Knee Pain: Causes, Symptoms, Treatment, and the Role of Physiotherapy

August 28, 2026

Knee pain is one of the most common musculoskeletal complaints seen in people of all ages. Doesn’t matter if you’re an athlete, office worker, homemaker, or 60+ — if your knee hurts, walking, stairs, squatting, even just standing becomes a problem.

The knee is one of the largest and most important joints in the human body. It bears body weight, absorbs shock, and allows movement during walking, running, jumping, and other functional activities. Because we use it every single day, it’s also one of the first joints to get injured or wear out.

The Good thing is most knee pain gets better without surgery. With the right diagnosis, proper exercises, and physiotherapy, most people recover really well.

Let’s Understand Your Knee First

To understand knee pain, it is important to know the basic structures of the knee joint.

The knee is formed by three bones:

Femur (thigh bone)
Tibia (shin bone)
Patella (kneecap)

Several important structures support the knee:

Cartilage

Cartilage covers the ends of the bones and helps them glide smoothly during movement while reducing friction.

Menisci

The medial and lateral menisci act as shock absorbers and help distribute body weight across the knee joint.

Ligaments

Ligaments provide stability to the knee.

The major ligaments include:

Anterior Cruciate Ligament (ACL)
Posterior Cruciate Ligament (PCL)
Medial Collateral Ligament (MCL)
Lateral Collateral Ligament (LCL)

Muscles

The quadriceps, hamstrings, gluteal muscles, and calf muscles work together to control knee movement and maintain stability.

Tendons

Tendons connect muscles to bones and allow movement of the joint.

When any of these structures become injured or irritated, knee pain can develop.

Common Symptoms I See in Clinic

Depends on the cause, but patients usually tell me:

Pain around or inside the knee
Swelling
Stiffness, especially in the morning
Trouble walking
Pain going up/down stairs
Pain while squatting or sitting cross-legged
Clicking, popping, or “locking” feeling
Knee giving way / feeling unstable
Can’t fully bend or straighten the knee
Tenderness around the joint
Pain after sitting too long

Some have mild pain. Others can barely walk and develop severe pain that limits daily activities.

What Actually Causes Knee Pain?

1. Osteoarthritis / “Wear and Tear”

Most common in older adults. Cartilage wears away.

You get pain, stiffness, swelling, and trouble walking. Usually worse with activity, better with rest.

2. Runner’s Knee / Patellofemoral Pain

Pain around or behind the kneecap.

Caused by weak quads, muscle imbalance, overuse.

Hurts more with stairs, squatting, running, or sitting long.

3. Meniscus Tear

Happens from twisting, sports, or just age.

Symptoms: pain on the side of knee, swelling, clicking, locking.

4. Ligament Injuries

ACL, MCL etc. Common in sports.

Sudden pain, swelling, knee feels unstable, can’t put weight on it.

5. Tendinitis

Overuse of quads or patellar tendon. Very common in jumpers and runners.

6. Bursitis

The small fluid sacs around knee get inflamed.

Causes swelling, tenderness, pain with movement.

7. IT Band Syndrome

Tight band on outside of thigh rubs on the knee. Very common in runners and cyclists.

8. Rheumatoid Arthritis

Autoimmune condition. Causes pain, swelling, morning stiffness.

9. Weight

Extra body weight = extra pressure on knees. Speeds up arthritis.

10. Weak Muscles + Bad Mechanics

Weak hips, weak quads, poor walking/posture. This puts extra stress on the knee.

Risk Factors

These are the factors that increase the risk of developing knee pain:

Aging
Obesity
Sports participation
Previous knee injuries
Poor physical fitness
Muscle weakness
Sedentary lifestyle
Poor footwear
Repetitive activities
Occupations involving kneeling or squatting

Diagnosis of Knee Pain

Diagnosis begins with a thorough assessment.

For additional information about knee health and common knee problems, you can also refer to the American Academy of Orthopaedic Surgeons (AAOS).

Being a physiotherapist I start with the evaluation of:

Pain location
Joint mobility: how far can you bend/straighten
Muscle strength: quads, hamstrings, hips
Swelling
Walking pattern
Functional limitations

When necessary, investigations may include:

X-rays
MRI
Ultrasound
CT Scan
Blood tests

Accurate diagnosis helps determine the most effective treatment plan.

Medical Management

Treatment depends on the underlying cause and may include:

Pain-relieving medications
Anti-inflammatory medications
Activity modification
Bracing
Corticosteroid injections
Surgical intervention in severe cases

Most people improve without surgery.

The Role of Physiotherapy in Knee Pain

Physiotherapy is one of the most effective treatments for knee pain. It focuses on reducing pain, restoring movement, improving strength, and helping patients return to normal activities safely.

If you are also experiencing Back Pain, you may find our guide on Back Pain helpful for understanding common causes, symptoms, and physiotherapy treatment options.

Goals of Physiotherapy

The primary goals include:

Reduce pain
Control inflammation
Improve joint mobility
Restore muscle strength
Improve balance and stability
Correct movement patterns
Prevent recurrence
Improve quality of life

Physiotherapy Assessment

A physiotherapist evaluates:

Posture
Gait pattern
Range of motion
Muscle flexibility
Muscle strength
Joint stability
Functional limitations

A personalized treatment program is then developed according to the patient’s needs.

Physiotherapy Interventions

1. Patient Education

Patients are educated about:

Activity modification
Weight management
Joint protection
Proper exercise techniques
Lifestyle modifications

Education plays a major role in long-term recovery.

2. Pain Management

Pain-relieving interventions may include:

Ice therapy
Heat therapy
TENS
Soft tissue techniques
Gentle movement exercises

These methods help reduce discomfort and prepare patients for exercise.

3. Range of Motion Exercises

Mobility exercises help maintain joint flexibility and reduce stiffness.

Examples include:

Heel slides
Knee flexion exercises
Knee extension exercises
Stationary cycling

4. Stretching Exercises

Common stretches include:

Hamstring stretching
Quadriceps stretching
Calf stretching
Hip flexor stretching

Improved flexibility reduces stress on the knee joint.

5. Strengthening Exercises

Strengthening is one of the most important components of rehabilitation.

Exercises may include:

Quadriceps sets
Straight leg raises
Mini squats
Step-ups
Bridges
Sit-to-stand exercises

Strong muscles provide better support and protection for the knee.

6. Balance and Proprioception Training

Balance exercises improve joint stability and reduce the risk of future injuries.

Examples include:

Single-leg standing
Balance board training
Functional stability drills

7. Manual Therapy

Physiotherapists may use:

Joint mobilization
Soft tissue release
Patellar mobilization
Muscle energy techniques

These techniques can improve mobility and reduce pain.

8. Functional Rehabilitation

As recovery progresses, treatment advances toward:

Walking training
Stair climbing practice
Running progression
Sports-specific rehabilitation
Return-to-work activities

Home Advice for Patients

To maintain healthy knees I always advice to:

Maintain a healthy body weight
Stay physically active
Perform strengthening exercises regularly
Wear appropriate footwear
Avoid sudden increases in activity
Warm up before exercise
Maintain flexibility
Practice good posture

Recovery and Prognosis

How fast you recover depends on what’s causing the knee pain, how bad it is, and how regularly you follow your treatment.

Most people see a big difference with physiotherapy and regular exercises.

And the sooner you start, the quicker you heal and the better your knee will stay in the long run.

Conclusion

Knee pain can happen to anyone, at any age, whether you’re active or not.

It can come from an injury, arthritis, weak muscles, doing too much, or just poor movement patterns.

Even though it makes daily things like walking and stairs difficult, the good news is most cases get much better with the right treatment.

Physiotherapy makes a huge difference.

It helps reduce pain, get your movement back, build strength, and get you back to your normal routine.

With a proper check-up, the right exercises, good guidance, and rehab, physio helps you move confidently again and keeps your knees healthy long term.

This article is for educational purposes and should not replace professional medical advice.

Written by Dr Areej Nadeem PT
College of Physiotherapy
JPMC Karachi