What causes knee pain? Patella maltracking and other problems

what causes knee painAt KneeStrength.com, we focus very much on overcoming patella maltracking as a means to dealing with knee pain. This is because the incorrect tracking of the patella, caused by muscle imbalances pulling the knee cap to one side, is one of the most common forms of knee pain. It is also the problem we have most personal experience with.

It is important to note that patella maltracking is not the only cause of knee pain; but bear in mind that the correct body mechanics we teach to resolve knee pain generally apply to other problems that may arise. Sadly, treating physical problems by correcting body movements is not something that healthcare institutions like to admit. So what other problems may you face with your knees, and how does correcting your body mechanics fit into the treatment?


Strains from Overexertion

A commonly cited cause for knee pain is strains, usually accounted for by ‘overexertion’. And a common way to deal with this, as you’ll find in traditional healthcare publications, is that strains can be avoided with warm ups and stretches, and often they can be resolved through rest. This kind of thinking is incredibly generalist; in actuality a strain could refer to an infinite number of entirely different injuries – some of which will actually get worse if your only solution is to rest.

Dismissing a problem as a strain promotes ignorance of your body, and what caused you to develop a problem. Further, warm ups and stretches performed improperly will certainly do you more harm than good. These kind of seemingly minor knee problems can be addressed, and can be avoided. But if you want to do it right, they require the sort of understanding that lets you know why they occur, and what movements you can correct do to address them.


Referred knee pain

Anterior knee pain syndrome is another blanket term used to describe many knee problems. Covering general pain at the front of the knee, the general advice you may hear is that the syndrome is not well understood. This gives it an air of mystery, which in turn provides an out when it comes to treating it. After all, if something is not fully understood, it’s best left alone, right?

The problem with this line of thinking is that anterior knee pain is understood. It is symptomatic of patella maltracking and the general muscle imbalance issues we have covered extensively on this site. Knee pain in the anterior of your knee, the front, may be caused by referred pain from trigger points in your quads. The position of this pain can vary depending on where in the quads the trigger points develop, and can also come from trigger points in the adductors. Trigger points can be addressed with foam rolling (or skilled massage), and prevented through the same biomechanic training we use to avoid patella maltracking.

We have seen traditional healthcare publications describing the ‘causes’  for these problems as relating to climbing actions. Actually these are more likely further symptoms of general muscle imbalance –  you climb, walk and sit incorrectly, all because of the muscle imbalance and the pain it causes, not the other way round. Our articles on sitting correctly, and general building of movement strength, can help with this.


Physical damage to the knee and surrounding area

Injuries and over-exerted movements, from stretching too far or twisting at an awkward angle to receiving blows or breaks to the leg, can cause a variety of lasting problems with knee pain. It is unlikely for you to develop these problems without noticing the moment that they are caused.

Tears in a meniscus (the tissue between the knee bones), or tears in ligaments, for example, can be caused by a sudden twist of the knee, while damage to the cartilage of the knee can also cause pain. These problems have varying degrees of severity; in some cases they may heal on their own, and in others they may require surgery. There is no telling when life might throw injury your way, but strength and movement training can help you reduce the risk of your body ending up in a position where a sudden impact/exertion is likely to cause an acute injury. It will also help you make a faster recovery.


Age-related problems

There are numerous ways the body can change as we get older, giving us another area for blanket excuses of body deterioration and knee pain. Prominent trainers insist, however, that if you move correctly, the tissues in the human body are designed to last about 120 years before they start to break down. The problem is that no-one moves 100% correctly.

One common problem that arises with age is when the tissue between the upper and lower leg bones at the knee joint, called menisci, which helps cushion the bones, become worn; the bones can rub and cause pain. Another problem, with repeated attacks of knee pain, may be osteoarthritis, when the arthritis does damage to the knee cartilage. Both of these issues ultimately come from imperfections in movement; the imperfections may be very slight, but the longer you live the more those imperfections will add up.

At the other end of the adult age spectrum, a knee pain problem common in adolescence is Osgood-Schlatter’s disease. This is found in teenagers who in engage in a high level of sport, when the top of the shin bone below the knee is continuing to form (osteochondrosis at the tibial tuberosity) – and the usual advice given is that if you wait, the growth will finish and the pain will stop. You may notice a common theme here – if you understand the mechanical reasons for this high tension on the tibial tuberosity, stemming from overly tight quadriceps and asymmetrical forces pulling on it, the problem can in fact be fixed. You don’t need to wait and hope for the best.


This short introduction is not an extensive list of knee problems and solutions, but is meant as an introduction, and a warning. The way the institutional medical world is led to dealing with many problems is to group them vaguely and treat them dismissively. While this website’s primary focus is in dealing with patella maltracking, the same principles used to tackle that problem will also lead you to develop the correct mentality and personal knowledge about your body mechanics to deal with any of these problems.

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