Knee pain is one of the most common chronic pains suffered by Americans. It has a variety of causes\u2014some easy to ID and others not so much. No matter the cause, knee pain can have a major impact on your daily life, since the knee is activated nearly every moment you\u2019re on your feet. So let\u2019s dive into what\u2019s going on under the cap, so to speak, and how you can root out the cause and find relief.<\/p>\n\n\n\n
The knee is a complex joint involving cartilage, muscles, four ligaments, two menisci, and four bones (femur, tibia, fibula, and patella). So complex, in fact, that it\u2019s technically considered two \u201cjoints\u201d: the patellofemoral joint<\/strong> (where the kneecap interfaces with the femur) and the tibiofemoral joint<\/strong> (where the tibia interfaces with the femur). <\/p>\n\n\n\n Numerous muscles surround these joints, including the popliteus, plantaris, gastrocnemius, and hamstrings crossing the back of the knee; quadriceps across the front; IT Band running along the lateral side; and the sartorius and gracilis on the medial side. With so many components involved in a well-functioning knee, it only takes one going awry to cause serious pain\u2014or worse.<\/p>\n\n\n\n Knee pain can present in several different ways. It can be persistent, occur at the beginning of activity and then taper off, ramp up during<\/em> activity, or occur when you\u2019re active and cease when you\u2019re not. The pain can feel achy, fiery, or sharp; and it can present under the kneecap, below or above it, or along the sides. These patterns provide important clues about the source of the pain.<\/p>\n\n\n\n The first step in decoding knee pain is to establish if the pain occurs in <\/strong>active or passive range of motion<\/strong><\/a>.<\/strong> If the pain occurs during passive range of motion\u2014meaning, when the knee joint is moved around by an external force without you actively moving it yourself\u2014you should consult a physician. But if the pain only occurs during active<\/em> range of motion (\u201cAROM\u201d), the cause is most likely muscular, which can often be improved with self-care, physical therapy, or massage.<\/p>\n\n\n\n Pain during active range of motion that presents below<\/em><\/strong> the kneecap<\/strong> around your shin is frequently caused by an issue with the quadricep<\/strong>, as could pain underneath the kneecap. <\/p>\n\n\n\n Pain on the outer side<\/em><\/strong> of your knee<\/strong> could be traced back to the IT band, while pain behind<\/em><\/strong> the knee<\/strong> could be connected to any of the several muscles that cross the back of the knee (see Structure and Components of the Knee above).<\/p>\n\n\n\n There are several ways you can address active range of motion knee pain on your own:<\/p>\n\n\n\n Massage therapy<\/a> is an excellent, low-risk (and relaxing!) way to tackle all sorts of chronic pain, including knee pain. Massage can help reduce inflammation and loosen tight muscles that may be contributing to your achy knees.<\/strong> Here\u2019s how a massage therapist would likely proceed:<\/p>\n\n\n\n To address knee pain with massage, the therapist will likely focus directly on your affected knee, doing gentle cross fiber friction<\/strong> on your patellar and quadriceps tendons<\/strong> (then tendons directly below and above your kneecap, respectively). They will also likely massage the quadriceps<\/strong>, which can entail pressure along the direction of your quad\u2019s grain with palms, fists, or forearms, (like the self massage described above), as well as cross fiber techniques perpendicular to the muscle grain. <\/p>\n\n\n\n On the other side of the leg, the therapist may massage the hamstring<\/strong>, using some of the same techniques described above. They will also work on your calves and shins<\/strong>, targeting such muscles as the gastrocnemius, which crosses the back of the knee. To the extent that you are comfortable, the therapist may address your gluteal muscles<\/strong>, since they can affect function throughout the leg. Your non-affected leg will also be massaged, to address any imbalances or misalignments contributing to your knee pain. <\/p>\n\n\n\n Massage can be employed in conjunction with any of the self-care techniques described above, or with physical therapy.<\/strong> Plus, your massage therapist may have more ideas after working on your body, so be sure to communicate candidly<\/a> with them!<\/p>\n\n\n\nWhat\u2019s Causing Your Knee Pain?<\/h2>\n\n\n\n
Active or Passive?<\/h3>\n\n\n\n
Muscular Causes of AROM Knee Pain<\/h3>\n\n\n\n
Self-Care Techniques for Treating Knee Pain from Active Range of Motion<\/h2>\n\n\n\n
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How Can Massage Help Knee Pain?<\/h2>\n\n\n\n