The knee is the largest and most complex joint in the human body, and one of the most injury-prone. It bears the full weight of the body during walking, running, and jumping, while also tolerating rotational forces that can stress its ligaments, cartilage, and tendons. Understanding the most common knee injuries helps you recognize what's happening in your body, seek appropriate care, and prevent future problems.
1. ACL Tear (Anterior Cruciate Ligament)
The ACL is one of the four major ligaments stabilizing the knee, running diagonally through the center of the joint to control rotational movement and prevent the tibia from sliding forward on the femur. ACL tears are among the most feared sports injuries, affecting an estimated 200,000 Americans annually.
Causes: Sudden deceleration, pivoting, cutting movements, or landing from a jump. Common in basketball, soccer, skiing, and football. A hallmark of ACL injury is the sensation or audible sound of a "pop" at the moment of injury.
Symptoms: Immediate severe pain, rapid swelling, instability or "giving way" of the knee, limited range of motion.
Treatment: Depends on severity and activity demands. Partial tears and lower-demand individuals may recover with conservative care including physical therapy and corrective exercise. Complete tears in active individuals typically require surgical reconstruction. Post-surgery, a structured rehabilitation program, including corrective exercise to restore neuromuscular control, is essential for preventing re-injury.
2. Meniscus Tear
The menisci are two C-shaped pads of fibrocartilage that sit between the femur and tibia, providing cushioning and distributing load across the knee joint. Meniscal tears are extremely common, occurring in both acute trauma and gradual degeneration.
Causes: Acute tears result from twisting or compressing the knee while bearing weight. Degenerative tears occur gradually with age and wear, often without a specific traumatic event.
Symptoms: Pain along the joint line, swelling, stiffness, locking or catching sensations, difficulty fully bending or straightening the knee.
Treatment: Many meniscus tears, particularly degenerative ones, respond well to conservative management including rest, anti-inflammatory measures, physical therapy, and chiropractic care to restore joint mechanics. Tears involving locking or significant mechanical symptoms may require arthroscopic surgery.
3. Patellar Tendinitis (Jumper's Knee)
Patellar tendinitis is an overuse injury affecting the tendon connecting the kneecap (patella) to the shinbone (tibia). This tendon transmits the force of the quadriceps muscle during jumping and explosive movements.
Causes: Repetitive jumping and landing, rapid increases in training load, quad-dominant movement patterns, and poor landing mechanics. Common in volleyball, basketball, and track athletes.
Symptoms: Pain and tenderness at the patellar tendon, typically just below the kneecap. Pain with jumping, squatting, and stairs. Initially painful after activity; in chronic cases, painful throughout.
Treatment: Corrective exercise addressing quad dominance, hip weakness, and landing mechanics is the cornerstone of long-term recovery. Eccentric exercises (particularly decline squats) have the strongest evidence. Chiropractic care can address contributing biomechanical factors in the hip, knee, and ankle.
4. IT Band Syndrome (Iliotibial Band Syndrome)
The iliotibial band is a thick band of connective tissue running from the hip down the outer thigh to the knee. IT band syndrome occurs when this band repeatedly rubs against the lateral femoral condyle during repetitive knee flexion and extension.
Causes: Running, particularly downhill or on cambered surfaces, cycling, weak hip abductors, excessive foot pronation, and rapid increases in training volume.
Symptoms: Sharp or burning pain on the outer side of the knee, typically appearing after a predictable distance of running and resolving with rest. No swelling or instability.
Treatment: Corrective exercise targeting hip abductor (particularly gluteus medius) strengthening is highly effective. Foam rolling the IT band provides temporary relief but doesn't address the root cause. Chiropractic evaluation often reveals hip or sacroiliac dysfunction contributing to altered lower extremity mechanics.
5. Bursitis
Bursae are small fluid-filled sacs that cushion areas of friction around joints. The knee has several bursae; the most commonly inflamed are the prepatellar bursa (in front of the kneecap) and the pes anserine bursa (on the inner side of the knee below the joint).
Causes: Prepatellar bursitis typically results from repetitive kneeling (common in carpet layers, gardeners, and religious practitioners who kneel frequently). Pes anserine bursitis is associated with obesity, osteoarthritis, and tight hamstrings.
Symptoms: Localized swelling, warmth, and tenderness over the bursa. Pain with direct pressure and movement.
Treatment: Activity modification, ice, compression, and anti-inflammatory measures address acute flares. Chiropractic and corrective exercise address biomechanical factors that increase bursal stress. Persistent cases may require corticosteroid injection or aspiration.
6. Chondromalacia Patellae (Runner's Knee)
Chondromalacia patellae refers to the softening and deterioration of the cartilage on the underside of the kneecap. As the patella tracks improperly in its groove on the femur, the cartilage is subjected to abnormal stress.
Causes: Muscle imbalances (weak VMO, the inner quad, relative to outer quad), poor patellar tracking, excessive pronation, and repetitive knee bending in running, cycling, and stair climbing.
Symptoms: Aching pain behind or around the kneecap, typically worse with prolonged sitting (the "theater sign"), squatting, and descending stairs. A grinding or crunching sensation may be present.
Treatment: Corrective exercise to improve VMO strength and patellar tracking, hip strengthening to reduce valgus stress, and gait retraining are the most effective interventions. Chiropractic care addresses underlying foot, ankle, and hip dysfunction that alters knee mechanics.
The Chiropractic and Corrective Exercise Approach
Most knee injuries have contributing factors above and below the knee, including hip weakness, limited ankle dorsiflexion, foot pronation, and lumbar spine dysfunction, that create abnormal forces at the knee joint. A comprehensive approach addresses the knee itself and the kinetic chain it belongs to. At Shin Wellness, our team combines chiropractic care, soft tissue therapy, and corrective exercise programming to restore proper movement patterns, resolve pain, and prevent recurrence.