Most common causes of knee pain.

Most of the time, people think that their knee pain or injury is a structural issue of the knee and that a sports therapy such as a sports massage is useless. Actually, 70-80% of the cases of knee pain are functional issues that a sports massage can resolve completely.

A few days ago, a patient came to our sports clinic for a sports massage and I asked her the reasons for her visit she responded: I know that you can do anything about my knee but just to let you know that I got a knee injury. Actually, we can do many things to fix your knee I have responded to her!
She was not the unique patient who believed that the knee pain was coming from “inside” and that the sports massage would have had no effects to cure or decrease the pain.

This is a wrong belief or misconception about how the knee joint works and what are the most common causes of knee pain. In fact, most of the time the pain is not produced by damage to the knee’s structures such as ligaments, capsule, meniscus, but by a functional issue of the structures that produce its movements such as muscles and its tendons.

The most common functional knee issue are:

  1. General Knee’s Muscles Stiffness.
  2. Particular Knee’s Muscle Knots ( for example rectus muscle ).
  3. Tendons inflammation.
  4. Tendon Strain ( overstretched, torn, or twisted tendon ).
  5. Muscle Strain ( overstretched, torn, or twisted muscle ).

Which muscles sports massage has to focus on to treat knee pain?

Sports Massage has to focus on muscles that have the connection ( through their tendon ) with the knee’s bones where is located the pain.

Knee pain can occur mainly in 4 areas:

  1. The top of the knee.
  2. The outer part of the knee.
  3. The inner part of the knee.
  4. The back of the knee.

If the patient, for example, is experiencing pain in the top of the knee, generally sports massage has to focus on the Quadriceps Femori Muscle ( Quad ) as their quadriceps tendons attach to the Tibia passing to the top of the Patella.

Quadriceps Femori Muscle

Despite these muscles could be the main causes of knee pain, to treat all its possible causes we need to have a systemic view of the issue rather than focus on the trigger point of the pain.

The biomechanics of the knee is quite complex and we need to consider all the muscles interaction that characterize the knee’s movements.

When we cure a knee pain localized on the top of it, we treat not only the quad muscles but their antagonist’s muscles too ( Hamstring ) as if they are tight they make a mechanical opposition to the quad muscles producing their easy fatigue. This happens very often when there is a Long-Term Sports Injury, with recurrent knee pain despite the quad muscles having been cured.

The photo gallery below shows to you the group of muscles involved in knee pain in the other 3 main areas of the joint ( Inner Knee; Outer Knee; Back knee ).

Outer Knee Muscles Attachments

Inner Knee Muscles Attachments

Back Knee Muscles Attachments

Another muscle that we treat with a sports massage when we have a patient that is experiencing back knee pain is the calf muscle. The calves, most of the time, are almost wrongly never considered as a possible cause of back knee pain. The origin of the calves is on the posterior superior femur condyles. As a result, the calves produce the knee flexion and not only the plantar flexion of the feet.

Calf Back Knee Attachment

Benefits of sports massage for knee pain or knee injury.

Sports Massage produces many benefits for the health of our knees. The first objective is to treat the symptoms of knee pain. The second objective is to treat the causes of knee pain or knee injury. The third objective is to recover the physiological biomechanics of the knee joint.

  1. Sports Massage Reduce Knee Inflammation.

The first objective of a sports therapy such as sports massage for knee pain or knee injury is to reduce the muscles’ tension and stiffness to decrease the tendon’s rigidity on the attachment point with the knees’ bones. Both tension and rigidity are the main causes of knee inflammation and knee pain.

  1. Sports Massage Increases Knee’s Muscles Power.

Stiff muscles are shorter than normal and for this reason, they are not able to produce their full power during their contraction. So another aim of sports massage is to ease the muscles bringing them to their physiological length which will permit them a full muscle contraction producing their full power.

Another aspect to consider to increase muscle power is to ease their antagonist muscle because in this way we reduce their mechanical opposition to their agonist’s muscles as explained above.

  1. Sports Massage reduces muscles and tendons pain.

Sports massage eases the muscles’ fibers and decreases the stimulation of both muscles and tendons’ nociceptors.

These nociceptors are stimulated when there is an excessive tendon tension or muscle-fibers stretching produced for example by muscle’s trigger points ( stiff areas alongside the muscle ).

As a result, the nociceptors transmit fewer signals to the brain reducing both muscle and tendon pain.

  1. Sports Massage reduces knee joint frictions.

When the muscles and tendons of the knee are too tense It produces a joint constriction. Because of that, there is less space between the joint’s bones with higher friction between them. Furthermore reduced joint space decrease the Synovial fluid production. So less synovial fluid results in not properly lubricated joints.

This condition is one of the most common causes of the so-called ” Clicking Knees

In this context, sports massage eases the muscles and tendons’ tightness decreasing joint constriction and bones frictions. This allows a higher synovial fluid quantity to flow inside the knee joint for better lubrication.

  1. Sports Massage reduces knee swelling.

One of the most common consequences of knee inflammation and knee pain is the swelling of the knee joint. This condition reduces the knee’s range of motion and produces knee pain.
Sports massage, if properly addressed, reduces the knee’s swelling and helps to remove all the waste cells produced from the inflammation process. As a result, It increases the knee’s range of motion and reduces the knee pain allowing the patient a better movement of the knee.
Reducing the effects of the inflammation process is fundamental to avoid to get adhesions and calcification that are a direct consequence of a chronic inflammation condition.

Knee Pain Self Management Tips

Now I am going to give you some tips about how to manage knee pain by yourself at home.

  1. Ice your knee for 72 hours.

You must ice as much as possible your knee in the immediate after the knee injury or pain. try to ice your knee at least three times a day for about 10-15 minutes each.

  1. After 72 hours do Shock Thermal Therapy.

After 72 hours is better to do shock thermal therapy rather than only icing because It is a combination of Ice Therapy and Heat Therapy at the same time.

It is a very valid therapy for any kind of inflammation, contusion, swelling of muscles, tendons, and the body’s joints.

Please find our complete Home Therapies Guide Here.

  1. Apply an anti-inflammatory gel or cream on the knee.

We advise you to apply 1 or 2 times a day any kind of anti-inflammatory gel or cream on the knee as it will help to reduce both pain and swelling. A local anti-inflammatory is more advisable than a systemic one ( pills ) as it acts directly on the area where is localised the inflammation. But sometimes if the pain is unbearable you can try the pills too.

  1. Keep moving your knee avoiding a static position.

It is important to keep moving your knee joint avoiding static positions like sitting for a long time because it increases the knee swelling, prolongs the waste cell removal, and produces muscle hypotonia.
So if you are in the office, for example, try to stand up every 45-60 minutes and walk for 4-5 minutes. Do some light stretching for the knee joint and come back to sit down.
During the night, while your knee will be in a static position for a long time, place a little pillow under the knee to help the fluid drainage and the waist cell removal.

  1. Keep hydrated and active.

Good hydration is fundamental for the health of our body in general but the healing process in particular. try to drink at least 2 liters of water a day.

Contrary to a common belief that for knee pain you need to get as much rest as possible, we advise you to keep yourself as much as possible active but without overloading too much the knee joint.

The best exercise in the immediate of a knee injury or knee pain are sports like cycling and swimming because you have a good range of motion of the knee but without the stress of the body weight acting on it.

Be aware that if the pain persists for more than 2 weeks we strongly advise you to seek the help of your trusted sports therapist or doctor!


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