Knee Pain: Understanding the Causes and How to Fix It

Purchase the Knee Fix Program on TrainHeroic

DM me “KNEE” or apply for 1:1 support

Knee pain is one of the most common complaints I see, and while people often assume it’s just a result of aging or “wear and tear,” the reality is far more complex. The knee is heavily influenced by what’s happening both above and below it—meaning a lack of mobility in the ankles or hips can force the knee to take on more than its fair share of work. Add in muscular imbalances, past injuries, or sudden increases in activity, and you’ve got a perfect recipe for knee pain.

The good news? There’s a lot that can be done to improve knee function, often without surgery. Let’s break it down.

Why Do Knees Hurt?

There are several potential culprits behind knee pain, and they often overlap:

1️⃣ Quadriceps Muscle Imbalances – The quads help keep the kneecap in place. If one part is working harder than another, the kneecap can track incorrectly, leading to pain (patellofemoral pain syndrome, aka “runner’s knee”).

2️⃣ Compensating for a Lack of Mobility – If your ankles and hips are stiff, your knees end up handling more of the movement and stress. This is especially common in people who sit a lot or don’t do enough mobility work.

3️⃣ Meniscus Issues – The meniscus is like your knee’s suspension system. A tear here can cause pain, locking, or instability. Some meniscus tears can heal, while others may need specific rehab strategies.

4️⃣ Ligament Injuries (ACL, MCL, etc.) – These ligaments provide stability to the knee. Tearing one (like the ACL) is common in sports, but believe it or not, you can function without an ACL if you build strength in the right areas.

5️⃣ Biceps Femoris (Part of the Hamstring) – This muscle crosses the knee joint and can contribute to instability or pain, especially if it’s not strong enough to support the knee’s movement.

6. Patellar Tendinopathy (Jumper’s Knee)

• What it is: Inflammation or degeneration of the patellar tendon (which connects your kneecap to your shin).
• Common causes: Repetitive jumping, running, or excessive strain on the tendon.
• Symptoms: Pain just below the kneecap, especially when jumping, squatting, or going downstairs.

7. IT Band Syndrome

• What it is: Irritation of the iliotibial (IT) band, a thick band of connective tissue that runs along the outside of the thigh and attaches to the knee.
• Common causes: Weak glutes, poor hip stability, or repetitive knee bending (e.g., running or cycling).
• Symptoms: Sharp pain on the outer side of the knee, often during running or after prolonged activity.

8. Hoffa’s Fat Pad Impingement (Fat Pad Syndrome)

• What it is: Irritation or pinching of the fat pad under the kneecap.
• Common causes: Trauma (falling on the knee), hyperextension, or excessive kneeling.
• Symptoms: Pain in the front of the knee, especially when extending the leg fully.