Knee pain cause, symptoms, and treatment with 6 exercises

Your knee is formed by your thigh and your shin bone. Both are covered with a layer of cartilage. Because your thigh bone is round and your shin is flat, they do not fit together very well. That is why there are 2 meniscuses on your shin bone. These ensure that the bones fit together properly and your knee is stable.

For further stability, your knee has an anterior and posterior cruciate ligament within the knee. There are also 2 knee straps on the inside and outside of the knee that provide further stability.

The kneecap is located on your thigh. The kneecap ensures that the forces from your thigh muscles are transferred to your lower leg, allowing you to move your knee. Your thigh muscles provide the strength and stability of your knee.

The bones in your knee are surrounded by the joint capsule. This is a rigid structure that provides further strength to your knee.

The cause of knee pain lies in damage or overuse of one of these structures. This damage can occur because you fall or twist your knee. Twisting your knee puts extra force on the meniscus, cartilage, and ligaments. These can tear, causing pain and instability.

Contrary to what many people think, running is not a cause of knee pain. Runners do not have more or less knee pain than non-runners.

Based on the symptoms of your knee pain, I will now describe the possible causes, so that you can recognize them yourself and treat them appropriately.

Based on the location of the knee pain and the associated symptoms, the cause of the knee pain is often easy to identify. I will now discuss the possible causes of your knee pain per location. 

Pain on the inside of the knee is the most common form of knee pain.

Pain on the inside can be caused by damage to the meniscus or a strain of a knee ligament. This often happens suddenly because you twist your knee or misstep. The knee feels unstable and often hurts when bending. Rotating your knee is also painful. Walking and climbing stairs is painful, but cycling is less sensitive.

Knee osteoarthritis is also most often felt on the inside. This is where the wear and tear begins because the inside of your knee is under the most pressure. Wear and tear of the knee often causes problems when getting up and taking the first steps. The knee feels stiff and maybe a bit swollen and warm. The knee also often cracks a bit more. Cycling goes well, but walking is painful and limited. Bending the knee is also painful and limited. Read here how you can reduce the pain of a worn knee so that you can postpone surgery for years to come.

With a strained inner knee ligament, the knee is painful when fully bent and the knee feels unstable.

By improving strength and stability through the exercises I describe later, you can treat knee pain on the inside of your knee yourself.

The most common cause of knee pain on the outside of the knee is irritation of the tendon plate. This tendon plate runs from the outside of your hip to just below your knee along the side of your leg. When it becomes overloaded or stiff, it rubs over a bone point just above your knee. This is called a runner’s knee.

To treat this form of knee pain, you should also perform the exercises for hip pain. A runner’s knee is more a result of a hip problem than a knee problem.

Other possible causes of knee pain on the outside of your knee could be your outer meniscus or the outer ligament of your knee. These complaints can be caused by overextending or twisting your knee. This is much less common than on the inside of your knee.

Pain around the kneecap is called patellofemoral pain syndrome. The pain is often vague and nagging and cannot be pinpointed in one spot. Sometimes the pain is felt behind the kneecap. The knee feels weak and the pain increases with strain.

Read all about patellofemoral pain syndrome here.

The patellar tendon attaches to the bottom of the kneecap. The patellar tendon runs from your kneecap to the protruding point on your shin bone. The tendon transfers the forces from your thigh muscles to your lower leg. When this tendon becomes overloaded, it irritates directly at the bottom of your kneecap. The pain is mainly felt when climbing stairs and jumping. It is therefore also called a jumper’s knee.

Pain at the back of your knee, in the knee pit is usually caused by overloading the knee. If your thigh muscles are too weak and your knee becomes overloaded, this can result in pain in the back of your knee. The muscles in the back of the knee try to take over the load, causing them to become overloaded. This makes them stiff and can cause pain.

A strain of your anterior cruciate ligament can also cause pain in the back of the knee. The cruciate ligament strain reduces the stability of the knee. As a result, he becomes overloaded more quickly when standing and walking for long periods. This causes a nagging pain in the knee and pain in the back of the knee because your calf muscles compensate and therefore become stiff. Stretching your knee is often painful.

Other possible causes of pain in the back of the knee osteoarthritis, hamstring muscle pain, and calf muscle pain. Your hamstring and calf run over the back of your knee. When these muscles are stiff, this also causes pain in the back of your knee.

By doing the knee pain exercises that I will discuss in a moment, you improve the load-bearing capacity of your knee, allowing the muscles at the back of your knee to recover. This will make your knee pain go away.

All forms of knee pain can be treated with exercises. By making the knee, hip, and thigh stronger and more stable, you reduce the load on the affected structures. This will reduce your knee pain.

The treatment of patellofemoral pain syndrome differs slightly from the treatment of other forms of knee pain. For this treatment, it is best to go to the special page about patellofemoral pain syndrome.

All other causes of knee pain can be treated with the following 6 physiotherapy exercises. For each exercise, I describe what you train with it, how to perform it, and what causes of knee pain it is good for.

If an exercise causes more knee pain, it is better not to perform it (yet).

In addition, you can wear a brace for knee osteoarthritis and meniscus complaints to reduce the burden on the knee and promote the recovery process. Furthermore, cycling on an exercise bike helps to keep your knee flexible and strong against knee complaints.

You can also reduce knee pain in the back of the knee by massaging the back of the knee. By massaging the stiff muscles in your knee, the pain will quickly decrease.

I will now discuss the 6 knee pain exercises.

The purpose of the first exercise is to strengthen your thigh muscles. By strengthening your leg muscles, the load on your knee joint decreases. It will reduce your knee pain. The exercise works for any knee pain, and you can do it right away.

The exercises go like this:

• Lie on your back
• Pull your toes towards you and straighten your knee
• Lift your leg
• Repeat this 10 times
• Do the same with the other leg
• Do this 3 times in a row

You can also find the execution of the exercise in this video.

You will notice that the exercise with your sore knee is harder than with your other leg. The strength of the leg muscles decreases as soon as you develop knee pain. That is because you put less stress on your knee as a result of the pain. When you have done the exercise several times, you will notice that the difference quickly disappears.

At this point, you can increase the number of repetitions to 15 or 20, and you can optionally use an ankle weight to make the exercise even harder.

The second knee pain exercise aims at improving the mobility of your knee. Bending the knee is often painful and limited in the case of pain in the back of the knee, meniscus complaints, and knee osteoarthritis.

That is because the joint capsule enclosing the bones and giving the joint strength has become too stiff.

By stretching the haircut and improving the bending of your knee, your knee will become more flexible, and the pain will decrease.

The exercise goes like this:

• Sit on a chair
• Place your healthy leg in front of your painful leg
• Now push your painful leg back with your healthy leg
• Hold this for 10 seconds
• Repeat this 10 times

You can also find the execution of the exercise in this video.

Repeat this exercise three times a day. As you have done the exercise more often, you will notice that your knee becomes more flexible.

The third knee pain exercise aims at improving the stability of your knee. Your meniscus, knee ligaments, and cruciate ligaments provide the stability of your knee joint. When one of these structures becomes damaged, the stability in your knee decreases. It can make it feel wobbly or make you sink through it. It also overloads the knee joint.

By training the stability of your knee, you ensure that your thigh muscles work better together to guarantee the stability of your knee. Your muscles take over the function of your knee ligaments. This increases stability and decreases knee pain.

This exercise is suitable for all types of knee pain but also ankle complaints.

The exercise goes like this:

• Stand on 1 leg (your sore leg)
• Bend your knee a little bit
• Continue to stand upright
• Hold this for 30 seconds\
• Repeat this 10 times

You can also find the execution of the exercise in this video.

If the exercise becomes too easy, you can do it with your eyes closed. You can even use a balance cushion to make the exercise even harder.

The second exercise focuses on strengthening your hip muscles. Strong glutes and hip muscles ensure that your hip is better positioned above your knee, putting less stress on your knee.

This exercise works for any knee pain, and it is also an excellent exercise for hip pain.

The exercise goes like this:

• Lie on your healthy side with both legs stretched out
• Pull your toes towards you
• Now lift your leg sideways to about 45 degrees
• Repeat this 10 times
• Now turn around and do the same for the other side
• Do this 3 times

You can find the execution of the exercise in this video.

In the beginning, the exercise will be challenging, but later you will notice that the exercise becomes more manageable. You can now try to increase the number of repetitions to 15 repetitions.

The fifth knee pain exercise aims at strengthening your thigh muscles. This exercise is a lot heavier and more taxing on your knee than the first exercise. Therefore, do not start with this exercise until your knee pain has already subsided and the other exercises are going well.

The exercise goes like this:

• Put your left leg in front of your right leg with your knee bent 90 degrees
• Bend your other knee slightly too
• Now bring your bodyweight straight down until your back knee almost touches the floor
• Make sure your front knee stays in place and doesn’t move forward
• Now come back up slowly
• Repeat this 10 times
• Do the same for the other leg
• Do this a total of 3 times per leg

You can also see the execution of the exercise in this photo.

Repeat the exercise 2 times a day and try to build up the number of repetitions slowly.

The last knee pain exercise aims at strengthening the leg muscles. In addition, with squats, you also include your glutes and back muscles.

This exercise is also very taxing on your knees, and you should only do it when your knee pain is improving.

The exercise goes like this:

• Stand with your legs shoulder-width apart
• Stretch your arms forward
• Bend your knees and bring your buttocks back as if you were sitting on a chair
• Repeat this 10 times
• Do this 3 times

You can also find the execution of the exercise in the photo.

When the exercise becomes more manageable, you can increase the number of repetitions to 15-20 and eventually start doing it with weight.