Knee Pain: Everything You Kneed to Know

The first in our monthly Physiotherapy series, we will be going throughout the body and telling you all you need to know about a given body part, its dysfunction, and steps you can take to improve it.

“Exercise is medicine, and the only bad posture is the one you stay in!”

The Knee

The largest joint in the human body, it is a hinge joint of the lower extremities that allows flexion, extension, and slight internal/external rotation. Stresses of the knee include weight-bearing, extension-locking, and impacts, twists, and turns.

Dysfunction

There are many different causes of knee pain and dysfunction. There are many different common causes of knee pain, stiffness, and tenderness that vary across different age groups, and can prevent us from being active. Common conditions include:

  • In Children; patella subluxation, osgood schlatters

  • In Adults; patella femoral pain, bursitis and trauma injuries such as ligament sprains and meniscal injuries 

  • In Older Adults; osteoarthritis, gout and bakers cyst

Treatment

Treatment for knee pain can vary depending on the underlying cause, but a proven treatment method is an exercise program. Talk to your doctor to if a serious pathology is expected or immediate investigation is needed, and consult a physiotherapist for an in-depth, personalized knee rehab program and support (book now, no doctor referral needed).

In treating knee pain with exercise, there isn’t a huge difference between different knee rehab protocols - they all aim to get the knee functioning fit and healthy again in a very similar way and often involve activating the hip, knee, and ankle muscles (separately and in unison). Recent studies have shown participating in a variety of physical activities including aerobic exercises (cycling, cross trainer, swimming) and strength training were found to be the most effective course of action in treating knee pain [1][2]. Pain should start to settle within 2 weeks, and typically, muscles take 4 - 6 weeks to respond to a strengthening program enough to really start to notice a functional difference in a typical case with proper guidance and execution.

Our Recommendations

  • HIIT style program 3 times a week; 20 minutes of alternating between 20 seconds of hard exertion and 30-40 seconds of rest

    • Timing and consistency are key

    • Start with low reps, pain-free ranges and work up

  • Seeing a physiotherapist for guidance with form and the desired intensity, duration, and frequency for your stage of recovery

5 Exercises for Knee Pain

  1. Single Leg Multi-Direction

    Using a slightly raised, stable surface, balance on one leg and do a shallow squat on that leg and move the other leg forwards, return to the upright position and repeat outwards, and backwards.

  2. Squat

    Standing with feet facing forward shoulder-width apart, slowly lower into a shallow squat position and then return to the upright position by imagining you are going to do to a vertical jump.

  3. Single Leg Dead-lift

    Stand on one leg, holding a kettlebell in the opposite hand. Keeping that knee slightly bent, perform a stiff-legged deadlift by bending at the hip and pulling the weight upwards towards your hip, extending your free leg behind you for balance. Continue lowering the kettlebell until you are parallel to the ground, and then return to the upright position.

  4. Forward Lunge with Heel Raise

    Stand with the feet hip-width apart. Step into a forward lunge position. Lift and then lower the heel with control. Drive the heel into the ground to return to the starting position.

  5. Modified Backward Lunge with Knee Bias

    Step into a backward lunge position and lean your weight onto the back leg. Lift the heel of your back leg and drive your toes into the ground to return to the starting position.

[1] https://ard.bmj.com/content/64/4/544.short

[2] https://www.jospt.org/doi/abs/10.2519/jospt.2003.33.11.647