Knee Joint Hands On Techniques

We have all spent sessions triggering the glute or applying hands-on treatment in hope that your knee pain patient will walk out of the clinic and the pain won’t come back.

Often it seems hard to know where to start. Today I’ll share a few key tissues that could just stop that pain experience and help you get your patient back on their feet.

The True Cause

In both part 1 and part 2 of this knee joint series we began to make sense of your objective assessment and how to implement the 80/20 rule. Now you need to take that information and feed it into your hands on treatment.

Below are some key tissues that are important to target when looking to reduce your patient’s pain experience but remember, this will only be effective if you can understand the 80% and find the true cause of the problem.

In the mentorship and return to play courses we teach, 20% of our attention is on the symptoms and the tissues causing the pain experience and 80% of our attention is directed toward what we think is the true cause of the problem.

These tissues are no magic bullet but they can help you reduce the pain experience so you can focus on the 80% and the true cause of the problem.

Key Tissues

Vastus Lateralis

In previous parts I have already mentioned the vastus lateralis. This area is worth considering, especially if the prone knee flexion test is restricted. I get a lot of value with knee pain patients in decreasing the protective tone in the vastus lateralis.

If a patient doesn’t have good intent through the mid foot, is finding it hard to co-contract at the knee, push through with the hamstring and the glute then this can be a very useful area. Hands-on treatment with this tissue can reduce symptoms almost immediately but you should always ask yourself, why has that gone into protective tone in the first place?


The popliteus lies close to the knee and occupies a space around the top 5th of the tibia. It is definitely worth considering when you are looking at reducing the pain experience in your knee joint patient. It’s proximity to the knee means that decreasing the perceived threat in this tissue will have a positive impact on your patient’s pain.

When we treat this tissue in particular you must get your patient standing and make sure they’re happy to put load through the tissue. If you decrease protective tone you want to reassure the system that it can load in a particular direction. You may want to do this with a transverse lunge or a similar exercise.

Half The Battle

Easing the pain experience is only half of the battle and it is only one small part of your graded exposure. After hands-on treatment you’ll need to restore and reassure the system so tissues do not tighten again. It all needs to be part of a wider plan.

Final thoughts

These are just some additional tissues to consider but you should not forget or neglect the basics we all learnt at university.

Taking the protective tone away will improve symptoms and knee flexion but this is useless if you’re not considering the true cause of the problem and your patient’s story.

If you have found this useful, click here to find out more on how to progress with your patient.

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