3 Common Causes Of Knee Pain

As chiropractors we often see patients with neck and back pain, but knee complaints are another common thing we see in the office. Although the majority of knee complaints are mechanical in nature, it’s important that we test the integrity of the knee to make sure it hasn’t been compromised.

Ruling out any ligamentous or cartilaginous damage helps assure the patient they are in the right place for care and allows us to continue our evaluation to figure out what’s causing the knee pain. Here are the 3 most common causes of knee pain that we see in our office:

Patellofemoral pain syndrome (PFPS) is a condition we see the most often in relation to knee pain. This is most commonly due to exaggerated internal rotation and shifting of the lower outside part of the femur into the patella causing pain around the knee. 

The pain can be exacerbated by activities such as prolonged walking, running, squatting, and stair climbing – especially going downstairs or downhill. There are a couple reasons for the internal rotation and shifting of the femur: hip weakness and hyperpronation of the feet.

IT band syndrome is another condition we often see. This is a common overuse injury, especially in runners, where there’s irritation of the tissues near the lower part of the IT band at the outside of the knee. It used to be thought that the pain was caused by the band snapping back and forth when the knee bends creating friction and irritation to the area. 

However, studies have shown this is not the case and more recent research provides a couple of explanations for the cause of the pain and irritation. At the upper part of the band there may be excessive pulling and tensile strain on the femur where the TFL and glute muscles meet the more tendinous portion of the band. At the lower part of the band, repetitive compression of highly sensitive fatty tissue underneath it may be the cause of pain.

Pes anserine bursitis is the third condition we commonly see. Pain with this is more so on the inside part of the knee. The tendons of 3 muscles all conjoin and attach on the inside of the tibia. These muscles include the sartorius, gracilis, and semitendinosus and they all share a role in flexing the knee. Underneath these tendons there’s a bursa, which is like a thin, lubricated cushion that helps reduce friction where the tendons meet the bone. 

If the bursa is repeatedly placed under stress, it will produce extra fluid and result in a painful inflammation of the area. This inflammatory response can be due to excessive rotation at the knee or that knee constantly diving in towards the midline. This is often seen when there’s weakness at the hip or tightness in the hamstrings.



Dr. Ryan Donahue was born and raised in Sioux City, IA. He attended the University of Iowa where he received a bachelor’s degree in Health and Human Physiology before graduating Magna Cum Laude from Northwestern Health Sciences University as a Doctor of Chiropractic. Dr. Donahue is a Certified Provider of Active Release Technique, RockTape kinesiology tape, and SMART Tools (Instrument Assisted Soft Tissue Mobilization). He has also had extensive post graduate training in various treatment and rehabilitation approaches that include McKenzie Mechanical Diagnosis and Therapy and Dynamic Neuromuscular Stabilization (DNS).

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