Knee Pain - Physical Therapy Exercises

Reasons for knee pain

If you’re not dealing with a specific injury - say, a torn ACL - sorting out knee pain can seem complicated. The knee is composed of two joints: the tibiofemoral joint, between the femur (thigh bone) and tibia (shin bone), and the patellofemoral joint, between the femur and patella (knee cap). Each is an anchor point for multiple tendons, fascia, and other structures, including the IT band. If you have bad biomechanics, typically caused by a muscle imbalance, especially weak glutes, repetitive movement can irritate structures in the knee and lead to what is broadly known as anterior knee pain - a catchall category for general pain in the front of the knee.
The stabilizer muscles for the knee, counterintuitively, are in the hips. When those muscles are weak or imbalanced, they can’t keep your knee properly aligned. “If you’re not able to control the position of your leg as your foot makes contact with the ground, pedal, or rock, it can result in increased stress to the structures of the knee. To further complicate the issue, once the pain signals your brain that there’s a problem, this can lead to further compensations in response to the irritation, which can shut off key muscles and tighten up other structures.

Explanation of all the muscles that need to be strengthened and why:


Quadriceps.

They cover the front of the thigh, cross the kneecap and form a tendon known as the patellar tendon. The quadriceps muscles allow you to extend or straiten the knee. If there is a weakness or tightness in the quadriceps you will get pain and stress in the joint as you go upstairs or get up from a chair.

Hip adductor muscles.

Hip Adductors allow you to adduct your leg or bring it to the midline of the body. They help to stabilise the hip joint and help maintain the body in a stationary position.

Hip flexor muscles.

Hip Flexor muscles allow you to flex your hip. Hip Flexor muscles come from the spine and the pelvis and attach to the upper thigh bone. If the hip flexors are tight or weak they can pull the thigh out of its proper alignment. This in turn pulls the kneecap out of its groove causing knee pain.

Hamstring muscles.

Hamstring muscles allow you to bend the knee and also extend your hip. Most importantly strong hamstring muscles will help you protect a very important ligament called the ACL.

Gastrocnemius muscle.

People with weak calf muscles often complain of pain in the front of the knee around the patellar tendon area.

Gluteus medius.

Gluteus medius allows you to perform activities including hip abduction and hip external rotation. When you’re walking you’re only on one foot at any given time. The Gluteus medius help you to stabilise your pelvis. If it’s weak you get a drop in your hip and that causes stress on the knee.

Gluteus maximus.

It allows you to extend your hip and externally rotate your hip. If the Gluteus maximus muscles are weak other muscles in the back of the leg tend to take over and you end up with overly active hamstrings and tight hamstrings lead to knee pain.