What's actually going on?

"Knee pain" covers many specific things. The most common diagnoses we treat:

  • Patellofemoral pain syndrome (runner's knee) — pain around the kneecap, worse with stairs, squats, prolonged sitting.
  • IT band syndrome — lateral knee pain in runners and cyclists.
  • Patellar tendinopathy (jumper's knee) — pain at the lower edge of the kneecap.
  • Meniscus injury — both degenerative (in adults) and traumatic (in athletes).
  • ACL sprain or post-reconstruction recovery.
  • MCL/LCL sprain — common in field sports.
  • Knee osteoarthritis — in older adults.

Who gets it?

  • Runners — patellofemoral pain, ITB syndrome, patellar tendinopathy.
  • Soccer, hockey, basketball players — ACL, MCL, meniscus injuries.
  • Older adults — knee osteoarthritis, meniscus degeneration.
  • Children and youth athletes — Osgood-Schlatter and related apophysitis around growth plates.
  • Post-surgical patients — ACL reconstruction, meniscectomy, total knee replacement.

What the evidence says

  • For patellofemoral pain, the JOSPT 2019 CPG (Collins et al.) is clear: hip + knee strengthening beats knee-only work.
  • For knee OA, OARSI guidelines (Bannuru et al., 2019) place exercise and weight management as core, first-line care.
  • For degenerative meniscus tears, the Kise BMJ trial and ESCAPE trial showed exercise is non-inferior to partial meniscectomy at 2 years.
  • For ACL return-to-sport, criteria-based testing (Grindem, BJSM 2016) cuts re-injury risk by 84%.
“The knee is usually the messenger. The hip and foot are often the message.”

The plan

  1. Thorough assessment — identify the specific diagnosis, screen for red flags.
  2. Movement assessment of the whole leg — hip control, foot mechanics, knee tracking.
  3. Manual therapy where helpful — tissue work, joint mobilization.
  4. Progressive loading specific to your diagnosis (heavy slow resistance for tendinopathy, hip-focused work for PFPS, etc.).
  5. Return-to-sport criteria where applicable.

When to seek emergency care

Some symptoms need urgent medical attention — not a chiropractic visit. Call 911 or go to the nearest emergency department for: progressive limb weakness, loss of bowel or bladder control, saddle anesthesia (numbness in the groin/inner thighs), severe unrelenting pain unrelieved by position, signs of fracture after significant trauma, chest pain, stroke-like symptoms (face drooping, arm weakness, speech changes), or any rapidly worsening or unusual symptom.

Bottom line

Most knee pain responds well to assessment-driven rehab. The path back depends on your specific diagnosis — but the principle is consistent: address the whole leg, load progressively, return based on criteria.