r/Kneesovertoes

I’m 37, 5’5”, and work as a graphic designer, so I’m at my desk about 8 hours a day. I love my job, but I’ve been struggling with knee pain that’s getting really frustrating.

It started in both knees (front and back), and over time my hamstrings and the front of my thighs started hurting too. I thought sitting was the problem, so I bought a standing desk. Then I realized standing for 20–30 minutes also caused pain. I even bought an ergonomic chair and now alternate between sitting and standing every 20 minutes, but nothing seems to help, bad no luck.

In May 2026, my doctor diagnosed me with Patellofemoral Pain Syndrome (PFPS). She gave me some exercises and I’ve been doing my exercises twice a day, along with heat and ice therapy, but I honestly don’t feel like I’m improving.

Has anyone else dealt with this? Did anything help? I’m open to any advice or hearing about your experience because this has been really affecting my ability to work.

Thanks for your time.

I’ve assessed hundreds of lifters over the years, and knee pain from squatting follows a
remarkably predictable pattern. It’s almost never the knee itself that’s the problem.
Here’s what I consistently find:
The actual causes, from most common:
Restricted ankle dorsiflexion. When the ankle can’t dorsiflex adequately, the knee
compensates by collapsing inward. The fix isn’t knee work — it’s ankle mobility and calf soft
tissue release. I’ve had some ankle-issues myself as a soccer/football player (injuries, stepped on, rolling my ankle, etc) - and everytime my ankle is affected, there’s pain in my knee or hip in some way or form.

Weak glute medius. The glute medius controls hip abduction and internal rotation. When
it’s underactive, the femur internally rotates under load, driving the knee into valgus. Lateral
band walks and single-leg work fix this faster than most people expect. I love these as a part of my warm up routine - it makes it way easier to engage my hips/glutes on more technical lifts (clean/jerk, other explosive movements I do for football)

Anterior pelvic tilt under load. When the pelvis tilts forward at the bottom of the squat, it
changes the tracking of the patella. This is a hip flexor and core stability issue, not a knee
issue. I believe combining soft tissue work, loaded stretches and proper warmup is the key here - especially if my clients have work that makes them sit for longer hours (office jobs, truck drivers, excavator drivers are some of the clients I’ve worked with who have these issues etc)

VMO inhibition. The VMO (the teardrop-shaped quad muscle) is the primary stabiliser of
the patella. It’s often inhibited in lifters with knee pain, creating a feedback loop where pain
causes inhibition causes more pain. I also see issues here with people who’ve had ACL-repairs if they are scared of using their knee, issues with loading etc.

The protocol I use:
Before every lower body session: 5 minutes of calf and hip flexor soft tissue work, 10 ankle
circles per side, 15 lateral band walks, 15 TKEs (terminal knee extensions) per side. Then load.
Most lifters see a meaningful improvement within 2–3 weeks of consistent application.
Happy to answer questions — this is what I do for a living (From Norway BTW 😊)

Hi everyone,

I'm 29 years old and I've been playing competitive soccer and tournaments for 6 years. A few months ago, I suddenly started experiencing pain in my right knee. At first, it was mild, but now it hurts even when I climb stairs.

I went to an orthopedist, who ordered an MRI, and I was diagnosed with grade 4 chondromalacia patellae. He said the only option is surgery: an autologous cartilage graft. They take healthy cartilage from another part of my body and implant it in my knee.

I've never been injured like this before, and I'm scared about the surgery. That's why I'm asking:

If you've had OATS, mosaicplasty, or MACI procedures, any experience would be helpful. I'm deciding between surgery or getting a second opinion, and it would really help to read real-life cases.

Were you able to return to competitive sports after the surgery?

Did the pain go away, or are you still experiencing discomfort?

Did the area where the cartilage was taken cause any problems?

Any experience would be helpful. I'm torn between surgery and seeking a second opinion, and reading real-life case studies would be incredibly helpful.

Not a doctor. Sharing what I learned so others don't have to spend 100 hours reading like I did.

The 5 things that mattered most:

1. Quad strength is #1. Not stretching, not "activating glutes" — pure quad. Every serious protocol I read (Australian sports med, JOSPT reviews, PT clinical guidelines) put quad strength at the center. If you have weak quads your knee gets loaded weirdly and the meniscus takes it.

2. Terminal knee extension is underrated. VMO activation matters more than "all-quad" work. A tiny 20 degree ROM band exercise beats a heavy squat if your extension is weak.

3. Load progression matters more than movement choice.Every source disagreed on WHICH exercises. Everyone agreed that PROGRESSIVE LOAD over 8-12 weeks was what changes tissue.

4. Pain during exercise ≠ damage. This one is huge and PT literature has moved a lot in the last 10 years. Some pain (2-4/10) during controlled exercise is normal and doesn't mean re-tear. But pain that INCREASES 24h post-exercise = you overdid it.

5. The "click" doesn't always matter. Palpable / audible knee clicks stress people out. Most non-surgical meniscus tears click and are still fine. If pain is decreasing and function increasing, don't chase the click.

My actual 8-week protocol summary:

- Weeks 1-2: Isometric quad sets, straight leg raises, heel slides

- Weeks 3-4: Wall sits, mini squats to 30°, step-ups

- Weeks 5-6: Full ROM squats to 90°, lunges, single-leg RDL

- Weeks 7-8: Split squats loaded, box jumps if pain-free, return to activity ramp

Happy to share sources if anyone wants them.

I added a powerlifting/bodybuilding hybrid leg day to my program about 6 months ago, I got back into the gym after not lifting for a few years so I wanted to start low and work my way back up, I am about 30 years old. I’ve been doing a PPL split for the past few months which meant leg day sometimes twice a week and semi heavy squatting both days, which I figure may already be what my problem was but I am curious if anyone has experience with the type of pain I experienced.

I kept sets between 6-8 reps and the bulk of my leg days have been 4 sets of squats for 6-8 and 4 sets of deadlifts for 6-8, followed by some accessories for 3 sets of 10-12.

Things have been progressing nicely until last week: I did my squats as normal, this time going for 225 for 4 sets of 7. I’ve squatted 225 for months now but went slightly higher volume than I usually do. The workout felt fine, form felt solid, and I wrapped up and went home. No pain during the movement itself.

Then about an hour after finishing my workout I was laying on the couch and felt a pain in my knee I never experienced before — it felt almost like a cramp (on the inside of my knee) and it hurt to try to extend my leg. It passed on one side after about 30 seconds but then a few minutes later I experienced the same thing on the other leg. That freaked me out so I’ve since decided to take a week off at least from training legs and have been afraid to run as that taxes the knees as well. They are not hurting me but I fear they are somewhat sensitive and something may have been strained, I tried to jog a bit the other day and it did not feel very comfortable.

Does anyone have experience with this type of knee pain? Have I simply been overtraining and should be fine as long as I go back with lower volume and a few weeks rest? I also have gained some weight (about 50lbs since I started weight lifting around a year ago) but a decent amount of this has been muscle as I’ve been training very often and eating relatively clean, just at a caloric surplus. I imagine the extra weight is tough on the knees but I still sense the squatting is the root of the issue.

Moving forward I plan to train legs only once a week and lower the weights to take it easy on my knees but curious what others experience and advice would be based on the description here. Thanks very much for any help and perspective 🙏

I've had patellar tendonitis for about 2 years and after months of targeted exercises I'm finally getting over it and returning to regular exercise (running, sports, etc.). However, as I'm starting to come back, I've been dealing with some pain in my heel below the spot where my achilles tendon meets the heel bone. I feel it especially after exercising. I'm wondering what this likely is and how I can deal with it to prevent it from turning into something more extreme. It's pretty mild pain atm.

54 M good shape, good diet, very active and hydrated. I had this issue arrive out of nowhere. Ive used a compression sleeve and iced for a couple of weeks and it seems to have gotten a little better but I am still afraid I might sublux again. Im afraid to jog but can go walking with a brace, even though I don't much. Anyway, is this an issue I will be prone to re injury? Do I need an MRI to make sure or with proper recovery can I get back to 100%?

Hoping some people here can relate to my story -

I tore my left ACL two days after turning 30. Eighteen months of knee reconstruction and PT followed. At the end of it I had a working knee and almost no record of how I got there. Every PT appointment started with "how do you feel today?". Good weeks were hard to replicate, bad days came randomly. The data was there in every session and every night of bad sleep. It just never got captured into something meaningful.

I kept thinking: was the pattern visible? Should I have kept a notebook for two years? And if someone had laid the data out properly for me, would that have helped?

I'm not a coach and I won't pretend to be. I'm just a health nut and a data nerd who went through 18 months of brutal knee recovery and came out the other side wishing I'd had something that could show me what actually happened and the small victories along the way. A timeline of my own daily rehab that made the invisible parts a little bit more visible.

I'm testing it now, manually, to see if it's actually useful to people before building something real. Looking for about 10 people who are currently injured, rehabbing, or interested in pain logging and data visualization.

You log your training and any pain once a day using sRPE, and once every two weeks I hand-build a one-page PDF. A personal-baseline load trend over 14 days specific to you. No diagnosis, no prediction. Just a transparent timeline.

15 seconds of logging a day for 4 weeks. PDF every two weeks.

DM me if you're in to help!

Hey everyone, 29M. I have been dealing with a L4/L5 disk herniation since i was 16. It happened after football season in higschool no traumatic injury. I thought I hurt my hamstring as I had this miserable pain down my leg. But darnt the doc told me to get an MRI and it was my sciatica. The pain was so bad and hard to describe. I couldn’t sit down, I couldn’t stand, I couldn’t bend.

After that diagnosis I went through the next 8 years running around seeing physical therapyists, getting massages, acupuncture, epidural shots, and finally diseconomy surgery. It was so demoralizing. Every physical therapists wanted me to do these horrible nerve glides that did nothing. Then pedestrians told me to stretch more or work my abs. But nothing worked. The doctors were telling me there was no way to fix disc herniations and i was F’ed for good. I came to accept my pain as part of my existence.

HOWEVER, I then saw an old friend in a bar that was dealing with something similar. He told me about this posture focused therapy that worked for him and I should try it. Since I was willing to try anything at that point I gave it a shot. The dude gave me 20-30 mins of “homework” every night and I made it my mission to do 40-60 minutes a night. After several months I was completely pain free and on top of the world. The feeling of overcoming what doctors said was not possible transformed me to look at life differently. I felt like I had reclaimed power and no one knew what was best for me besides me. I ended up running two marathons and getting in great shape. What a time. This lasted from about 24-28 years old.

Well I ended up getting lazy for a year (came after meeting my fiance who enjoys the finer things in life more than committing to properly moving function) and the pain came back in a massive way. Did an mri and sure enough those herniations were back this time l5/s1. I was down BAD. could not sit could not stand. Very difficult to think or do anything. I went back to my physical therapist and spent the last seven months going back into that zone of rehab comes extremely (extremely) high on the priority list. I am not done yet but I’m 65% back to where I want to be. Considering how down bad I was it again has absolutely amazed me at what was possible.

These histories have inspired me to try and find like minded people who to share war stories and inspire people who were told they were done for. And also to get way smarter on movement. Once we get out of pain I want to take more steps and go beyond the possibility to slip back. I’ve gone thru a lot of physical traumas so it’s taking time but I’m determined not to stop when I’m out of pain.

What’s your story?

Hi everyone, I'm 23 years old.

Its been 3 years since my my hoffas impingement/PFPS had started. I played some soccer in college, and had started to get into long daily walking around this time to rehab a small MCL injury.

I started getting this hot, dull pain on the front of my knees during my walks, which made me stop for a while. It kicks in whenever I sit down, and even when I lay on my back. Like, really? I can't even lay flat down without it burning?

Whats funny, I've been sleeping on my side because of this, and my shoulders are starting to go now.

But the one thing that's been REALLY killing me is how I haven't been able to sit down for long. Standing feels fine.

Whenever I sit for more than a few minutes, my anterior knee area has this persistent discomfort.

It feels hot, but the pain isn't sharp. For 3 years, I've created a baseline of pain in my knees that is constant and seems neverending.

its been such a slowdeath

is this just a normal part of life? do most people go through this? i don't want this

My PT diagnosed that my kneecap maltracks to the side when I walk, but I have slight knock knees, structural not functional. We haven't been able to alter my gait in a pain-free way.

Theres also a deep clunk whenever I bend my knees, and because of this my fat pads have been impinging for the 3 years. I've done days-worth of crab walks, glute work, and 6 months of PT and It hasn't really gotten better. Maybe I needed more stretching..? I do,'nt jnow

strengthening has only seemed to make it worse, and the maltracking more prevalent.

sorry to vent haha, ive kind of given up. this was a last cry for something, anything. I am a rat, on a sticky surface.

thank you for being her e with me, i hope your pain escapesyou forever