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Kinds of Knee Pain

Hey, it’s Jennifer. And I’m here today to talk to you about my PT pet peeve and explain a little more about knee pain.

So a lot of people come in with knee pain on the front of the knee. It’s usually diagnosed as patellofemoral pain syndrome. This is a long fancy term, that sounds really good, but I feel like it’s pretty worthless. Because it just means “knee pain.” And it doesn’t describe why there is knee pain or where exactly in the knee is it. Or even what’s happening. So I want to break it down into four categories of common knee pain. This should actually be a little more useful for understanding what’s happening.

  1. So one kind of knee pain you can get is lateral compression. That’s on the outside of your kneecap. And that can come from stiffness in the outer quad, and the structures that hold your kneecap stable by attaching on the outside of the knee. When those tissues are stiff, they can create extra compression, pulling on that outer edge of the kneecap and pushing it into the structures below it. So there’s a little bit of extra compression on the outer knee. And that bothers you most when you’re getting into a more bent position. So that’s lateral compression.
  2. Medial gapping is when you have pain on the inside of your kneecap. It happens a lot when you tend to bend your knee in when you move. It’s either just structurally the way you’re put together or the way you move. And so when that happens, and that knee is kind of angled in, the structures on the inside of the knee are getting pulled on. So it’s more of like a tension force. And that irritates the structures stabilizing the kneecap on the inner side. So that’s medial gapping.
  3. If you are someone who feels like the whole thing is just on the front of your knee, it’s not really inner outer. That’s called global compression. And that can come from a stiff or tight quad. Or just landing mechanics that are putting your knee in a position where you have more forces encountered at the knee. And so that’s basically your tight quads coming over the top of your kneecap. They push your kneecap down onto the structures below it. So that’s global compression.
  4. And then the fourth category here is tendinopathy. So your pain is more specific, and it’s either right above your kneecap that’s tender, or right below. If either of those spots is specifically giving you pain, that’s what we call tendinopathy. And that is an unhealthy tendon basically. It’s usually from overuse.  Something happens where you’re tendon works above its capacity, and the healing response didn’t quite get all the way there. So the tendon is a little bit damaged and not healing properly or not making its way through the entire healing process. That’s tendinopathy.


So we’ve got lateral compression, or compressing that outer kneecap down onto the structures below it. Medial gapping which is more of a pulling apart of tissues on the inside of the knee. Global compression is tightness coming over the kneecap pushing it down onto everything below it. And then tendinopathy right above or below the kneecap where all those quads kind of turn into a tendon and hook into your shin.

So I hope that sheds a little bit of light on different kinds of knee pain. And each one of these you should work with a little bit differently to get you over the hump and not having knee pain. I recommend scheduling a visit and we can get you started with whatever is going to work well for your particular knee pain. Thanks for reading. Hope this helps!

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Here at Peak Endurance Performance & Physical Therapy we help active adults in the Madison Area get back to the activities they love without pain or limitations. We see people of all ages, ability levels, and individuals trying to get back to a multitude of movements including: getting back into running, women postpartum, CrossFit athletes, climbers, gymnasts, wrestlers, overhead athletes, and your recreational weekend warrior. If you’re looking to get back to the activities that give you meaning, relieve stress, and make you feel like you again, feel free to reach out below and we’ll see if we’re the right fit for you.