Knee Pain: Causes, Treatment and When to See a Doctor

Knee pain can show up in many ways. A futsal player twists their knee during a game. A runner who adds distance or speed too quickly. An older person whose knee feels stiff every time they get up from a chair.

Sometimes the cause is clear, and there was a real injury. Sometimes the pain builds up slowly. First it hurts going up stairs, then when you squat, and after a while even sitting for a long time feels uncomfortable.

On this page, I explain what is inside the knee joint, the common causes of knee pain, what the doctor will examine, and how treatment works at my clinic in Kuantan.

What is inside the knee joint

The knee is the joint between the thigh bone (femur) and the shin bone (tibia). The kneecap (patella) sits at the front, and it moves up and down every time the knee bends or straightens. Inside this small joint space there are several important structures, and each one has its own job.

• Cartilage. A smooth layer that covers the ends of the bones so the joint can move smoothly.
• Meniscus. A rubbery cushion between the thigh bone and the shin bone. Its job is to absorb the impact every time you walk, jump or land.
• Ligaments. Strong straps that tie bone to bone. These are what keep the knee stable and stop it from sliding.
• Tendons. Cords that connect muscle to bone. When a muscle tightens, the tendon pulls on the bone so the knee can move.

Why does this matter? Because each structure, when injured, feels different. A torn ligament usually makes the knee feel loose. A torn meniscus can make the knee feel like it catches. An inflamed tendon usually hurts when you use it. That is why the doctor asks a lot of questions before examining your knee.

When a part is injured, the knee shows it. Some knees hurt, some swell, some feel unstable, and some cannot bend or straighten fully. Different causes give different signs. The doctor’s job is to find the real cause behind the signs.

Common causes of knee pain

Knee pain is not one disease. It has many causes. The easiest way to understand it is to find the situation closest to yours.

Sports injuries

It usually happens when the knee twists, stops suddenly, or takes an impact. We see many of these cases in futsal, football, badminton and netball. The most common ones:

• A torn ligament, including the ACL. The ACL is the ligament that stops the knee from sliding forward. The signs are a “pop” sound at the moment of injury, swelling within a few hours, and a knee that feels loose after that.
• A torn meniscus or cartilage. The pain is usually along the joint line, either the inner or outer side of the knee. Sometimes the knee feels like it catches, or locks completely.
• Tendon injuries. Tendons can strain, become inflamed or tear when the load on them is more than they can carry.

Overuse

Not all knee pain comes from a single event. Repeated load can cause injury too.

• Runner’s knee. Pain at the front of the knee, around or behind the kneecap. It is usually worse going downhill or down stairs.
• Jumper’s knee. Pain just below the kneecap, on the tendon that works hard every time you jump and land.

Joint wear

Osteoarthritis happens when cartilage gets thinner with age and use. The knee feels painful and stiff, especially when you first start moving and after activity. This is a big topic, so we explain it more fully on our knee osteoarthritis page.

Other causes

Gout (older patients call it asam urat) can also attack the knee. The knee becomes swollen, red and very painful, often suddenly, so it is sometimes mistaken for an ordinary injury. There are other causes too, which is why the doctor’s assessment matters before any treatment starts.

What Dr Harith will examine

The assessment starts with a conversation. The doctor asks how the pain started, which activities make it worse, whether there is any swelling, and whether the knee has ever felt like it catches or gives way.

Then comes the physical examination. The doctor feels the painful part of the knee, tests the ligaments, and checks how far the knee can move and how strong the muscles around it are. Sometimes the doctor will ask you to walk, squat or jump a little, to see how the knee works when it carries your weight.

In most cases, the doctor already knows the problem at this stage. Through the examination, not through a scan.

A scan is only done when there is a question the examination cannot answer.

• X-ray. To look at the bones, confirm there is no fracture, and see signs of joint wear.
• Ultrasound. To look at the tendons and the soft tissues around the knee.
• MRI. To look at the structures inside the knee in more detail, such as the ligaments, meniscus and cartilage.

So not every painful knee needs an MRI at the first visit. The doctor decides which scan is suitable after the examination, not before.

At ISMEC, an X-ray can be arranged directly by the clinic. You will be taken to SASMEC @IIUM by buggy or van. An MRI can also be arranged by the clinic, or you can bring your own MRI CD if you have had one done before.

After the examination, what happens next?

Good knee treatment starts with a proper assessment. Not straight to an injection, and not straight to surgery. The order goes like this:

1. Assessment. Your history, a physical examination, and a scan if needed.
2. Diagnosis. The doctor explains what is happening inside your knee, and why.
3. Treatment options. These are decided by the diagnosis. They include:
   • Medicine, to control pain early so you can still move.
   • Physiotherapy, to strengthen the thigh and hip muscles, restore knee movement, and rebuild strength.
   • Injections, for suitable cases, including PRP. There is more about PRP on the procedure page.
   • Surgery, only when it is truly needed. For example a completely torn ligament, or a knee that locks.
4. Rehabilitation. A structured programme matched to the state of your knee, with clear targets at each stage. It usually involves exercise, changes to how you train, and follow-up sessions to track your progress.
5. Return to activity. You go back to playing, training or working when your knee is truly ready, not just when the pain is gone.

There is one question almost every patient asks: “Does my knee need surgery?”

The answer is, not necessarily. The decision for surgery is made after a full assessment, not based on an X-ray alone. Some cases recover with physiotherapy and load management. Others do need surgery to return to activity safely. What matters is following the order. Diagnosis first, then the decision.

Warning signs, when to come in urgently

Some symptoms cannot wait. Get assessed urgently if you have any of the following:

• Your knee cannot bear your weight.
• Severe swelling, or swelling that comes on fast after an injury.
• A knee that locks and cannot be straightened.
• A knee that feels loose or “gives way” when you walk or turn.
• A “pop” sound, or a feeling of something tearing at the moment of injury.
• Fever, together with a knee that is swollen and red.

All of these signs need to be checked quickly, because they may point to an injury that needs early treatment. The doctor will assess your condition, decide whether a scan is needed right away, and explain the next steps.

Frequently Asked Questions

What are the common causes of knee pain?

The most common are sports injuries such as a torn ACL, a torn meniscus or cartilage, and tendon injuries. Some come from repeated load, such as runner’s knee and jumper’s knee, some from joint wear (osteoarthritis), and some from other causes such as gout. Each cause gives different symptoms, so it is the doctor’s assessment that confirms what is really happening in your knee.

When should I see a doctor about knee pain?

Come in urgently if your knee cannot bear your weight, is badly swollen or swells quickly, locks or feels loose, there was a “pop” sound at the time of injury, or you have a fever with a knee that is swollen and red. If the pain keeps going, keeps coming back, or is getting in the way of your work and sport, book an appointment. Do not wait until it gets worse.

Does knee pain always need surgery?

Not necessarily. The decision is made after a full assessment, not based on an X-ray alone. Some cases recover with physiotherapy, load management and medicine, and some do need surgery. Once the cause is clear, the doctor will explain the options and make the decision with you, based on your activities and your goals.

Book an Appointment

Assessments are done at the IIUM Sports Medicine Clinic (ISMEC), IIUM Kuantan Campus.

Bring your MyKad, a referral letter if you have one, and records of any old scans such as X-ray films or MRI CDs. A referral letter is not required. But if you have old scans, the doctor can compare them with how your knee is now.

Book through WhatsApp at +609 591 2609. Please make an appointment before you come.

Clinic hours: Monday and Thursday, 8.30am to 4.30pm. Friday, 8.30am to 11.30am.

The first appointment takes about 30 to 45 minutes.

For guides on other conditions, visit our patient information page.