Most Common Causes of Knee Pain

In the United States, roughly 25% of adults report knee pain.

There are roughly 700,000 knee surgeries that occur within a single year.

But what happens if you address the symptom (pain) without addressing the reason it's there in the first place?

This is where I hope to change your mind.

Is Pain the Problem?

Often times, people go to their doctor to determine the cause of knee pain. Next steps are usually to get an X-ray or MRI, you find some arthritis or some deterioration (common signs found in most adults who get X-rays). From there, you get some pain pills, a knee brace, some simple exercises, and usually recommended an injection or surgery to solve.

But does it truly solve the issue?

A research study from 2020 makes us ask a different question - here's what they found:

• Out of 230 knees that had MRIs, 97% of those had abnormalities found in their images (arthritis, meniscal issues, etc.)

  
  

• 100% of those people were asymptomatic, meaning that had NO pain.

  
  

• This means that what you see on the X-ray or MRI, might not be the root cause of your pain.

  
  

What does this mean? Your pain may be originating from an imbalance going on within your body. Not your knee itself.

Your Knee is the Middle Man

The knee joint is one of the most stable, strongest joints in our body. It is called a "hinge" joint and it does 2 simple movements - flex (bend) and extend (straighten). When pain arises, it is more often than not due to more work/force going to your knee, because a neighboring joint nearby isn't doing its job to the fullest.

• Foot & Ankle Position: If you've had a previous ankle injury, this may be where I look first. By simple turning your ankle to cave in or roll out, your knee position changes. This can cause torque to the knee joint and pressure on the inside or outside of your knee. Think about when you are hiking on uneven surfaces or walking on the beach - your ankle should work as a "shock absorber" to prevent more work for your knee.

  
  

• Hip Tightness & Position: If your hip is tight or you've had a history of low back pain, this may be your main contributor. The same way your ankle works, your hip does the job from the top down. If you twist your body to change directions or bend down to pick up something, and you feel it in your knee - this may be because your hip isn't allowing the proper amount of rotation, leading to a twisting force directly to the knee.

  
  

• Muscle Imbalances: If you tell me the front middle of your knee is where you feel it, this is likely due to a muscular imbalance. I often find that quad-dominant people (meaning, people who have really strong quads), end up biasing the quadricep muscle when they move more. When you overuse the quadricep muscle, the tendons that hold your knee cap in place have more tension. If this is you, we may work on balancing out the strength of your glutes and hamstrings to better support knee movement.

  
  

These 3 simple root causes are often huge contributors to knee pain. Which one might be you?

Everything is Connected

If these situations resonate with you, your knee might not be the problem. It may be where you are feeling the symptoms of pain and the "extra work" your body is putting on it. My suggestion to you would be to ensure that every part of your body is doing its job well, before you start down the pathway of pain pills, injections, and surgery.

Addressing knee pain isn’t just about making the pain go away -- it’s about restoring balance throughout the body. When you strengthen the right muscles, improve mobility, and retrain how you move, you’re not only reducing pain -- you’re preventing it from coming back.

The key is to think of your body as a connected system, not a set of isolated joints. When one part isn’t moving well, another will always try to pick up the slack. The longer that imbalance goes unchecked, the more strain your knees (and other joints) will take on.

Why Physical Therapy Might Be The Right Next Step

Research shows that musculoskeletal imbalances can explain nearly 40% of the variation in knee pain, yet these imbalances can’t be “seen” on an X-ray or MRI. This is where physical therapy shines.

A movement-based evaluation can identify how your hips, core, and feet are influencing your knee mechanics -- and help you correct the real cause of your pain. Instead of chasing symptoms, we help you retrain your movement patterns, build joint stability, and restore efficient strength where your body needs it most.

For many people, that means fewer injections, fewer medications, and a much smaller chance of ending up in that group of 700,000 surgeries each year.

What Next...?

If you’ve been living with knee pain -- or you’re tired of trying quick fixes that don’t last -- this is your sign to take a deeper look.

With Realigned by Regan, I help you get to the root of your pain, restore balance throughout your body, and move confidently again. Whether you’re recovering from an injury or just want to feel stronger and more capable, your path starts with a personalized movement assessment.