum of possibilities for a cause of pain. I will let you know some of the most common reasons which are as followed:
Overuse or overloading (tendonitis)
Wear and tear from aging (osteoarthritis)
Tight muscles around the knee
Meniscus tears
Injuries to the mentioned ligaments
Soreness after a workout
Everything that I just mentioned is the tip of the iceberg so it is important to know when to seek a healthcare professional, such as a physical therapist or orthopedist.
When To Seek a Healthcare Professional
Significant swelling around the knee
Sharp, shooting pain with walking
Sharp pain with going up and down steps
Tenderness and warmth around the knee
Feeling of clicking, locking or popping
Sudden weakness
Pain that wakes you up at night
Inability to bare weight
What Can Be Done?
As I mentioned earlier, as a physical therapist, knee pain is one of the most frequent conditions I treat. One thing that I have learned in my years of practicing is there are common impairments most people with knee pain present with such as; tight muscles, instability of the joint, and weakness of muscles surrounding the knee. Even though no person should ever be viewed the same when prescribing a plan of care the following exercises are what I find to be most helpful when addressing the mentioned impairments.
It is important to note this is a very limited list of exercises but a good starting point to address some of the most common issues.
Conclusion
Overall, it's safe to say that having knee pain is quite common. You know your body more than anyone else, so if you are having pain it’s your body's way of communicating to you that something is going on. Please seek a healthcare professional in order to help identify what the issue may be. Please feel free to contact us with any questions or concerns.
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