Sports Physical Therapy for Knee Pain in Eagan, MN

What causes knee pain in athletes?

Sports-related knee pain can come from several different structures, including the patellar tendon, meniscus, ligaments, cartilage, kneecap, or surrounding muscles.

Some knee injuries occur suddenly, while others develop gradually when training demands exceed the knee's current capacity.

Common causes of knee pain in athletes include:

• Patellofemoral pain or runner's knee

• Patellar tendon pain or jumper's knee

• Meniscus injuries

• ACL and other ligament injuries

• Post-surgical weakness or stiffness

• IT band-related lateral knee pain

• Quadriceps or patellar tendon overload

• Rapid increases in running or jumping volume

• Strength and load-capacity deficits

The location of your pain, how the injury occurred, swelling, instability, training history, strength, and which activities reproduce symptoms can help determine what may be contributing to the problem.

If you experienced a sudden pop, rapid swelling, or instability during cutting or pivoting, learn more about our ACL rehab and sports physical therapy.

Pain or catching closer to the knee joint line may involve the meniscus. Learn more about meniscus tear rehabilitation in Eagan.

Pain directly below the kneecap during jumping, sprinting, or squatting may be related to the patellar tendon. Learn more about patellar tendonitis and jumper's knee rehab.

What are common symptoms of a knee injury?

Knee symptoms can vary depending on the structure involved and whether the problem developed gradually or from an acute injury.

Common symptoms include:

• Pain during or after running

• Pain with squatting or lunging

• Pain going up or down stairs

• Pain with jumping or landing

• Pain when cutting or changing direction

• Swelling around the knee

• Knee stiffness or loss of motion

• Weakness or reduced power

• Clicking, catching, or locking

• Knee instability or giving way

• Difficulty reaching full speed

• Pain after increases in training volume

The activity that causes pain can provide useful information, but symptoms alone do not always identify the exact diagnosis.

For athletes, the bigger question is often not simply “Why does my knee hurt?” but “What is preventing my knee from tolerating the demands of my sport?”

A sports physical therapy evaluation can help identify strength deficits, movement limitations, load intolerance, or signs that further medical evaluation or imaging may be appropriate.

How can I tell what type of knee injury I have?

The location and behavior of knee pain can help narrow down possible causes.

Pain around or behind the kneecap may be associated with patellofemoral pain, commonly called runner's knee. Symptoms frequently occur with running, stairs, squatting, prolonged sitting, or repetitive knee bending.

Pain directly below the kneecap may indicate patellar tendon pain or jumper's knee, particularly in athletes who perform frequent jumping, sprinting, or rapid changes of direction.

Pain along the inside or outside joint line may occur with a meniscus injury. Some athletes also experience swelling, catching, locking, or discomfort with twisting and deep squatting.

A sudden pop, rapid swelling, or instability following cutting, pivoting, landing, or contact may indicate an ACL or other ligament injury.

Pain on the outside of the knee during running can sometimes be associated with IT band-related irritation or other lateral knee structures.

These patterns can help guide an evaluation, but they should not be used as a diagnosis by themselves. A detailed examination can assess knee mobility, strength, swelling, stability, movement quality, and functional capacity to determine the appropriate next step.

Why does my knee hurt when running, squatting, jumping, or going down stairs?

Activities such as running, squatting, jumping, landing, and using stairs increase the forces the knee must absorb and produce.

Pain often appears when those demands exceed the current capacity of the knee.

For example, an athlete may feel completely normal while walking but develop knee pain after several miles of running. Another athlete may tolerate normal strength training but experience symptoms during repeated jumping or high-intensity soccer training.

Potential contributors include:

• Reduced quadriceps strength

• Poor tolerance to repetitive loading

• Rapid increases in training volume

• Reduced hip or calf capacity

• Limited ankle or knee mobility

• Previous injury or surgery

• Inadequate recovery between training sessions

• Returning to running or sport too quickly

This is why simply resting until knee pain disappears does not always solve the problem.

Reducing symptoms can be an important first step, but rehabilitation should also increase the knee's ability to tolerate the activities that originally caused symptoms.

If knee pain appears when you return to running, read our guide on how to safely return to running after an injury.

What Makes First Touch Performance Rehab Different for Knee Rehabilitation?

Knee rehabilitation at First Touch Performance Rehab is designed to bridge the gap between traditional physical therapy and full athletic performance.

Led by Dr. Calvin Mai, a Board-Certified Sports Clinical Specialist and former Minnesota United FC team physical therapist, our approach uses principles developed in high-performance sports environments and applies them to youth athletes, high school and college athletes, runners, active adults, and professional athletes.

Our knee rehabilitation approach emphasizes:

• 60-minute, one-on-one physical therapy sessions

• Individualized rehabilitation instead of standardized exercise sheets

• Objective strength and performance testing

• Progressive quadriceps and lower-body strength development

• Criteria-based return-to-running and return-to-sport decisions

• Plyometric, jumping, landing, and deceleration progression

• Sprinting and change-of-direction training when appropriate

• Sport-specific rehabilitation and performance preparation

Your rehabilitation program is based on your diagnosis, symptoms, sport, injury history, surgical history, training demands, and performance goals.

The goal is not simply to make stairs or squats less painful. For athletes, rehabilitation should eventually prepare the knee to tolerate the speed, force, repetition, and unpredictability required during sport.

What does sports physical therapy for knee pain involve?

Knee rehabilitation should address the specific reason your knee is struggling to tolerate activity.

Depending on your injury and stage of recovery, treatment may include:

• Knee mobility and range-of-motion exercises

• Quadriceps strengthening

• Hip, hamstring, and calf strengthening

• Single-leg strength development

• Progressive tendon loading

• Blood Flow Restriction (BFR) training

• Neuromuscular electrical stimulation when appropriate

• Squat, lunge, and landing mechanics

• Plyometric progression

• Running progression

• Sprint and acceleration training

• Deceleration and change-of-direction drills

• Sport-specific training

• Objective return-to-sport testing

Early rehabilitation may focus on reducing irritability, improving mobility, and restoring muscle function.

As symptoms improve, the emphasis should shift toward progressively increasing strength and load capacity.

For athletes, later rehabilitation should eventually reproduce the demands of sport. That may include running, jumping, sprinting, cutting, reacting, and performing repeated high-intensity movements while fatigued.

Phase 1: Reduce Pain, Swelling & Restore Movement

Goals: Reduce symptoms, restore comfortable knee motion, and begin rebuilding muscle activation.

Focus: Range of motion, quadriceps activation, basic strength, gait, and appropriate activity modification.

Examples: Isometric quadriceps exercises, controlled squats, step variations, bridges, low-level single-leg exercises, cycling, and progressive resistance as tolerated.

Phase 2: Build Strength & Load Capacity

Goals: Restore quadriceps and lower-body strength and increase the knee's tolerance to resistance.

Focus: Progressive loading, single-leg strength, hip and posterior-chain strength, movement control, and increasing training capacity.

Examples: Squats, split squats, step-ups, leg press, single-leg RDLs, hamstring exercises, calf strengthening, and progressive knee-extension loading when appropriate.

Phase 3: Running, Jumping & Power Development

Goals: Prepare the knee for impact and higher-speed athletic activity.

Focus: Running preparation, plyometrics, jumping and landing, eccentric strength, rate of force development, and progressively faster movement.

Examples: Walk-run progressions, pogo jumps, landing drills, box jumps, bounds, acceleration drills, and higher-intensity strength training.

Phase 4: Return to Sport & Performance

Goals: Restore confidence and prepare the athlete for unrestricted training and competition.

Focus: Sprinting, deceleration, cutting, reactive movement, repeated efforts, fatigue tolerance, and sport-specific training.

Examples: Sprint progressions, change-of-direction drills, reactive agility, repeated jumps, soccer-specific movement, positional drills, and objective return-to-sport testing.

How is knee rehabilitation different after ACL or meniscus surgery?

Post-operative knee rehabilitation depends heavily on the surgical procedure.

After ACL reconstruction, athletes typically require a longer progression focused on restoring knee motion, quadriceps strength, running capacity, plyometrics, change of direction, and objective return-to-sport criteria.

Read more about our ACL reconstruction rehabilitation process.

Meniscus surgery varies significantly depending on whether the athlete has undergone a meniscus repair or partial meniscectomy.

A meniscus repair attempts to preserve and heal the injured meniscus. Early rehabilitation may therefore include restrictions designed to protect healing tissue.

A partial meniscectomy removes the damaged portion of the meniscus and often allows athletes to progress more quickly, but restoring quadriceps strength, controlling swelling, and rebuilding athletic capacity remain important before returning to sport.

For a deeper look at post-operative recovery, read:

Meniscus Repair Recovery: 3 Key Priorities Athletes Must Focus on After Surgery

and

Partial Meniscectomy Recovery: 3 Major Mistakes Athletes Make After Surgery.

You can also learn more about meniscus tear rehabilitation, meniscus repair, and meniscectomy.

When can I start running again after a knee injury?

Return to running should depend on more than whether your knee feels better during everyday activities.

Before progressing into running, athletes should generally demonstrate adequate strength, knee mobility, control, impact tolerance, and the ability to complete lower-level activities without significant pain or swelling.

The appropriate timeline depends on the injury.

Someone returning from patellofemoral knee pain may follow a very different progression than an athlete recovering from ACL reconstruction, meniscus repair, meniscectomy, or patellar tendon pain.

A structured return-to-running progression often begins with controlled running volume before gradually adding longer durations, faster speeds, hills, sprinting, and sport-specific movements.

Read our full guide on returning to running after an injury without reinjuring yourself.

When can I return to sport after knee pain or a knee injury?

Return to sport should be based on the injury and the demands of the athlete's sport rather than pain alone.

Before returning to unrestricted competition, an athlete may need to demonstrate:

• Adequate quadriceps and hamstring strength

• Single-leg strength and control

• Ability to tolerate running and sprinting

• Jumping and landing capacity

• Deceleration ability

• Change-of-direction control

• Sport-specific conditioning

• Confidence in the injured knee

An athlete returning to soccer, basketball, football, volleyball, or another multidirectional sport needs more than the ability to jog or perform basic strengthening exercises.

The final stages of knee rehabilitation should progressively recreate the speed and movement demands of competition.

How long does knee pain take to improve?

There is no single recovery timeline for knee pain because “knee pain” describes many different conditions.

Some training-related knee pain may improve within several weeks when load and strength are appropriately managed. Tendon-related conditions may require a longer progressive loading process. Significant ligament injuries and post-operative conditions may require several months of structured rehabilitation.

Recovery can depend on:

• The specific diagnosis

• How long symptoms have been present

• Whether surgery was required

• Swelling and mobility

• Strength deficits

• Training and sport demands

• Previous knee injuries

• Consistency with rehabilitation

• Readiness to run, jump, and return to sport

Instead of focusing only on how many weeks have passed, athletes should also consider what the knee can actually tolerate.

When should I see a sports physical therapist for knee pain?

Consider a sports physical therapy evaluation when knee pain repeatedly returns, limits training, affects running or sport performance, or does not improve with basic activity modification.

An evaluation is especially important following an acute injury involving significant swelling, instability, difficulty bearing weight, loss of motion, or mechanical symptoms such as persistent catching or locking.

At First Touch Performance Rehab in Eagan, MN, we help athletes determine what may be limiting their knee and create an individualized progression back to strength training, running, and sport.