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Knee pain falls into 2 main categories: overuse injuries like patello-femoral pain or acute trauma like an ACL injury. These suggestions are directed at the overuse injuries. If you have a more acute injury be on the lookout for another blog article soon!

Knee Pain

Here are 6 simple suggestions to decrease your knee pain:


1. Wear good shoes

Current footwear tends have people wearing minimalist shoes, flip-flops, sandals and heeled shoes. None of these are likely to help with your knee pain. A good shoe should give your foot support and cushioning. Support is important as if your foot is either collapsing inwards or rolling outwards it will pull your knee with it. Cushioning is important as we tend to spend a lot of time standing/walking on hard surfaces where each step creates shock at the knee joint.


2. Add low impact activities

Low impact activities like cross-country skiing, yoga, Tai Chi, rock climbing, pilates are all good ways to keep knees strong and healthy without overloading them. Biking is a particularly great low impact activity for knees. It moves your knee through a fairly large range of motion, with resistance it will build strength and if you do enough, it will help you to lose weight.


3. Control your weight

If you have weight to lose, this can be a huge help. When walking, the load at your knee can be up to 3x bodyweight each time you put your foot on the floor. With running the loads at the knee joint can be up to 12x bodyweight. In other words losing even 1lb in weight will result in 3lbs less load at your knee joint each time you take a step when walking and 12lbs less load if you are running.


4. See a good physical therapist

In addition to these suggestions, a physical therapist will be able to help you with restoring range of motion, strengthening and giving you more detailed suggestions to improve YOUR mechanics.


5. Avoid end ranges

Sitting cross legged forces your knees to twist placing stress on your joint and the surrounding muscles. Kneeling places your knee in full flexion and creates a lot of pressure under your knee cap. Avoiding these positions will put less stress on your knees causing less pain.


6. Squatting or Getting in/out of a chair

There is a lot of gym-myth about how to squat, but really the function of a knee during squatting or getting in/out of a chair is very simple. Your feet should be about hip width apart. Your knees should point in the same direction as your toes. Your shins and trunk should be fairly parallel (looking from the side) – this will help share the load between your hips, knees and ankles.


These suggestions should help you start to reduce your knee pain. For further help tailored to your specific needs, contact us to schedule an appointment. Call us at (802) 876-1000 or e-mail us at


Some common causes of knee pain are:


1. Patello-femoral syndrome:

This is a mechanical issue where you knee cap does not track properly as you bend/straighten your knee. The back of your kneecap become sore and you may feel clicking under your kneecap. It will be sore to walk up or down stairs, lift weights and even just sitting with you knee bent for prolonged periods (this is also referred to as movie-goers knee since it causes pain just sitting around). The best way to remedy this is by working on the mechanics of your knees. Rest and ice can help and tape can also be used to try to help control your patella as your bend/straighten your knee.


2. Patellar tendinitis:

The patellar tendon runs from your knee cap to your shin bone and can be overused and painful. You will often feel it walking upstairs or downstairs, lifting weights, jumping or pedaling a bike in a heavy gear. The tendon is tender to touch and the pain is typically located at the very bottom point of your knee cap. In severe cases the tendon might actually creak when you move your knee. Feels better with rest and ice.


3. Arthritis:

This typically occurs in older individuals or people with a history of a major knee injury and/or surgery. Symptoms may include pain, swelling, loss of flexibility and a feeling of grinding when moving the joint. With arthritis the name of the game is “do as much as you can without overdoing it”. If you avoid moving your joint it will continue to lose motion making your condition steadily worse – at the same time you do not want to overuse the joint making it so sore that you have to take a few days off from doing anything. Often times people with knee arthritis have a hard time fully extending their knees.


Treating knee arthritis conservatively it is key to try to maintain full extension of the knee as this allows you to use the “screw-home” mechanism of the knee which is a wonderful feat of engineering that saves us energy when we stand and walk. Working on mechanics to balance loads across the joint is also important. If this is not enough you can talk to a surgeon about what other options are available.


4. ITBand friction syndrome:

The ITBand runs over the outside of your knee. Runners are especially prone to ITBand issues. ITBand pain may start as a mild twinge but can become a sharp, stabbing pain on the outside (lateral) of the knee. Some people describe it like someone is tightening a hose clamp and some people have even said it is like being stabbed by a screwdriver. You may even feel it snapping over your outer knee as you walk/run/pedal. Ice and rest help as do foam rollers and stretching. Working on your mechanics and having good shoes if you are a runner or a good bike fit if you are a biker are key to long term resolution.


5. Meniscus:

The meniscus is shaped like 2 saucers that your thigh bone (femur or to follow the analogy the tea-cup) sits in. If they are injured you may have pain with full flexion or full extension of your knee. You may feel clicking or catching as you move your knee and in rare cases your knee may lock (this has to be treated surgically). The meniscus has a limited blood supply so healing is very limited. Some tears will require surgery to fix, but others can be treated by working on mechanics – specifically trying to keep the knee lined up with the foot. People with a lot of rotation at the knee (knee points in and foot points out for example) are putting a lot of stress on the meniscus and can cause damage over time.


6. Ligaments:

Ligaments injuries are associated with a fall or impact of some kind – skiing is a common way to tear a knee ligament. You will often experience significant swelling and your knee will feel unstable – like it is going to give out. You may also hear a pop in your knee if you tear a ligament.


If you have these symptoms you should be seen by orthopaedics to determine the severity of the ligament injury.