Knee Pain
Pain in or around the knee from patellofemoral, meniscal, or tendon issues.
Knee pain encompasses a wide range of presentations including patellofemoral pain syndrome, patellar and quadriceps tendinopathy, meniscal irritation, IT band syndrome, and osteoarthritis. Patellofemoral pain alone affects roughly 23% of adults and 29% of adolescents annually (Smith et al., PLOS One 2018). Importantly, MRI studies (Horga et al., Skeletal Radiology 2020) show meniscal tears, cartilage defects, and bone marrow lesions in over 30% of asymptomatic adults — meaning imaging findings must always be interpreted alongside symptoms.
Common presentations include front-of-knee pain with stairs, squatting, or prolonged sitting (the classic 'movie theater sign'), pain or catching along the joint line, clicking or pseudo-locking, swelling after activity, and a sense of instability or 'giving way'. Sharp lateral knee pain that builds during running suggests IT band involvement; pain at the tendon below the kneecap points to patellar tendinopathy.
Patellofemoral pain disproportionately affects adolescent and young-adult females, runners, and squatting/lunging athletes. Tendinopathies are most common in jumping athletes (basketball, volleyball). Osteoarthritis-driven pain rises sharply after age 50, particularly in former athletes, manual laborers, and individuals with elevated BMI.
A combined, root-cause approach.
JOSPT clinical practice guidelines (2019) for patellofemoral pain recommend hip- and knee-targeted exercise, manual therapy, and patient education as first-line care. We assess the hip and ankle for the true drivers of knee overload, release the quadriceps, IT band, TFL, and calf with ART and dry needling, mobilize the joint and patellofemoral surfaces, and progressively rebuild the glute and quadriceps strength needed to absorb load.
- ART and Graston around the knee
- Hip and ankle mobilization
- Dry needling
- Glute and quad rehab