The Role of Muscle Imbalance in Chronic Knee Pain—And How to Fix It

When most people think about knee pain, they picture an injury—maybe a torn ligament or a worn-out joint. But there’s another, often-overlooked cause that plays a major role in ongoing discomfort: muscle imbalance.

If you’ve been living with knee pain that just won’t go away, even without a clear injury, your muscles might be sending your joint into overdrive. The good news? Muscle imbalances can be addressed, corrected, and strengthened—with the right approach.

Let’s break down how it all works, and what can be done to bring lasting relief.

What is Muscle Imbalance?

Muscle imbalance happens when some muscles are stronger, tighter, or more dominant than others around a joint. The body relies on a delicate balance of muscle groups to keep joints stable and aligned. When one group overpowers another or doesn’t activate correctly, it can throw off movement and put stress in all the wrong places.

In the case of the knee, that often means increased pressure on the joint, altered movement patterns, and eventually—pain.

Why Muscle Imbalance Affects the Knee So Much

The knee doesn’t operate in isolation. It sits between the hip and the ankle, which means any weakness or tightness above or below can affect how it moves and absorbs force. And because the knee is a weight-bearing joint, it’s particularly sensitive to even small changes in alignment and stability.

Here are a few common muscle imbalances that can cause chronic knee pain:

1. Weak Glutes (Especially the Gluteus Medius)

When your glutes aren’t firing properly, the thigh tends to rotate inward during walking or running. This creates added strain on the inner knee and kneecap.

2. Tight or Overactive Quadriceps

Tight quads, especially the rectus femoris, can pull the kneecap upward and out of its normal tracking path. Over time, this can cause irritation and pain in the front of the knee.

3. Weak Hamstrings

The hamstrings help control the forward movement of the shin bone. When they’re weak, the knee can become unstable and less supported, especially during dynamic movements like squatting or climbing stairs.

4. Tight Hip Flexors

Tight hips tilt the pelvis forward, which shifts the body’s centre of gravity and changes how the knee absorbs impact. This can lead to poor alignment and stress on the joint.

5. Calf and Ankle Restrictions

If your ankle doesn’t move freely (due to tight calves or previous injuries), your body compensates further up the chain—and often, the knee pays the price.

What Does Chronic Knee Pain from Muscle Imbalance Feel Like?

People with muscle imbalance-related knee pain often report:

• A dull ache around the kneecap or joint line

• Discomfort during or after walking, running, or climbing stairs

• Pain when sitting for long periods (sometimes called “moviegoer’s knee”)

• Feeling like the knee is unstable, weak, or “off” during certain movements

Pain can be one-sided or affect both knees depending on how your body is compensating.

How Tewantin Physiotherapy Can Help

At Tewantin Physiotherapy, we take a whole-body approach to knee pain. That means not just looking at the joint itself, but also assessing how the surrounding muscles and movements are contributing to the problem.

Here’s how we address muscle imbalance and chronic knee pain:

✅ Detailed Movement Assessment

We begin with a thorough assessment of how you move—watching how your hips, knees, and ankles work together. This helps pinpoint exactly which muscles are underperforming or overactive.

✅ Manual Therapy

If there’s tightness or restriction in certain muscles or soft tissues, we use hands-on techniques to help release tension and restore mobility.

✅ Targeted Strength and Stretch Programs

This is where the magic happens. You’ll receive an individualised exercise program designed to strengthen weak areas and improve flexibility where needed.
Think glute activation, hamstring strengthening, quad control, and hip mobility—all geared toward bringing balance back to your movement.

✅ Postural and Movement Education

We help you understand how your daily habits might be contributing to the problem—and show you better ways to move, sit, stand, and exercise to avoid future pain.

✅ Ongoing Progress Monitoring

As your strength improves and pain reduces, we adjust your program to keep your body moving forward (literally and figuratively).

You Don’t Have to Live with Chronic Knee Pain

If muscle imbalance is the hidden cause of your knee discomfort, ignoring it won’t make it go away. But with the right support and guidance, you can correct the issue, restore balance, and return to doing the things you love—pain-free.

Book your appointment with Tewantin Physiotherapy today and let’s get your knees moving better, one step at a time.