• Gino Alho

Knee Pain: Risk Factors, Prevention & Treatment


Part 3


Risk Factors


There is a wide variety of risk factors that can increase the risk for developing knee problems. Risk factors can be categorized into factors you can control (modifiable) and factors you cannot control (non-modifiable).


Modifiable factors:

  1. Muscle strength and flexibility: a lack of muscle strength and inflexibility can increase the risk of knee injuries. Muscle strength is vital to provide stability and protection of your joints, especially during exercise. Deficits in these may negatively influence your movement mechanics. As a result excessive stress is placed on the knee joint and other body areas. Muscle flexibility is important so that you can use your knee through an optimal range of motion. Certainly this is important for daily life or sports.

  2. Training errors: training too much too soon in your exercise programme. In addition, sudden changes in your training routine can place significant stress on the knee. This may include large increases in training intensity (total repetitions, sets, load) and/or duration (time spent exercising). You need to gradually allow your knee to adapt to your exercise program. A Biokineticist will assist you in getting this right.

  3. Movement quality: each person has a unique way of moving their body. In some cases, movement can be extremely poor resulting in excessive stress placed on the knee. As a result, your knees are at a increased risk of developing pain.

  4. Excessive weight: people who are overweight or obese place unhealthy stress on their joints. This increased stress is even present with merely walking. Excessive weight may also increase the risk of developing osteoarthritis and other knee problems.

  5. Nutrition: this a key component for knee joint health, especially for younger children who are still growing. Good nutrition is essential to develop strong bones, muscles and joints. As people grow older, good nutrition remains important for healthy bodies. Nutrition is key in reducing the risk of developing chronic conditions that may affect knees.


Non-modifiable factors:

  1. Age: age is a major factor contributing to knee problems. Specific knee problems are common to certain age categories. Aging may increase susceptibility for the development of knee problems (e.g. osteoarthritis). As you age, there is a greater cumulative wear and tear on knee joints. You are never too old for regular exercise. Exercise is best supervised by a qualified exercise treatment professional such as a Biokineticist.

  2. Gender: gender can increase risk for developing certain knee problems. Women are twice as likely to develop patellofemoral pain due to the pelvis shape that women have which is larger than men. A larger pelvis can negatively affect alignment of a person’s lower limbs placing strain on the knees. Patellofemoral syndrome is a broad term to describe a general pain felt around or under the kneecap. This is generally as due to kneecap malalignment. As a result, the knee cap moves in an irregular manner which can irritate various tissues at the knee.

  3. Previous injury: previous knee injuries can increase the risk of future injury or development of other knee problems. Proper injury treatment is required to reduce the risk of re-injury or other injuries.

Read our article on the common causes of knee pain


So what can you do?

Prevention & Treatment


Biokineticists can assist you in many ways to solve knee problems, reduce the risk of injury and assist in recovery from a previous injury or knee pain. Biokineticist’s have a thorough understanding of assessment and treatment of knee injuries and can assist you in dealing with your knee pain as follows:



1. A structured exercise programme that is specific to you.

Your exercise programme must be customized for you as you are unique. At Health & Fitness Hub, our Biokineticist does not follow a one-size fits-all approach. This holds not only for exercise but also for injury. Two people with the same injury require different programmes customized for them. We consider your unique needs when designing your programme and formulate it based on thoroughly researched scientific principles.

2. Holistic exercise programme.

People often neglect the small things when it comes to exercise programmes. Firstly, they often avoid flexibility training, or a pre-exercise warm up. Secondly, they focus on training only prominent muscle groups and forget other key small muscle groups. Lastly, endurance athletes often do not incorporate resistance training into their exercise programmes.

A light 5 to 10-minute pre-exercise warm up can significantly enhance performance during your exercise session. It is also better to gradually prepare your body for exercise. Smaller muscle groups such as the calves and various outer hip muscles rarely receive attention, yet these muscles are vital for providing knee stability during exercise and movement. Resistance training is key to strengthening muscles, tendons, bones, and joints and ideal for ironing out any muscle deficits that you may have.

3. Progressive exercise.

The human body adapts to the stress placed on it to become stronger. This is key to build and maintain strong muscles, ligaments, tendons, joints and bones. Exercise is a stressor and should be implemented gradually. Too much stress too soon is harmful. A Biokineticist adapts your exercise programme systematically and as a result, you get better and stronger without running the risk of injury.

4. Exercise smart.

Listen to your body, pain is the body’s signal that something is wrong. Never train through severe pain. In addition, avoid significant bouts of rest as this can make the problem a lot worse. Too much rest can weaken muscles, which can worsen joint pain. If you have a knee injury or suffer from knee pain or arthritis, a proper exercise plan is key. You may be required to change the way you exercise.

The knee is a prominent weight bearing joint, therefore it may be wise to switch to lower impact exercises such as Pilates and/or swimming at least for a few days or weeks. We can assist you formulate a programme so that you can train “around your pain” while strengthening the area of weakness.

5. Shed those extra pounds.

Excessive body weight places additional strain on your joints and increases the risk of knee injuries, osteoarthritis and resulting pain. A well-structured exercise programme is key to achieving and maintaining a healthy weight. One common misconception of exercise is that cardio is the only form of exercise for weight loss.

Resistance training should form an integral part of a properly structured exercise plan that helps you reach and maintain your target weight. Resistance training has the added advantage of building muscle. Muscle is more metabolically active than fat which means the more muscle you have, the easier it is to shed extra weight. As a bonus; stronger muscles protect your joints, specifically the knee.

6. Prehab / Proactive exercise.

Exercise is important to condition or prepare your body for the stresses placed on it from activities of everyday life. In a sporting context, strength and conditioning is vital so that your body is ready to meet the specific demands of your sport. Prehab is also important to improve movement quality that avoids excessive stress on your joints. We suggest you work with your Biokineticist to “bulletproof” your body and make it more injury resistant.

Give our Biokineticist a call to set up your appointment. Tell us your story. Let us investigate your complaint or provide insight. We invite you to contact us or leave a message by clicking this link.

Learn more about what a Biokineticist does and how we differ from Physiotherapists



We all want to achieve our health and fitness goals, but must remember that it is a process. Sustainable improvements are achieved gradually, not overnight. Remember, Rome was not built in a day!