Here's how to get knee pain relief by self-treatment, when possible, whether your joint pain is from sports, overuse, or just age. These treatments are safe, effective, recommended by coaches and sports therapists.
I am not a doctor, and the following does not constitute medical advice. If your knee is unstable, you should see a chiropractor. DO NOT SELF-TREAT IF YOUR KNEE IS UNSTABLE.
If your knee does not get better with self-treatment, you should see a chiropractor or physical therapist.
All joint injuries can be helped by the R.I.C.E. method, unless the bone is broken. RICE is rest, ice (10 to 20 minutes, 2 to 3 times per day), compression, and elevation. Always use RICE to take care of swelling and pain. The self-treatments that follow are for restoring health and functionality and to keep you from re-injuring yourself.
Most people do their therapy until the pain goes away, then quit. Usually, the joint is not completely healed or stabilized at that time, and so the injury just comes back. Also, if you don't take care of the weakness or imbalance that made you prone to injury in the first place, it will also come back.
That said, follow the links below to see suggested self-treatments. Again, all advice here is just suggestions. You are treating yourself, and I am not a doctor or physical therapist. I'm just an active, middle-aged guy who gets a lot of aches and pains from exercise, jogging, and weekend sports. I do live at Rose Creek Village, which means I have a couple hundred close friends that I get to test these remedies on. I'm only passing on the ones that seem safe and have worked.
If your knee is unstable, see a chiropractor! Don't use internet advice to treat an unstable knee. If it feels wobbly, or if it “goes out,” then this is not the place to treat your knee. This advice is for pain!
Follow the appropriate link if your knee is stable and your pain is
My best guess for pain all around the kneecap is that your kneecap is misaligned, especially if you're a runner. Your kneecap is completely encased in the tendon of the four-headed muscle at the front of your thigh, which is appropriately called the quadriceps muscle (quadri=four and ceps=head). It moves in the groove of your femur (thigh bone) on the upper side of the knee joint. Believe it or not, it can get misaligned and rub on your knee, and you can realign it!
In order to realign your kneecap, you're going to have to do some weight-bearing exercises with your knee bent to near 90o. Therefore, it is MANDATORY THAT YOUR KNEE IS STABLE. If your knee is not stable, you may (and probably do) have ligament damage, and the following exercises can aggravate or compound the injury. In fact, they probably will. DON'T DO THIS IF YOUR KNEE IS NOT STABLE!
If you are a runner, the most likely reason you're having pain like this, you may have noticed that when you began running the outside of your upper thigh grew. Your thigh muscles probably rounded out a bit on the outside. It is that outer (lateral) head of the quadriceps that gained the most strength because it is the most involved when your leg is almost straight. You don't bend your knee much when you're jogging, at least not while there's weight on your leg, so the weight-bearing part of jogging is done with an almost straight leg. So you're strengthening your quadriceps muscle through a very short range of motion. This strengthens one part of the quadriceps muscle, the upper lateral portion, more than the rest of the muscle.
When this happens, your quadriceps muscle will adjust the tendon that holds your kneecap slightly to the outside. This can result in your kneecap, and thus the part of the tendon that's between the kneecap and the knee, rubbing against the groove in your knee. The tendon then becomes irritated and sore. It swells up, thus making the problem even worse, and the whole tendon will hurt, making the whole front of your knee hurt.
You need to do two things. One, take care of the swelling and speed up healing with RICE. Two, realign the kneecap. You do this by doing weight-bearing exercises with your knees bent. Don't bend them too much, as you can damage the ligaments in your knee, but you should shoot for a 90o bend in the knee. I have two favorite exercises to do for this.
One is the duckwalk. I drop down into a squat and walk as far as I can. Again, you do not want to let your thighs get below parallel with the floor. Some people can drop so far down into a squat that their butt just about touches their achilles tendon at the back of their ankle. Don't do that. You want to feel your weight, so shoot for having your thighs parallel with the floor. If you can't do that, opt for higher, not lower. You'll get stronger, and you'll be able to have your thighs parallel with the floor eventually.
I like to count steps and do at least two sets, preferably three or four.
WARNING! Okay, I warned you. If you ignore me, you'll pay with pain. Don't overestimate your strength. If you do weight-bearing exercises on your quadriceps muscle, and it's the first time in a long time you've done it, you will get very, very sore. Make sure that it's easy the first two or three times. Don't press through until you're hurting a bit. You can do that after you've been duckwalking for a month. If you do it too soon, you will have terrible soreness. It'll fool you. Don't ignore my warning!
The second exercise I like to do is one-legged squats. The nice side benefit of these is that you will improve your balance, which will help you with everything you do sport-wise. It is always good to work on balance, and all balance exercises will make your ankles stronger as well. So if you sprain your ankle a lot, the one-legged squats are an awesome way to help that.
One-legged squats are very simple. You stand on one leg, squat down as far as you can, then stand back up. If you can only go down a few inches, you won't help your knee much, though, so you may have to begin with two-legged squats. You need to be able to at least reach a 45o angle from the ground with your upper thigh. Do the one-legged squat next to a mirror, and you'll be able to tell whether you're achieving that. You'll probably have to hold onto a chair or something, though, if you're looking sideways into a mirror. Your balance is much better if you're looking straight ahead and keeping your eyes still.
If you have to do a two-legged squat, don't do a whole squat. Simply squat down until your thighs are parallel with the floor, then hold it. Or else, squat until your thighs are parallel with the floor, then go up only a couple inches before going back down. Do multiple two-inch squats that way. If you can't do a one-legged squat to a 45o angle, then I assure you that those two-inch squats will tire you quickly.
These exercises will especially hit that teardrop-shaped muscle just above and to the inside (medial to) your knee. You can see that muscle real well on soccer and football players. Look up some soccer pictures, and you'll see that muscle. It's called the vastus medialis, and it's by strengthening that muscle that you're aligning your knee and making up for the fact that you've overworked your legs while they were close to straight.
Again, don't overdo it. You'll make yourself real sore when you start out.
This condition is called jumper's knee, and it is very common. It is also prone to be chronic, and if you keep exercising without taking care of it you can damage the tendon so badly that you'll need surgery. So this is no game. I have scoured the internet for suggestions on this because I have this problem currently myself. The suggestions have helped dramatically.
I have had this condition for a couple years. The treatment given in this section works for me when I stick to it. However ...
When my jumper's knee came back recently, I treated it with trigger point therapy. I searched my quadriceps muscle (front of the thigh) for sore spots, then pressed on those spots for 20 to 60 seconds. I have a tool I purchased from julstro.com that I use for that.
It worked much faster than the physician recommended treatment I give in this section. However, since I have only myself as a test case, I can't have confidence it will work for you.
Trigger point therapy is safe, though. You can't hurt yourself by pressing on a muscle like that. (It's also called acupressure, which sounds very eastern and esoteric, but isn't.)
Despite the fact that this condition is called jumper's knee, both myself and a friend of mine got it while we had stopped exercising. So I don't know what causes it. I do know that the suggestions for fixing it worked for me. My friend just told me about his condition a couple days ago, so I don't know how his treatment is going yet.
The repair is slow. So take some time, and STICK TO IT AFTER THE PAIN IS GONE. The only reason I'm still treating mine is because I didn't listen to that advice. This therapy worked great for me, but when the pain goes away I've been quitting. I'm back on it now, though. Remember, jumpers knee is prone to becoming chronic and leading to surgery. STICK WITH IT!
If you have jumpers knee, you'll really be able to feel the pain when you press on the tendon right at the bottom of the kneecap or just below. The treatment is simple. Use RICE to keep the knee healing, and then exercise your quadriceps eccentrically. Hopefully, I'm not confusing that with the concentrically, but since I'm about to explain what to do, it's just terminology. If I used the wrong word, it won't matter, so I'm not going to go look it up right now.
What I mean is that you need to exercise your quadriceps with negative reps. I didn't read any explanations of how anyone else did that, but here's what I did. I got a chair, I lowered myself down into it on one leg, then I used both legs to stand back up. That way, the quadriceps is just working hard on the way down. I've been doing two sets of five on each leg, but I do the five slowly. The work is in going down slowly into the chair, especially at the end. If you use an office chair, you can adjust the height to your strength level. If you don't have an office chair and you end up plopping down into a kitchen chair, try adding a dictionary or two to the seat. Then lower yourself gently, on one leg, onto the chair or books. Then stand up with two legs.
I read a lot on this, and they all say you should go ahead and exercise through the pain, unless it's very intense pain. If the pain is intense, use two legs and let the good leg help out the painful one. Everything I read says it's the exercise that helps, and it worked wonderfully for me. One scientist who had looked into all the studies said it does appear that doing negative reps (only working the muscle on the way down--as it is lengthening) is better, but only somewhat better than doing normal thigh exercises. So, if you want, you can do one legged squats or deep two-legged squats exercising both up and down, but better is better even if it's only a little better. I'd do the negative reps only.
Pain on the inside of the knee is, uh, a pain to diagnose. There's a lot it could be. For me, I ended up deciding it was the gracilis tendon, which is a groin muscle, that was causing me the problem. I ended up getting advice from a physical therapist I ran across on the Runner's World forums. She gave me some exercises to do, and they worked instantly. I'd been dealing with the pain for many months, and her exercises had me pain free in two days. It doesn't even make sense that strengthening exercises would work that fast.
So, for the inside of the knee I'm going to recommend something that will attempt to address all the possible problems it might be. You may find the problem as you do these things, or maybe it will end up working. Everything I'm recommending here is good for your knee long term, so you might as well do them anyway.
First, here's the possible problems. You have a bursa right at the top inside of the tibia. A bursa is a fluid-filled sack that provides something for the tendons to glide on as they move past the joint. When you have “bursitis,” that means your bursa is swollen. Normally, if your bursa is swollen, then it's been beat up somehow, so it's painful too. Then, because it's swollen, the tendons are even tighter on it, so the swelling and pain get worse. It's not nice to have bursitis.
Anyway, there are several tendons that cross the knee joint on the medial side (inside), and they all go across one bursa called something latin that means “goosefoot.” Any of them can get too tight due to spasms in the muscle and lead to bursitis. Basically, there's one long thin groin muscle (gracilis) and two long thin hamstring muscles (semitendinosis & semimembranosis) that cross the knee coming from the thigh, and the inner head of the gastrocnemus coming from the lower leg. Oh, and the sartorius muscle also sends a tendon across it after wandering all the way from your hip.
So, you need to massage and stretch all those muscles. If you have knee pain, you should make sure you own a dowel. You can cut down a broomstick or wooden closet rod, preferably with at least a 1" diameter, to about 18" long. You can use that to do your own massage. Make sure you have pants on, so you're not rubbing the rod across your skin, then you simply hold both ends and use the middle to massage your muscles. For your front thigh, you just sit in a chair and run it along the top of your thigh from your lap to your knee. For your hamstrings, you can lay or sit on the floor with your knees bent. You then run the rod from the knee down to your rear end. DON'T START TOO CLOSE TO THE KNEE. You don't want to do that near the knee at the place you can feel the tendons really well. Just massage the meat of the muscles, not the tendon. If you hit any tender spots, stop and put pressure on them for twenty or thirty seconds. Put enough pressure so that it “hurts so good.” You don't want it to hurt too much, but those tender spots are spasms in the muscle, and you want to press them out. It's called accupressure, and it works really well.
For your calf you do the same thing. My calf muscles are sensitive to the rod, and they are often sore enough for me to have to do it gently. You might not experience that. Either way, it's the same process. Sit on the floor with your knees bent and use the rod to massage the calf muscles. For inside knee pain, you especially want to focus on the medial (inside) head of the gastrocnemus. That's the big, fat muscle at the top of the lower leg in the back.
If the muscles get too tight or get spasms in them, they shorten, pulling the tendons down tight on the bursa. That can be true of all joints, which is why it's good for your joints to stretch and warm up. Tight muscles pull joints tight so that even if they don't give you bursitis they make you prone to joint problems.
You should also stretch all those muscles. You can find stretches for your hamstrings, quadriceps, and calves all over the internet. You probably already know some. It's important to stretch those quadriceps. You can do that standing on one leg by pulling the other foot up to your butt. To get a better stretch, pull your heel all the way to your butt, then try to move your knee posterior (towards the back).
You also need to stretch the gracilis, which means doing groin stretches. The easiest one is the butterfly stretch. Sit down on the floor, put your heels together, pull them up towards your groin, then force your knees down towards the ground. That's really hard for some people to do, but there's also some people who naturally have no problem with it. My brother was one of those. If you're one of those, don't bother. Your gracilis is not causing your problem. You're probably not, though. If you're my age, the chances are you'll feel like an idiot even trying to get your heels together near your groin. You should probably avoid doing this stretch where people can see if that's the case.
Also, you should know that you have two major muscles in your calf. The gastrocnemus I mentioned. It's higher, bigger, and on the surface. The soleus is under the gastrocnemus. Both those muscles go down to your achilles tendon to move your foot, but the soleus originates in your lower leg, while the heads of the gastrocnemus attach to your femur (which is why their tendons cross the knee joint). In order to stretch your gastrocnemus, you keep your leg straight. To stretch the soleus, you have to bend the knee. The easy way to stretch your calf is either to stand on a stair or curb and lower your heel or heels as much as possible, or to lean against a wall keeping one or both heels on the ground. The more you lean forward, the better stretch you get. For both exercises, straighten the knee to hit the gastrocnemus and bend it to hit the soleus. For knee problems, you want to stretch the gastrocnemus.
Okay, that said, I did all that, and it didn't help. Again, I contacted a physical therapist to get help for all that. In fact, I recommend that particular physical therapist. Her name is Julie Donnelly, and her web site is at www.julstro.com. She has stuff there on carpal tunnel syndrome that could save the United States billions of dollars if people would just listen to it, but hardly anyone does. Everyone thought my wife had carpal tunnel syndrome, and we bought gadgets that were supposed to help, fixed her posture when she typed, and did all sorts of things, including visiting a chiropractor. I read up on carpal tunnel syndrome on Julie's site, and I ended up curing her symptoms by massaging her neck. Yes, her neck. The medial nerve that is the victim of carpal tunnel syndrome originates at the top of the spine. Muscles all the way from the neck to the hand can cause the exact symptoms of carpal tunnel syndrom.
What did help is some exercises. Apparently, your gluteus maximus (yes, your rear end muscles) have a lot to do with keeping your knees moving correctly. I have a flat rear end, and that's because my glutes are weak. I had to strengthen them, and I also had to teach them to work independently better. So I'm going to give you some exercises that are embarrassing to talk about.
One of the main ones is simply tensing your glutes. You stand on two feet, shoulder width apart. Shift your weight to one of your feet (but stay on two feet), then tense the “cheek” of the side with weight on it. You want to work very hard at tensing only that one cheek of your butt and not any muscles in your thigh or back. It's difficult at first, but you'll get the hang of it over the first week. After a couple seconds, shift your weight to the other foot and tense the other cheek. Do that back and forth for a few reps. Do that whenever you think about it.
For strength, you can lay on your stomach on the floor with a pillow under your hips. Bend one leg, then lift that leg gently into the air. Again, try to tense only your rear end. Try not to feel it in your back. If your hamstrings flex, that's fine. Try not to flex your back. This means you won't be able to lift your leg as high as if you did flex your back. Again, go back and forth, doing perhaps 15 reps. Do a couple sets, too.
It would do you good to stretch your piriformis, too. That's a muscle in your rear end that sits on your sciatic nerve. It's hard to stretch. Here's the easiest way, though. Lay on your back with your knees bent. Pick up one leg and cross it over the other. This will be like you are sitting in a chair with one leg crossed over the other, but you're on your back. Then reach around both legs, grab the knee of the leg that's still on the ground, and pull both knees up to your chest. However, try to keep your rear end on the ground. Don't curl up. You should be folding neatly, like you've got a crease at the top of your thighs. You probably won't be able to lay the top knee on your belly or chest this way, but you'll feel the stretch in your butt on the side of the leg that's on top. The more you rotate your top leg to the outside, the more you hit the piriformis. That means you can get a good stretch by just crossing the ankle of the top leg of the knee, rather than trying to get one knee on top of the other.
Those exercises helped me. I also found that when I'm driving with cruise control on, I can press one foot at a time into the floor (close to the seat, so my legs are very bent) focusing on tensing that one buttock. I alternate, and I can get really good exercise in my glutes doing that. Your glutes help stabilize the leg while you are running, which is why these exercises help so much.
Okay, that's it. It's a lot, but you're hitting a lot of possibilities, and that's why you're having to do all this.
This is the easiest one. 90% of the time, if you have lateral (outside) knee pain, it's your iliotibial band. You are also probably a runner. There is a band of fibrous tissue that runs from the top of the hip (at the gluteus and TFL muscles down to the kneecap and tibia. It can get tense and rub on the outside of the knee. You have to stretch it. Stretching it is easy, and if it's tense, it feels very, very nice to get it stretched out. Stand sideways an arm's length from a wall, put your palm against the wall, then move only your hip towards the wall. It will stretch the IT band closest to the wall.
If you have IT band syndrome, and you stick to stretching that will fix it. Yippee.
However, what if you don't? The first time I got outside knee pain, I thought, “Oh, easy. I know what to do.” It didn't work. So I got out my dowel and started exploring. As I ran it along the outside of my lower leg I hit a very tender spot. I used the the dowel to press and massage out the spot. Presto, the pain was gone the next day.
You have a muscle on the outside of your lower leg called the peroneal. It stabilizes your ankle, as well as moving your foot to the outside. If you sprain your ankle, chances are you'll strain the peroneal. I had twisted my ankle a few days earlier, and my peroneal had knotted up. All it took was one day with dowel, and I was better.
We have a lot of dancers at Rose Creek Village. Because of the type of dancing they do (Irish/Celtic), they often twist their ankles. I hand my dowel out to them all the time. “Take care of that lower leg,” I always tell them, and then, “And do more balance exercises! Strengthen those ankles!” Balance exercises help your proprioception as well, which is the ability of your body to know where your body parts are without looking. That helps make sure that your foot is in the right position and properly angled when it hits the ground, further preventing turned ankles.
Nothing else really attaches on the outside of the knee, so chances are it's the IT band or something in the lower leg. For me the pain was actually an inch or so below the knee joint when the peroneal was the problem. The spot that hurt on the peroneal was different from the spot that hurt on my knee. The spot that hurt on my knee was at the origin of the peroneal muscle. The muscle was tensed from my minor injury, so it was pulling too hard on the bone where it's attached. The pain in the meat of the muscle was further down, and I didn't find that until I pressed on it. It's called a spasm, and it's a knotted up spot in the muscle. Just for your info, your muscles help damaged fibers by “gluing” other fibers to it. Sometimes those glued together spots don't loosen back up after the minor injury. When you press on them you break up the fibers and release sealed up lactic acid. Sometimes, I think because of the released lactic acid, the spot around it will be a little sore after breaking up the spasm. Always, though you get relief.
Let's start with the most surprising one. I don't think it's really the most important, but it's important.
Eat Right!
Every part of your body needs nutrition. Your bones need calcium, and your body needs a lot of stuff to maintain your cartilage; things like sulfur, copper, and vitamin C (interesting, huh?). I once saw a joint formula in Wal-Mart that was designed just for your joints. Don't go for the pills. The pills can't be as good as a powder because a major thing that helps is collagen, also called gelatin. Yes, the very same stuff that jello is made from, but it would be good if you didn't add all the sugar. You can't fit enough in a pill unless you take a couple capsules.
However, one pill that does help is glucosamine, although any joint formula with collagen will definitely have glucosamine and MSM too, and probably chondroitin as well. Those are all good. In fact, an MSM/Glucosamine cream from Nature's Sunshine took the pain away from a bunion that had hurt for years. I applied it daily, once per day, for about four years, though I quit a couple times to make sure that the relief was really coming from the cream. When I would stop the cream, the pain would come back after a couple weeks. However, after about four years I quit and the pain has never returned. That was about five years ago. Talk about an awesome remedy! Better yet, a small and, in my opinion, expensive tube of the cream lasts about six months when you're only using it on a bunion, so then the $20 price is not bad. Search for Nature's Sunshine MSM/Glucosamine cream on Google, and there will be plenty of suppliers. I don't feel like doing it for you, sorry.
So eat right. It's probably sufficient to eat well in general, but you can also try taking gelatin on a regular basis. That is hard to do unless you feel like eating a lot of Jell-O, which I don't recommend. The only reasonable thing I found was to put a tablespoon in my coffee in the morning. It makes the coffee a little thicker, but it doesn't change the taste a bit. If you're smarter than me, you don't drink coffee in the morning, so you can put it in tea instead. You may have to order the gelatin (beef collagen) online. It's hard to find in stores, unless you buy a joint formula in the pharmacy section of a department store. If you do that, however, you'll pay about double the price.
Move the Joint!
All joints do better with movement through a full range of motion. Move. Often. Bend your knee all the way in whatever way you want to do it.
Keep the Muscles flexible, supple, and limber
I hope it's not redundant to use those three words together.
Get that rod I talked about above. Something about 18" long and 1" in diameter. Use it on your thighs and lower leg. Massage the muscles with it and find any sore spots and acupressure them out (20 to 30 seconds). There are spots that will take at least a week, maybe longer, to get all the soreness out of. No place on your legs, unless it's right on the bone, should hurt under light pressure. Time applying pressure till it “hurts so good” will take the soreness out. Don't press till it “hurts so bad.”
Stretch. It's tight muscles that cause tendons to be tight around joints, causing joint problems and misalignment of the joints. If you don't keep your muscles flexible and loose, then you'll get a joint problem. Then you'll rest and take care of it, it will get better, you'll go back to activity, and you'll be hurting again soon because you haven't cured the problem. Stretch. Move. Exercise through a full range of motion. Keep your muscles happy and free, and they will keep your joints happy.
Exercise
Exercise is awesome for your body. Everything works better when you exercise. Strong muscles help hold joints in place and protect them. They shouldn't be tight. They should be strong. There's a difference. They should be able to relax and take pressure off the joint when there's no load on the joint, and they should be able to help the joint bear weight when there is a load. It's harder to hurt a strong person than a weak one. That's a simply fact.
Strengthen Support Muscles
Joints have a difficult job. They do it best when used at certain angles. There are some muscles that are responsible for stability. Make them strong. They're your most important muscles.
You can hit the little ones with balance exercises. Everybody should spend a couple minutes of every day on one foot. Sorry if that sounds weird. It will help. Stand on one foot and practice balancing for a minute or two each day on each foot. If standing is too easy, then try putting things on the ground and bending down and picking them up. Do it over and over during that one minute. If that gets too hard, stand on one foot with your eyes closed. That will not be easy. That can be hard even for people with good balance. If even that gets too easy, pick things up off the ground while standing on one foot with your eyes closed. If that's easy, then I don't know what to recommend. Try walking on your hands or standing on a basketball on one foot. I saw a little kid on a youtube video that could do that while pulling the other foot over his head. Whoo whee.
You can hit the big ones with core exercises. I mention butt exercises in one of the sections above. Look up core exercises on the internet. They're popular, and they should be. They're great for you. You can do some simple ones. Pushups are an okay core exercise. Here's a better one. Get in a pushup position. Make it a good one. Keep your body straight and your feet all the way together. Now lift one hand straight up in the air towards the ceiling, balancing on the other. You'll have to rotate your shoulders to do that. Then put that hand down and do the same with the other.
Want to make that harder? Do it on your elbows.
Your strong core muscles will help stabilize you and thus help keep your knees healthy. Find ways to work your hips, too. Try doing karate kicks, whether you're in karate or not. Work at getting them higher, and learn to do at least three or four. Do front kicks, side kicks, and roundhouse kicks. Those are wonderful for keeping your hips flexible and strong, and that will reap benefits for your knees.