Knee Pain
The knee is a hinge stuck between a ball-and-socket joint and a foot, and it has almost no say in what either of them does. It is usually the victim, not the culprit. Dr. Andrew Allen evaluates the whole chain.
Over 20 years of experience · Wheat Ridge, Arvada, Lakewood, Golden & West DenverSomebody told you it is just wear and tear
Maybe you got an X-ray and heard the words bone on bone, and you have been walking around with that sentence in your head ever since. Maybe you were told to stop running, lose weight, and consider a brace. Here is what is worth knowing: knee imaging findings correlate poorly with knee pain. Plenty of people have textbook-ugly knees and no symptoms, and plenty have clean scans and cannot get down stairs. Age is not a diagnosis, and neither is wear and tear. Something specific is loading your knee wrong, and that something is findable.
How knee pain actually shows up
Location is everything with knees. Where it hurts narrows the field faster than almost anywhere else in the body:
Pain around or under the kneecap
Vague, achy, hard to point at. Worse on stairs, hills, and after sitting a long time. The most common presentation we see.
The movie theater sign
Sitting with the knee bent for an hour and then needing a minute to straighten out. Classic patellofemoral pattern.
Down is worse than up
Stairs and descents hurt more than climbing. Descending is eccentric loading, and it exposes control problems that going up hides.
Sharp pain on the outside
A stab or burn at the outer knee, often arriving at a predictable point in a run or ride. Classic IT band presentation.
Pain on the inside
Along the inner joint line. Could be meniscus, could be ligament, could be referral. It needs testing, not guessing.
Catching or locking
The knee gets stuck or gives way. This one earns a proper evaluation rather than a wait-and-see.
Swelling that comes and goes
Puffy after activity, better with rest. Swelling is information, and its timing tells us a great deal.
Grinding and crunching
Noise on its own is usually meaningless and almost never the problem. Noise with pain is worth looking at.
Pain just below the kneecap
Right on the tendon. Common in jumpers, lifters, and anyone who ramped up quickly. See strained muscles.
Your knee goes where your hip and foot send it
The knee is a hinge. It bends and straightens, and that is close to the whole job description. Rotation and side-to-side control come from the hip above and the foot below. When one of those quits, the knee absorbs forces it was never designed to handle. These are the root causes Dr. Allen is actively ruling in or out:
Weak or late-firing glutes
The glute medius controls whether your knee stays over your foot or collapses inward when you load one leg. When it fails, the knee dives in on every step, and the kneecap grinds accordingly. This is the single most common driver we find in knee pain. See hip pain.
Restricted ankle dorsiflexion
If your ankle cannot bend forward far enough, your knee has to compensate on every squat, step, and descent. It is one of the most overlooked findings in the body and one of the most changeable.
Foot mechanics
A collapsing arch drives internal rotation up the chain straight into the knee. A rigid, high arch fails to absorb shock and sends it up instead. Both end at the knee. Related: plantar fasciitis.
Patellar tracking
The kneecap glides in a groove. Tight lateral structures and an underperforming inner quad pull it slightly off track, and thousands of repetitions later, it hurts.
Hip rotation loss
If the hip will not rotate, the rotation has to happen somewhere. The knee is next in line, and it does not rotate well. This is how a hip problem becomes a knee complaint.
Quad and hamstring imbalance
Very quad-dominant people load the front of the knee constantly. The hamstrings and glutes are supposed to share that work.
Meniscus and cartilage
Real, and worth identifying. Also worth knowing that many meniscal findings on imaging are incidental and do not require surgery, which is why testing matters more than pictures.
Load spike
You added mileage, vertical, or weight faster than the tissue adapted. The knee is often the first thing to complain about a training decision.
Old injuries and compensation
The ankle you rolled years ago changed how you load that leg, permanently, and the knee has been paying interest ever since.
Low back and nerve referral
Lumbar nerve irritation can produce knee-area pain with a healthy knee. It gets missed. See lower back pain and sciatica.
How Dr. Allen figures out what is actually wrong
You get evaluated and treated on day one. Not a clipboard and a handshake and a see-you-next-week.
We listen to the whole story
When it started, whether there was a moment or it crept in, exactly where it hurts, what makes it worse, and what you are actually trying to get back to. Skiing, running, and getting down your own basement stairs are three different goals.
We watch you load one leg
A single-leg squat tells us more in ten seconds than most knee exams do in twenty minutes. If the knee dives inward, we have found the conversation, and it is a hip conversation.
We check the ankle and the foot
Dorsiflexion, arch behavior, and how your foot strikes. Every knee evaluation here includes the joint below, because the knee is downstream of it.
Orthopedic and neurological testing
Specific tests to differentiate patellofemoral from meniscus from ligament from IT band from referral. This is what separates a real diagnosis from the phrase runner’s knee.
We connect it to your life
Your mileage, your ramp-up, your ski season, your stairs, your shoes. The cause is usually sitting in your calendar.
You get treated the same day
You leave your first visit having actually been treated, and knowing in plain English what is going on. If your case needs imaging or an orthopedic opinion, Dr. Allen will say so directly rather than string you along.
Colorado is hard on a knee
We would not live anywhere else. But the Front Range lifestyle has a signature, and after twenty years Dr. Allen can usually guess your hobby from your movement pattern.
Ski and snowboard season
The knee is the sport’s signature injury for a reason. Sustained deep flexion, rotation under load, and edges that catch. The I-70 corridor keeps this page busy from November through April.
Fourteener descents
Four thousand feet of downhill is hours of eccentric quad loading with a pack on. Ask anyone who has come down Bierstadt what hurt the next day.
Clear Creek Trail miles
Repetitive, single-plane loading. Runners and cyclists here log real volume, and knees are where under-recovered volume shows up first.
Trail running on uneven ground
Constant micro-corrections that demand hip and ankle control the knee cannot supply on its own.
Mountain biking
Thousands of pedal strokes in a fixed plane plus chatter absorption. Great cardio, very repetitive knee loading.
Gardening season
Wheat Ridge earned the Carnation City name honestly. Hours of kneeling on hard ground is direct compression on the front of the knee.
The Denver commute
Eight hours of sitting shuts the glutes down and shortens the hip flexors. Then you go ski, and the knee finds out the hip is not helping.
The first warm weekend
Sixty-five degrees in March and everyone goes outside at once. The load spike is real and the following week is predictable.
Wadsworth and Kipling traffic
Dashboard knee injuries in collisions are common and underdiagnosed. See our car accident injury care.
How we treat knee pain
Treating a knee without treating the hip and ankle is why knee pain keeps coming back. Dr. Allen builds care around what your evaluation actually found.
Chiropractic adjustments
Restoring motion at the ankle, hip, and low back that the knee has been compensating for, plus the knee joint itself where indicated.
Soft tissue therapy
Hands-on work across the quads, IT band and its attachments, hip rotators, and calves, addressing the tension that is pulling the kneecap off track.
Dry needling
Thin monofilament needles into the deep quad, glute, and calf trigger points hands cannot reach. Often the fastest way into a stubborn knee.
Cupping therapy
Decompression-based soft tissue work that may help circulation and tissue mobility around the thigh and knee.
Therapeutic exercise
Glute control, ankle mobility, and progressive loading. This is the part that actually changes the knee, because it changes what the knee is being asked to do.
Functional movement assessment
The reassessment loop. We re-test the single-leg squat so you can see the change, and so we know whether the plan is working.
Knee pain FAQ
I was told I am bone on bone. Is there anything to do?
Often, yes. That phrase gets used loosely and it lands hard. Cartilage findings on imaging correlate poorly with symptoms, and many people with significant changes get meaningfully better with conservative care because we change how the joint is loaded, not what the picture looks like. Some knees do need a replacement, and Dr. Allen will tell you honestly if yours looks like one.
Should I stop running?
Usually not. Running does not wear knees out the way people assume, and stopping tends to make the underlying weakness worse. Modifying volume while we fix the driver is almost always a better plan than quitting.
Why does my knee hurt if the problem is my hip?
Because the knee is a hinge caught between two joints that control rotation. When the hip stops controlling it, the knee absorbs forces it cannot manage. The tissue that fails is the tissue under load, not the tissue that caused the load.
Do I need an MRI?
Usually not to start. Imaging matters when there are specific findings or when a surgical decision is on the table. Incidental findings are extremely common and can send you down the wrong road, so testing first is generally the better order.
Is clicking or popping bad?
Almost never on its own. Noise without pain is just noise. Noise with pain, catching, or giving way is a different conversation and worth evaluating.
Can a chiropractor treat knees?
Extremities are within chiropractic scope, and knees especially benefit from someone treating the hip, knee, ankle, and low back as one chain, because that is how the leg actually works.
Will I have to come three times a week forever?
No. There are no long-term contracts and no forced treatment plans here. The goal is to get you out of pain, teach you what caused it, and send you back to your life.
Do you take my insurance?
Coverage questions are best answered directly. Call or text (303) 351-0744, or check the FAQ.
Wear and tear is not a diagnosis.
Before you accept that this is just what knees do now, get a real evaluation from a doctor with twenty years of hands and find out what is actually loading it wrong.
Lakeside Spine & Injury Center · 6073 W 44th Ave #101, Wheat Ridge, CO 80033 · Proudly serving Wheat Ridge, Arvada, Lakewood, Golden, Edgewater, Applewood, and West Denver.