Knee Pain
Treatment in Hursville
Where Do You Feel Knee Pain?
The location of your pain can provide useful clues about which structures may be contributing to your symptoms. Although pain location alone cannot diagnose a condition, different tissues within and around the knee tend to produce different patterns of pain.
1. Pain Around Or Behind The Kneecap
This may be associated with:
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Patellofemoral Pain Syndrome (often referred to as Runner's Knee)
Commonly aggravated by:
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Squatting
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Lunging
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Going upstairs or downstairs
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Running
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Prolonged sitting
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Getting up from a chair
2. Pain Directly Below The Kneecap
Pain is often localised and can usually be pointed to with one finger
This may be associated with:
Commonly aggravated by:
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Patellar Tendinopathy
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Jumping
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Sprinting
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Running
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Squatting
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Change-of-direction activities
3. Pain Along The Inner Or Outer Joint Line
Some people may also notice clicking, catching, or swelling after activity.
This may be associated with:
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Meniscal irritation or tear
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Early osteoarthritis
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Joint irritation
Commonly aggravated by:
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Twisting
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Pivoting
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Deep squatting
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Kneeling
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Getting up from a squat
4. Pain On The Outer Side Of The Knee
This presentation is particularly common in runners and endurance athletes.
This may be associated with:
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Iliotibial Band-Related Pain
Commonly aggravated by:
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Running
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Downhill walking or running
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Cycling
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Sudden increases in training load
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Repetitive knee bending
5. Pain Associated With A Twisting Injury
Not everyone with an ACL injury requires surgery, but appropriate assessment is important.
This may be associated with:
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ACL injury
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Meniscal injury
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Other ligament injuries
Commonly aggravated by:
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A popping sensation
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Rapid swelling
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Instability or giving way
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Difficulty returning to sport
6. Generalised Knee Pain with Stiffness
This may be associated with:
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Knee Osteoarthritis
Commonly aggravated by:
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Walking longer distances
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Stairs
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Squatting
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Prolonged standing
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Getting up after periods of rest
Common Questions About Knee Pain
1. Sudden Changes In Activity Or Training Load
One of the most common contributors to knee pain is doing more than the body is currently prepared for. Many knee conditions, including PFPS, patellar tendinopathy, and ITB-related pain, are strongly influenced by load management.
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Increasing running mileage
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Returning to sport too quickly
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More hills or stairs
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Higher gym volume
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Increased jumping activities
2. Movement Demands
While movement patterns may contribute to symptoms, there is rarely a single "perfect" movement pattern that explains all knee pain.
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Running
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Jumping
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Pivoting
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Deep squatting
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Repeated kneeling
3. Strength And Physical Capacity
The muscles around the hips, thighs, and lower limbs help absorb force and support movement. Reduced strength or reduced physical capacity may influence how well the knee tolerates daily activities and sport.
4. Sleep, Stress And Recovery
Poor sleep, high stress levels, and inadequate recovery may influence pain sensitivity and affect how symptoms are experienced.
5. General Health Factors
Smoking, obesity, diabetes, high cholesterol, and some health conditions may influence tendon health and recovery. Understanding these factors allows treatment to focus not only on the painful area but also on the contributors that may be slowing recovery.
When Should I Seek Medical Attention?
Medical assessment may be recommended if you experience:
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Significant trauma or a suspected fracture
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Inability to bear weight
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Rapid and substantial swelling
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A knee that repeatedly gives way
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True locking of the knee
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Significant loss of movement
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Symptoms that continue to worsen despite appropriate care
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Fever, redness, or signs of infection
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Unexplained weight loss with persistent pain
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Severe night pain
How Can We Help With Knee Pain?
At Evergreen Spine & Wellness, we focus on helping you understand why your knee pain developed and what can be done to improve it.
1. Thorough Assessment
We assess the entire lower limb, including the knee, hip, ankle, strength, balance, walking and running mechanics, movement patterns, and lifestyle factors that may be contributing to your symptoms.
Detailed history
Neurological assessment
Movement assessment
Strength assessment
X-ray if indicated
Orthopaedic test
2. Understanding your condition & Making sense of your pain
Our goal is not only to identify the painful structure, but also to understand why the problem developed and what factors may be limiting your recovery.
Understanding what is contributing to your symptoms can help reduce uncertainty and improve confidence in recovery.
3. Understanding Load And Capacity
Knee pain comes down to the balance between the demands on your knee and your knee's capacity. Problem occur when load exceeds capacity. This does not only apply to tendon injuries. Conditions such as patellofemoral pain, osteoarthritis, runner's knee, and some meniscus-related symptoms may also become more sensitive when activity levels increase faster than the knee can adapt. As capacity improves, the knee is often able to tolerate more movement and activity with greater confidence.
4. Treatment
Hands-on care may help reduce pain, improve mobility, and make movement more comfortable.
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Chiropractic adjustment
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Joint mobilisation
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Manual stretching
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Soft tissue therapy
Research consistently supports exercise as an important part of managing many hip conditions.
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Facilitating recovery and building strength and confidence in movement with long-term resilience
Reference
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Bricca, A., Juhl, C.B., Skou, S.T., Roos, E.M. and Thorlund, J.B., 2025. Exercise therapy ‘wears down’ my knee joint: myth or reality? Osteoarthritis and Cartilage, 33(1), pp.1–4.
Deng, F., Razaviasfali, S.M., Birn-Jeffery, A., Cortes, N. and Neal, B.S., 2025. What prognostic indicators and treatment mechanisms exist for efficacious treatments in people with patellofemoral pain? A secondary meta-regression with an updated search. JOSPT Open, 3(2), pp.193–209.
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Filbay, S.R., Culvenor, A.G., Ackerman, I.N., Russell, T.G., Crossley, K.M. and Morris, H.G., 2026. ACL-ARCH: MRI healing criteria and contemporary considerations for anterior cruciate ligament injury management. British Journal of Sports Medicine.
Gleadhill, C. and Barton, C.J., 2021. Infographic: What does current evidence tell us about anterior cruciate ligament rupture management? British Journal of Sports Medicine, 55(17), pp.975–976.
Holden, M.A., Barton, C.J., Dziedzic, K.S., Jones, M.H., Paddison, J.S., Marshall, M. and Mallen, C.D., 2021. Guidance for implementing best practice therapeutic exercise for patients with knee and hip osteoarthritis. The Lancet Rheumatology, 3(5), pp.e338–e346.
Logerstedt, D.S., Scalzitti, D., Risberg, M.A., Engebretsen, L., Webster, K.E., Feller, J., Snyder-Mackler, L., Axe, M.J., Lynch, A.D., Eitzen, I. and others, 2018. Knee pain and mobility impairments: meniscal and articular cartilage lesions revision 2018. Journal of Orthopaedic & Sports Physical Therapy, 48(2), pp.A1–A50.
Neal, B.S., Lack, S.D., Bartholomew, C. and Morrissey, D., 2024. Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. British Journal of Sports Medicine, 58(24), pp.1486–1495.
National Institute for Health and Care Excellence (NICE), 2022. Osteoarthritis in over 16s: diagnosis and management (NG226). London: NICE.
Opara, J., Małecki, A., Małecka, E. and Socha, T., 2023. Stretching and releasing of iliotibial band complex in patients with iliotibial band syndrome: a critical review. International Journal of Environmental Research and Public Health, 20(12), p.6118.
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Sanchez-Alvarado, J.I., Wyndow, N., Willy, R.W., Esculier, J.F. and Barton, C.J., 2024. Effects of conservative treatment strategies for iliotibial band syndrome on pain and function in runners: a systematic review. Frontiers in Sports and Active Living, 6, Article 1386456.
American Academy of Orthopaedic Surgeons (AAOS), 2021. Management of Osteoarthritis of the Knee (Non-Arthroplasty), Third Edition: Clinical Practice Guideline. Rosemont, IL: AAOS.
Williams, B. and Gyer, G., 2025. Tendons under load: Understanding pathology and progression. Journal of Musculoskeletal Surgery and Research, 9(3), pp.393–402.
Willy, R.W., Hoglund, L.T., Barton, C.J., Bolgla, L.A., Scalzitti, D.A., Logerstedt, D.S., Lynch, A.D., Snyder-Mackler, L. and McDonough, C.M., 2019. Patellofemoral pain: clinical practice guideline linked to the International Classification of Functioning, Disability and Health from the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 49(9), pp.CPG1–CPG95.
