The First Step in Diagnosing Knee Pain

Knee prob­lems can be com­pli­cat­ed.

But if you grasp one basic con­cept, it will sim­pli­fy your under­stand­ing of your knee prob­lem.

How to Diagnose Knee Pain

The first major step in diag­nos­ing an individual’s knee prob­lem is to dis­tin­guish between two broad cat­e­gories:

Issues within the knee joint itself


Problems of the patellar-quadriceps mechanism.

Take a look at this pic­ture of the knee so you’ll know what I’m talk­ing about.


The knee and patellar ligaments

The knee joint and patel­lar lig­a­ments

The Most Common Cause of Knee Pain

The knee joint itself is where motion flows between the thigh bone (the femur) and the shin bone (the tib­ia).

But over­ly­ing the knee joint is the quadri­ceps mus­cle (not shown in this pic­ture) along with the patel­la (kneecap) and the ten­dons attached to the patel­la (the patel­lar and quadri­ceps ten­dons). Prob­lems with these patel­lar and quadri­ceps struc­tures are the most com­mon cause of knee pain.

Diag­nos­tic pos­si­bil­i­ties with­in this gen­er­al cat­e­go­ry include:

  • quadri­ceps ten­dini­tis,
  • patel­lar ten­dini­tis,
  • quadri­ceps strain,
  • chon­dro­ma­la­cia patel­lae, and
  • patellofemoral dis­or­der.

Second-Most Common Cause of Knee Pain

The next-most-com­mon cause of knee pain is dis­rup­tion of the lig­a­ments or car­ti­lage inside the knee joint. Some of the var­i­ous prob­lems inside the knee joint include injuries to the ante­ri­or cru­ci­ate lig­a­ment, pos­te­ri­or cru­ci­ate lig­a­ment, or one of the menis­ci.

The phys­i­cal exam­i­na­tion your doc­tor per­forms should be designed for starters to deter­mine the gen­er­al cat­e­go­ry of con­di­tion that’s affect­ing your knee. (Of course, you can have a mix­ture of prob­lems of both types.) In many cas­es, X-rays or MRI’s are not need­ed to tell what’s going on.

The good news is that most knee con­di­tions can be treat­ed with the right com­bi­na­tion of brac­ing, con­nec­tive tis­sue ther­a­py, reha­bil­i­ta­tive exer­cise, and anti-inflam­ma­to­ry mea­sures. Surgery can be an effec­tive option in some cas­es, too, but for­tu­nate­ly it’s not often nec­es­sary.

Here’s a great guide to self-care for the most com­mon vari­ety of knee pain, writ­ten by my col­league Paul Ingra­ham:  Patellofemoral Pain Syn­drome.


Deepen Your Body of Knowledge

Run­ners with knee pain — ili­otib­ial band fric­tion syn­drome

Self-care secrets for mus­cle and joint pain

More on chon­dro­ma­la­cia patel­lae


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website,, provides more information about his approach.

Please contact him at or at 212-400-9663.

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