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Understanding Knee Pain: A Performance Physical Therapy Perspective

Knee pain can be a frustrating and debilitating issue, especially when it disrupts your ability to stay active and perform at your best. One of the most common causes of knee pain people face is Patellofemoral Pain Syndrome (PFPS). Often referred to as "runner's knee," PFPS can affect anyone, from seasoned athletes to those just starting their fitness journey. Check out the video below to learn more about PFPS.



At The Impact Initiative Physical Therapy & Performance, we take a holistic approach to treating PFPS by addressing both the symptoms and the underlying causes. Here's how we tackle this common issue and some practical exercises you can incorporate into your routine.


The Underlying Cause of Knee Pain: Weak Hips and Quads

PFPS is often the result of biomechanical imbalances that place excessive stress on the patellofemoral joint. Weakness in the hips and quadriceps can lead to poor tracking of the kneecap, increasing the likelihood of pain and dysfunction. By strengthening these areas, we can help realign the knee and reduce the stress that contributes to PFPS.


Initial Knee Pain Relief: Soft Tissue Techniques

Before jumping into exercises, it's important to manage the pain and inflammation. Soft tissue massage, dry needling, and cupping are effective techniques we use to reduce pain and improve tissue quality. These methods help to release tight muscles and trigger points, improve blood flow, and prepare the muscles for strengthening exercises.


Key Exercises to Implement

Once the pain is under control, it's time to focus on strengthening the muscles that support your knee. Here are two key exercises that target the hips and quads. Before implementing any exercises, be sure to consult with your physical therapist as there is no one size fits all approach to your health.

  • Side Lying Plank with Clamshells for Hip Strength

    • Why: The gluteus medius plays a crucial role in stabilizing the pelvis and knee during movement. Weakness in this muscle can contribute to poor knee alignment.

    • How: Lie on your side with your legs stacked and knees bent at a 90-degree angle. Position your elbow directly under your shoulder, forearm flat on the floor.

      Engage your core and lift your hips off the ground into a side plank, creating a straight line from your head to your knees. Keeping your feet together, lift your top knee as high as possible without rotating your pelvis. Hold for a second at the top, then slowly lower back down. Hold the side lying plank with clam for 10 sec x 5-10 each on each side

    • Progression: Add a resistance band around your thighs to increase the challenge.

    • Check out our video to see how this exercise is done!


  • Single Leg Box Squats for Strengthening Quads

    • Why: Strong quads help support the patellofemoral joint, reducing stress on the knee during activities.

    • How: Start with a box or bench that is at knee height or slightly lower. Stand a few inches in front of the box, facing away from it. Stand on one leg with your other leg extended straight out in front of you. Keep your weight centered over your standing foot. Be sure to engage your core throughout the movement. Slowly lower your hips back and down toward the box, as if you’re sitting on it. Keep your knee in line with your toes, avoiding any inward collapse. Once your hips lightly touch the box, pause briefly without fully sitting down. Push through your heel and engage your glutes and quads to return to the standing position. Perform 2-3 sets of 8 reps on each leg.

    • Progression: As you become more comfortable with the movement, you can lower the height of the box to increase the challenge.

Addressing Patellofemoral Pain Syndrome involves not just treating the pain, but also correcting the underlying muscle imbalances. By strengthening the hips and quads, you can improve knee stability, reduce pain, and prevent future issues. If you're dealing with knee pain, reach out to us at The Impact Initiative Physical Therapy & Performance for a personalized assessment and treatment plan.


Fitness-Forward. Evidence-Based. Impact-Driven.

Woodstock Performance Physical Therapy


Woodstock Physical Therapy

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