Physical Therapist’s Guide to Knee Pain

March 1, 2013 —

Knee Pain

Knee pain can be the result of disease or injury. The most common disease affecting the knee is osteoarthritis, which is caused by the cartilage in the knee gradually wearing away, resulting in pain and swelling. Knee injuries can occur gradually over time, as the result of a direct blow or sudden movement that strains the knee beyond its normal range of motion. Knee pain caused by an injury is often associated with knee cartilage tears, such as meniscal tears, or ligament tears, such as anterior cruciate ligament tears. Repeated stress may also cause sprains/strains to the muscles and ligaments around the knee or direct pain to the knee cap or a condition called patellofemoral pain syndrome. 

A painful knee can restrict movement, affect muscle control in the sore leg, and reduce the strength and endurance of the muscles that support the knee. When an injury has occurred or there is a disease in the knee, you may feel pain in different parts of the knee joint depending on the problem affecting it. By identifying the location of the pain your physical therapist can determine the cause of the knee pain.

The physical therapist will make a diagnosis based on symptoms, medical history and through an examination. A physical therapist may ask you some of the following questions to help diagnose a condition:

  • Where exactly on your knee is the pain?
  • Did you twist your knee?
  • Did you feel a “tearing” sensation at the time of injury?
  • Do you notice swelling?
  • Have you ever felt like your knee joint is “catching,” or “locking,” or will give way?
  • Do you have difficulty walking up and down stairs?
  • Do you have difficulty sitting with your knee bent for long periods, as on an airplane or
  • at the movies?
  • Does your pain increase when you straighten or bend your knee?
  • Does your knee hurt if you have to twist or turn quickly?

Based on the evaluation a physical therapist will develop a customized rehabilitation program, to include a specific set of knee exercises for you. Depending on the severity
of the knee problem, the individual’s age and lifestyle, the therapist may select such treatments as: strengthening and functional exercises, correction of any faulty body
mechanics with walking, running, squatting. Electrical stimulation of the knee to retrain the muscles may also be utilized.

To keep knee pain and other musculoskeletal pain at bay, it’s important to maintain an overall healthy lifestyle, exercise, get adequate rest, and eat healthy foods. It’s also
important for runners and other athletes to perform stretching and warm-up exercises  on a daily basis, especially before beginning physical activity. Ideally, everyone should regularly perform three types of exercises to prevent injury to all parts of the body, including the knees:

  • Range-of-motion exercises to help maintain normal joint movement and relieve stiffness.
  • Strengthening exercises to keep or increase muscle strength.

Aerobic or endurance exercises (such as walking or swimming) to improve function of the heart and circulation and to help control weight. Weight control can be important to people who have arthritis because extra weight puts pressure on many joints, including the knee.

For more information about knee pain (before or after surgery) and physical therapy, visit: