Physical Therapist's Guide to Knee Pain

Article courtesy of the APTA


Knee pain can be caused by disease or injury. Among American adults, approximately 25% have experienced knee pain affecting the function of the knee. The prevalence of knee pain has increased over the past 20 years, with osteoarthritis being the most common cause in individuals over the age of 50. Knee pain that is caused by injury is most often associated with knee cartilage tears. Knee injuries can occur as the result of a direct blow or sudden movement that strains the knee beyond its normal range of movement. Knee pain can cause difficulty performing activities such as walking, rising from a chair, climbing stairs, or playing sports. Physical therapists are specially trained to help diagnose and treat knee pain, and help individuals return to their normal activities without pain or limitation.

How Does it Feel?

Knee pain can occur suddenly for no apparent reason or develop slowly, as the result of repetitive trauma. Knee pain occurs in different parts of the knee, depending on what structures in the knee are involved. These structures can include the ligaments, tendons, joint surfaces, cartilage, or muscle meniscus.

What Causes Knee Pain?

The most common cause of knee pain is osteoarthritis, a condition that occurs when the cartilage that protects the inside surfaces your joints gradually wears away, resulting in pain and swelling in the knee. 

How Is It Diagnosed?

Your physical therapist will make a diagnosis based on your symptoms, medical history, and a thorough examination.

He or she will perform an evaluation that will start with discussing your medical history and your symptoms. Your therapist will ask questions to determine where your pain is located, if you sustained any trauma or injury to the knee, and what functional daily activities are painful or difficult for you to perform. For Example:

  • Limited range of motion in the knee
  • Pain in the knee with certain movements
  • Weakness in the muscles around your hip, knee, or ankle
  • Limited flexibility in your hip, knee, or ankle
  • Difficulty walking
  • Difficulty performing activities, such as rising from a chair or climbing stairs
  • Problems with your balance or coordination
  • Difficulty controlling the knee during certain activities
  • Difficulty performing specific sports activities (for athletes)

How Can a Physical Therapist Help?

Based on the findings of your evaluation, your physical therapist will develop a customized rehabilitation program to ensure a safe return to your desired activities. Some general treatment techniques may include:

Pain management: Your physical therapist may provide treatments using different "modalities" such as ice, heat, ultrasound, or electrical stimulation to help decrease pain and swelling.

Manual therapy: Your therapist will apply manual (hands-on) therapy to gently guide movement of the knee area to restore joint and tissue mobility.

Therapeutic exercises: Your physical therapist will prescribe specific strengthening, flexibility, and endurance exercises to address your specific needs and goals.

Functional exercises: You will learn individualized exercises designed to help you return to your home, work, and sport activities. These also may include balance and coordination exercises.

Self-care instruction: Your physical therapist will teach you ways to manage your pain at home, and design a safe and effective home-exercise program based on your specific condition, which you can continue long after your formal physical therapy sessions have ended. You also will learn how to avoid placing unnecessary forces on the knee during your daily activities for years to come.

Can this Injury or Condition be Prevented?

To help reduce knee pain, it is important to maintain a healthy lifestyle, perform regular safe exercise, get adequate rest, and eat healthy foods. Weight management is important for maintaining healthy knee function, as increased body weight puts extra pressure on all the joints, including the knees. Ideally, individuals of all ages should regularly perform some form of flexibility, strength, and heart-conditioning exercises.

It also is important for athletes to perform appropriate warm-up exercises and stretches on a daily basis and before beginning physical activity.

CAUTION: If any exercise or activity provokes knee pain, seek professional help before the symptoms worsen.

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