Many people who are active have at one time or another experienced knee pain. Some of these injuries are serious, and require surgery and/or time off from activity. But much of the knee discomfort that I see in my clients is due to chronic overuse. Massage can greatly help in these cases, and can prevent that discomfort from becoming an injury.
Numerous muscles cross over and attach around the knee. If these muscles are tight enough, pain can sometimes be felt where they attach. Please note that I will only address muscle issues that can be helped by massage. For more serious issues involving the inner workings of the knee that cause severe pain and/or swelling, please see a doctor right away.
There are 4 areas where one typically feels pain: the front (anterior) of the knee (in the area of the kneecap and slightly below), the back (posterior) knee, the inner (medial) knee, or on the outside (lateral) knee.
Probably the most prevalent knee problem I see (especially with runners) is pain on the outside of the knee. This is often caused by a tight iliotibial band (IT band). The IT band is a thick sheath of connective tissue that begins at the outside of the hip, continues down the outer thigh and connects at the lateral knee. When tight one might feel pain with activity (running), and tenderness with palpation right at the outer knee. Ice, stretching, massage, and self-massage with use of a foam roller, can be very effective in decreasing the tightness of the IT band and reducing/eliminating the pain. Here is a more in depth description and image of the IT band.
If there is pain just below the inner knee, it could be inflammation of the pes anserine. In the image on the left, the pes anserine is pointed out.
The pes anserine is where the tendons of 3 muscles meet. The sartorius (a muscle that runs across the front of the thigh), the gracilis (an inner leg muscle), and the semitendinosus (an inner hamstring muscle) meet and attach to the tibia at the inner knee. Overuse of these muscles (as with cycling or running) can cause tenderness in this area. Reducing the tightness of these 3 muscles (sartorius, gracilis and semitendinosus) by stretching and massage can reduce pain in this area. Self-massage with a foam roller can be preformed on all 3 muscles, as well as icing the pes anserine. For more info please click here.
Pain in the front of the knee (and slight below) could be related to tightness of the quadricep muscles and the patella tendon The large muscles of the quadriceps join together and form the patella tendon, which attaches right below the knee.
Stretching and foam rolling of the quadriceps can reduce this tightness on the front of the knee.
Pain behind the knee could be due to tight hamstrings or tight calves. The hamstrings cross the back of the knee from above. The gastrocnemius muscle cross the back of the knee from below. If any of these muscles are tight, one may feel tightness behind the knee.
These muscles can be loosened with stretching and massage, and again the foam roller works wonders for this.
There are also muscles in the very back of the knee that can get irritated and tight. I have worked with a number of clients with tightness in their popliteus and plantaris muscles. On the right is an image of where the plantaris is located.
Unfortunately both muscles are difficult to access, due to the area’s vulnerability (an artery is located in the posterior knee). Please try not to access these muscles on your own. A massage therapist, PT or other health care professional will be able to get in and release the tightness.
This is not a full list of possibilities for those dealing with knee pain, but these are the issues I see most often in my active clients. For the most part, all of the above issues will come on slowly and if caught and dealt with early enough, do not have to cause an injury. If you are interested in a more complete list of possible knee injuries, please consult this site.