Knee pain is a widespread issue that affects millions of Americans every year. Whether caused by an injury, arthritis, or biomechanical imbalances, knee pain can significantly impact daily life, limiting mobility and function. Understanding the root causes of knee pain and addressing them with proper treatment is key to long-term relief and recovery.
Key Knee Pain Statistics
Knee pain is more common than ever, with research showing a steady increase in cases over the past two decades. Here are some key statistics to consider:
25% of American adults struggle with chronic knee pain.
Approximately 45% of individuals will develop knee osteoarthritis in their lifetime.
The prevalence of knee pain has increased by 65% over the past 20 years.
Knee pain accounts for 4 million primary care visits annually and is a leading cause of disability and loss of mobility.
With such a high prevalence and in order to provide the best Physical Therapy treatment, it's crucial to understand the structure of the knee joint and how injuries or conditions develop.
Overview of Knee Anatomy
The knee joint is a complex joint in the body, playing a vital role in movement and stability. It is classified as a synovial hinge joint, consisting of synovial fluid (for joint lubrication) and allowing for knee extension (straightening) and flexion (bending). However, unlike a traditional hinge joint, the knee also has a small degree of rotational movement, which helps with function and adaptability.
The knee joint is composed of three main bones:
Femur (thigh bone)
Tibia (shin bone)
Patella (knee cap)
In addition to bones, several soft tissue structures support the knee, including:
Ligaments: Provide static stability by attaching bone to bone. A few important knee ligaments include:
Anterior Cruciate Ligament (ACL)
Posterior Cruciate Ligament (PCL)
Medial Collateral Ligament (MCL)
Lateral Collateral Ligament (LCL)
Medial Patellofemoral Ligament (MPFL)
Tendons: Attach muscle to bone, with the most notable being:
Patellar tendon - Below the kneecap
Quadriceps tendon - Above the kneecap
Knee Meniscus: Two menisci (medial and lateral) sit between the femur and tibia, providing cushioning, stability, shock absorption, and joint congruency.
Common Knee Injuries
Several knee injuries and conditions can cause pain and dysfunction. The most common injuries include:
1. Patellofemoral Pain Syndrome (PFPS)
Often referred to as “runner’s knee,” PFPS is characterized by pain in the front of the knee, particularly around or behind the patella. It is usually caused by overuse, muscle imbalances, or poor biomechanics.
2. Meniscus Injury
Meniscus tears occur due to twisting motions, sudden stops, or degenerative changes over time. Symptoms often include pain with deep squats/stairs, sharp and painful clicking, and a locking sensation in the knee.
3. ACL Tear/Sprain
The ACL is one of the most commonly injured knee ligaments, particularly in athletes. ACL injuries typically occur from sudden deceleration, pivoting, or direct contact. A complete tear may require surgery, while mild sprains should be treated with rehabilitation.
4. Knee Osteoarthritis (Osteo = Bone / Arthro = Joint / -itis = Inflammation – aka Knee Joint Inflammation)
Osteoarthritis is the most common form of arthritis affecting the knee. It occurs due to cartilage breakdown, commonly leading to pain, stiffness, and swelling. This is routinely and negatively described as “bone on bone.” Risk factors include age, obesity, and previous knee injuries; however, natural joint degeneration should be considered normal - especially at weight bearing joints - and osteoarthritis does not guarantee pain symptoms. This is why many people have arthritic changes at multiple joints; however, they are not in pain.
Cutting edge research from the American Academy of Manipulative Therapy (AAMT) highlights the benefits of specific Osteopractic dry needling protocols for knee osteoarthritis. Studies have shown that Osteopractic dry needling significantly reduces pain, improves function, and enhances mobility in individuals with knee arthritis, making it a valuable addition to traditional physical therapy interventions.
5. Jumper’s Knee (Patellar Tendinopathy)
Common in athletes who perform repetitive jumping motions, this condition is caused by overuse of the patellar tendon. Symptoms include pain just below the kneecap, especially during activities like squatting, jumping, or running.
This is not to be confused with Osgood-Schlatter’s Disease (OSD) which is an inflammatory condition at the attachment of the patellar tendon to the shin bone and more commonly seen in children who are both going through growth spurts and involved in jumping/plyometric sports.
Common Threads Needing to be Addressed with All Knee Injuries
Understanding the underlying root cause of knee pain is paramount before jumping into treatment. While some basic exercises may be useful, others can be detrimental depending on the condition. Take the following points:
The Correct Diagnosis Matters: Not all knee pain is the same. A thorough assessment is necessary to determine if an injury involves the joint, ligaments, tendons, or other structures.
Are Seated Knee Extensions (Kick-Outs) Good or Bad?: This exercise may be helpful for some injuries but harmful for others. A quick example is simply that seated knee extensions can be problematic for individuals with patellofemoral pain syndrome but useful for post-surgical ACL rehabilitation.
Hip Strengthening Is Always Crucial: Many knee injuries stem from weak hip muscles, which can lead to poor movement patterns and increased stress on the knee. This leads to another, more important question – Why are your hips and/or glutes weak?!
Ankle Mobility Plays a Role in Knee Pain: Limited ankle dorsiflexion (toes to nose) can alter movement mechanics, increasing strain on the knee.
What’s Happening at the Lumbar Spine?: The body functions as a connected system, meaning that biomechanical issues at the lower back or pelvis can contribute to knee dysfunction.
In other words - I always tell my patients - a leaky pipe in the ceiling will cause a puddle on the floor. Sure it is important to mop up the puddle on the floor (treat the knee pain), but we must address the leaky pipe (hip strength? / ankle mobility? / lumbar spine? / hip biomechanics? / and many more) or the puddle will always return.
Importance of a Differential Diagnosis
Before starting a generic knee exercise routine for knee pain, a comprehensive Physical Therapy evaluation is necessary to pinpoint the exact root cause and diagnosis. A differential diagnosis ensures that treatment is tailored to the individual's needs rather than a cookie cutter approach.
Putting It All Together
A thorough Osteopractic Physical Therapy Evaluation, performed by a Fellowship-Trained Physical Therapist, is crucial for accurately diagnosing and efficiently treating knee pain. At Flow Physical Therapy and Wellness in Lafayette, Louisiana, we always provide comprehensive 60 minute, uninterrupted physical therapy treatments consisting of a customized mix of dry needling, cupping, scraping, joint mobilizations, spinal manipulations, and corrective exercises addressing not only the knee but also biomechanical factors above and below the kinetic chain.
If you’re struggling with knee pain and looking for expert guidance, click the button below to schedule an evaluation with Flow Physical Therapy and Wellness today and take the first step toward lasting relief and improved mobility!
Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Owner of Flow Physical Therapy and Wellness
337-366-1703
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