Knee Pain and Causes


Knee Pain and Causes 

The knee is arguably the most injured joint in the body. It is a complex joint that takes the brunt of compressive forces during standing, walking, and running. Even in people not experiencing pain, the knee can make sounds like Rice Krispies Cereal: Snap, crackle, and pop. Knee injuries can occur at any age and are the result of sudden trauma, overuse, lack of use, or underlying conditions such as arthritis. Pain can be felt around the kneecap, behind the knee, or inside the joint. Common injuries include muscle strains, ligament sprains, patella femoral pain syndrome, patellar tendinitis, IT band syndrome, bursitis, meniscal injuries, and osteoarthritis. Each can have a negative effect on everyday activities such as standing, walking, squatting, climbing stairs, and even getting in and out of a car. Luckily, most knee injuries respond very well to physical therapy and conservative management.  

Common knee injuries include: 

Muscle strains: A strain occurs when a muscle supporting the knee is stretched beyond its limits. This results in pain, tenderness, and tightness around the knee, behind the thigh, or in front of the thigh. Strains usually occur when the muscle is in its most lengthened position (think of a runner pulling his hamstring when the leg is completely straight). Overuse of the muscles in these areas can also lead to tendinitis and tendinopathy.  

Ligament sprains: There are numerous ligaments that stabilize the knee, but the four most important are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Like muscles, a ligament can be sprained when it is stressed beyond its limits. When this occurs, it will leave the knee feeling unstable, often causing it to buckle with weightbearing movements.  

Patella femoral pain syndrome (PFPS): Pain is usually felt around or underneath the kneecap. PFPS is more common in young, active populations during activities such as running and jumping, but pain can also occur during prolonged sitting. The culprit causing the pain is weakened quadriceps and weak areas of the hip that cause the kneecap to move abnormally.  

Patellar tendinitis: Pain is felt below the knee, along the patellar tendon, close to the tibial tubercle (the bony area below the knee). It is a common injury in activities requiring sprinting and jumping when the patellar tendon is loaded or stressed excessively.  It can also make going up and down stairs very difficult. In adolescents, you may see similar injuries referred to as Osgood- Schlatters or Sinding-Larsen-Johansson disease.  


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