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Why Your Knees Hurt and How to Feel Better

By Lauren Bedosky ; Updated November 26, 2016

Among active people, knee issues seem to be as widespread as Spandex clothing. From an annoying, nagging ache to full-blown sidelining pain, nearly every runner, athlete and weekend warrior has experienced knee pain of some form.

Knee pain, however, isn’t inevitable. The following are the three most common causes of knee pain among the active population. See if you recognize any of these in yourself. If you do, follow the simple exercises below to find relief.

The Most Common Causes of Knee Pain

In most cases, it’s a good idea to see a physical therapist if your knee pain has lasted longer than a couple of weeks. See a doctor as soon as possible if your pain is severe and came on suddenly, which may be a sign of a serious injury.

Here are the three most common knee issues that physical therapists see in active people:

1. Patellofemoral Pain Syndrome

Pain level: Mild

Patellofemoral pain syndrome is the number-one knee condition for runners, according to Alice Holland, D.P.T., of Stride Strong Physical Therapy. Aside from running, this type of pain is often caused by other repetitive movements in the forward plane, such as lunges and squats.

The common condition is characterized by pain underneath the kneecap toward the middle of the knee. “If you draw a smiley face under the kneecap, that tends to be the area where it’s irritated the most,” says Holland.

Patellofemoral pain is the mildest of the three types of knee pain and is very responsive to physical therapy. A bit of rest and strength work will help significantly, Holland says.

2. Meniscus Tear

Pain level: Mild to moderate

Common among athletes, a meniscus tear is often caused by pivoting and twisting movements. “Meniscus tears usually happen from an abrupt event,” says Holland. “The athlete could suddenly cut to the left, and that could be enough to tear a meniscus.”

You’ll know you have a meniscus tear if you experience loud, painful clicks in your knee while squatting or using the stairs. Though it will hurt most when running, you may also feel pain when sitting cross-legged or lying down.

Contrary to popular belief, “just because you have a meniscus tear doesn’t mean you need surgery,” says Marc Tompkins, M.D., of TRIA Orthopaedic Center. In fact, surgery is rare and, in most cases, rest and physical therapy are sufficient.

3. Chondromalacia Patella

Pain level: Mild to severe

Chondromalacia patella is a condition in which the cartilage underneath the kneecap wears down, typically due to the constant stress that occurs when runners repeatedly pound the pavement. “Most people who’ve had some sort of athletic career when they were younger have a mild form of chondromalacia patella,” says Holland.

There are varying levels of soreness associated with chondromalacia patella, from a mild ache when squatting to pain so severe that running is impossible. The pain is felt underneath the kneecap in a larger surface area than you see with patellofemoral pain syndrome, and you may occasionally hear crackling sounds.

In mild cases, physical therapy will help correct the issues and ease the pain, while severe cases typically call for cortisone injections or surgery.

Exercises to Correct and Relieve Knee Pain

The way to treat any knee issue is to address poor biomechanics, Holland explains. “All knee pain comes from bad biomechanics. It just depends on which structure is strained over time,” she says.

For those with mild to moderate knee pain, Holland prescribes the following exercises. (Those with severe pain should see an orthopedic doctor or physical therapist.)

Side-Lying Leg Raise

Begin lying on your side with your legs stacked on top of each other. Flex your top foot and lift your top leg as far as you can, all the while keeping your heel slightly behind your body and your toes pointing forward. Perform three sets of 10 reps per leg twice per day. Tip: Bend your bottom knee if needed to provide extra stability.

Mini Squat Hold

Stand with your legs hip-width apart. Hold a railing or bar for support. Lower into a shallow squat (approximately one-quarter to one-third of the depth of a full squat). Hold for 10 seconds, and then return to standing. Perform five 10-second holds twice per day.

Crab Walk

Wrap a resistance band around your legs just above the knees. Begin by standing with legs hip-width apart and knees bent slightly. Step sideways to the right, taking small steps. Move about 25 feet to the right, then reverse the direction. Repeat for a total of two rounds. Perform the routine twice a day.

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