Understanding Knee Pain

The knee is a load-bearing joint that handles thousands of steps per day. When discomfort develops, it’s often most noticeable during activities like climbing stairs, getting up from a chair, running, kneeling, or squatting.

Some knee pain begins suddenly after a specific event. Other times, symptoms build gradually as activity levels, training demands, or daily workload increase. Because the knee sits between the hip and ankle, changes in strength, coordination, or movement patterns elsewhere in the leg can influence how stress is distributed through the joint.

Knee pain does not always reflect a single damaged structure. In many cases, it relates to how well the joint and surrounding tissues tolerate repeated loading over time. When capacity and demand become mismatched, irritation can develop.

Rather than focusing only on the site of discomfort, assessment looks at how the entire lower limb functions together. Identifying contributing factors helps guide a plan that supports improved tolerance, movement confidence, and long-term management.

What Often Contributes to Knee Pain

Knee discomfort rarely comes from one single factor. More often, symptoms develop when the demands placed on the joint exceed what the surrounding tissues are currently prepared to handle.

Common contributing factors may include:

  • Rapid increases in running, training volume, or activity intensity

  • Repetitive movements such as stairs, squatting, jumping, or kneeling

  • Strength or control deficits at the hip or ankle

  • Changes in footwear or training surface

  • Previous knee injuries or recurring flare-ups

  • Limited recovery between higher-load activities

  • Prolonged sitting followed by sudden activity

  • Sensitivity in the surrounding tendons, joint surfaces, or soft tissues

How Knee Pain Is Evaluated

Assessment begins by understanding when symptoms occur and what activities aggravate them — whether that’s stairs, running, squatting, kneeling, or prolonged sitting. The timing, location, and behavior of symptoms often provide important clues.

From there, evaluation focuses on how the knee performs under load. This may include observing walking, single-leg balance, squatting mechanics, step-down movements, or sport-specific tasks. Strength and control at the hip and ankle are also considered, since these areas influence how forces are distributed through the knee.

Rather than isolating one structure, the goal is to determine how well the joint and surrounding tissues tolerate current demands. In most cases, imaging is not immediately required and is typically reserved for situations where findings suggest it would meaningfully influence care decisions.

Therapist assessing knee pain during treatment at Burlington Sports Therapy Clinic in Burlington Ontario

How Knee Pain Is Managed

Building Strength and Load Tolerance

Care is guided by how the knee responds to current demands and what activities are most important to you — whether that’s walking comfortably, returning to running, climbing stairs without discomfort, or training without flare-ups.

Because many knee conditions relate to how tissues tolerate repeated stress, management often focuses on gradually improving strength, coordination, and control throughout the lower limb. This typically includes progressive exercise designed to increase the knee’s capacity over time rather than avoiding activity altogether.

Hands-on techniques may be used when appropriate to address stiffness or irritation, but long-term improvement usually depends on restoring confidence and tolerance to loading. Adjustments to training volume, activity frequency, or movement strategy may also be recommended during recovery.

Education plays an important role, helping you understand how to manage symptoms, modify activity when needed, and reduce the likelihood of recurring irritation. When appropriate, collaborative care across disciplines may support both short-term recovery and long-term function.

Burlington Care Options for Knee Pain

Care for knee pain may involve a combination of services, selected based on individual findings, activity goals, and how the knee responds to load.

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Massage Therapy

Massage therapy may help reduce muscle tension and soft-tissue irritation in the surrounding muscles, including the quadriceps, hamstrings, or calf, which can influence knee discomfort.

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Chiropractic Treatment

Chiropractic care may focus on improving joint mobility in the knee, hip, and ankle while addressing movement patterns that influence how forces are distributed through the lower limb. Treatment is guided by assessment findings and individual activity demands.

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Physiotherapy

Physiotherapy often emphasizes progressive strengthening, movement retraining, and improving tolerance to activities such as walking, running, stairs, or sport. Guided exercise and education support gradual return to desired activities.

What to Expect From Knee Pain Care

Care is guided by assessment findings and adapts based on how your knee responds to loading over time.

Initial Focus

Settling irritation and restoring comfortable movement while identifying activities or positions that may be exceeding current tolerance.

Progressive Care

Gradually rebuilding strength and control through the hip, knee, and ankle to improve tolerance to stairs, walking, running, or sport.

Active Involvement

Participating in targeted exercise and movement strategies designed to increase the knee’s capacity and support long-term activity.

Ongoing Reassessment

Monitoring how symptoms respond to increased demand and adjusting programming to support continued progress.

Frequently Asked Questions About Knee Pain

These are some of the most common questions we hear from people dealing with knee pain.

Helping Burlington patients move better since 2005.

In many cases, yes. Knee pain often relates to how well the joint and surrounding tissues tolerate load. By gradually improving strength, coordination, and activity tolerance, many individuals notice meaningful improvement over time. The specific approach depends on individual findings and goals.

Activities like stairs and squatting place higher compressive forces through the knee joint. If strength, control, or tissue tolerance is reduced, these movements can temporarily increase discomfort. Improving lower-limb strength and movement efficiency often helps reduce irritation during these tasks.

Imaging is not required in many cases of knee pain. Decisions about X-rays or MRI are typically based on symptoms, clinical findings, and whether imaging would change management. Many load-related knee conditions can be addressed effectively without imaging.

In many situations, activity does not need to stop completely. Modifying volume, intensity, or frequency while gradually rebuilding strength is often more helpful than prolonged rest. A structured progression can support a return to running or sport when appropriate.

Not necessarily. While joint changes can occur over time, knee pain is frequently influenced by activity levels, strength, mechanics, and tissue sensitivity. Many people with imaging findings such as mild degenerative changes are able to stay active with appropriate management.

Improving lower-limb strength, gradually progressing training loads, allowing adequate recovery, and maintaining consistent movement habits can help reduce flare-ups. Understanding early warning signs also allows for small adjustments before symptoms escalate.

Meet Our Practitioners

Our clinicians work collaboratively to support recovery across a wide range of conditions.

Dr. Kevin McIntyre

Dr. Kevin McIntyre B.Kin, DC

Clinic Director

Dr. Leslie McDowall

Dr. Leslie McDowall B.Sc, DC

Clinic Director

Beth Slack

Elisabeth (Beth) Slack

Registered Physiotherapist

Samantha Costabile

Samantha Costabile

Registered Physiotherapist

Deanna St. Clair

Deanna St. Clair

Registered Physiotherapist

Valerie Morris

Valerie Morris

Registered Massage Therapist

Ryan Smith

Ryan Smith

Registered Massage Therapist

Michael DeCiantis

Michael DeCiantis

Registered Massage Therapist

Maraisa (Mara) Ockenden

Allie Hoegl

Registered Physiotherapist