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Knee Pain

Knee pain is usually a hip problem or a foot problem. The knee is where you feel it. It is rarely where it starts.

Written by Alexander Khang, ISRM Level 5 Soft Tissue Therapist. 935 sessions delivered. 265+ five-star reviews.

What is Knee Pain?

Knee pain in active populations covers patellofemoral pain (anterior, around the kneecap), IT band syndrome (lateral, sharp with running), and pes anserine bursitis (medial). Each has a distinct pattern.

Patellofemoral pain, common in runners, cyclists, and people who sit for long periods, is driven by how the patella tracks in the femoral groove. IT band syndrome is a compression issue at the lateral femoral condyle, not a friction issue as commonly described. Both are hip problems presenting at the knee.

Knee Pain explained: Patella and patellar tendon, knee joint | Achilles Clinic condition guide

Why it happens

Patellofemoral pain: weak hip abductors and external rotators allow the femur to drop inward under load, increasing lateral patellar stress. The knee is not failing, the hip is not doing its job.

IT band syndrome: the IT band is not tight, it is being compressed because the hip is in a position that increases lateral knee load. Stretching the IT band does not decompress it. Strengthening the hip does.

"Foam-rolling the IT band and stretching the quads is the most popular and least effective approach to knee pain in runners."

How we treat Knee Pain

Assessment

We find which kind of knee pain you have, and check how the hip and foot are loading the knee.

Tension Release

Hands-on soft tissue work around the hip and knee, aimed at what the assessment found.

Strength Rebuild

Building strength from the hip down, then a gradual return to running and sport.

Relevant Clinical Articles

LOWER LIMB

IT band syndrome: compression, not friction

The IT band does not rub against the femur, it compresses. This changes the treatment entirely. Foam rolling cannot decompress it.

Read article

LOWER LIMB

Patellar tendinopathy: the jumping knee

Patellar tendinopathy is driven by compressive load at the bottom of the kneecap. Why stretching and rest both fail, and what helps instead.

Read article

LOWER LIMB

Gluteal tendinopathy: the cause of most lateral hip pain

Lateral hip pain in runners and desk workers is usually gluteal tendinopathy, not bursitis. The distinction changes the treatment entirely.

Read article

Treating this properly

This guide explains the problem. The Knee Pain Programme treats it: a full assessment, then a course of hands-on treatment with the same practitioner.

See the Knee Pain Programme