Knee Pain? Why Physical Therapy Should Be Your First Stop.

Knee pain has a way of sneaking into daily life. Maybe it started as a dull ache going up stairs. Maybe your runs don’t feel as smooth anymore. Or maybe your knee just doesn’t trust you the way it used to.

For many adults, the first instinct is to book a doctor’s appointment or request imaging. But here’s something most people don’t realize:

For the majority of knee pain cases, physical therapy should be the first stop—not the last.

Knee Pain Is Common—And Often Mechanical

The knee is a load-sharing joint. It relies heavily on:

• Hip strength

• Ankle mobility

• Quadriceps and hamstring coordination

• Good movement mechanics
  

When any of those pieces fall off—even slightly—the knee often takes the hit.

Common knee complaints we see include:

• Anterior knee pain (often labeled “runner’s knee”)

• Pain with stairs or squatting

• Swelling after activity

• Stiffness after sitting

• Knee pain without a clear injury
  

Most of these issues are mechanical, not structural emergencies.

Why Imaging Is Often Unnecessary Early On

MRIs and X-rays can be useful tools—but they’re frequently overused in early-stage knee pain.

Research consistently shows:

• Many people without pain have “abnormal” imaging findings

• Degenerative changes are common and often unrelated to symptoms

• Imaging does not reliably predict pain or function

• Early imaging rarely changes the initial plan of care
  

More importantly, seeing something “wrong” on a scan can increase fear, avoidance of movement, and delayed recovery—even when the knee is safe to load.

You Do NOT Need a Physician Referral to Start PT

In Tennessee, you have direct access to physical therapy. That means:

• No referral required

• No waiting weeks for appointments

• No unnecessary imaging before evaluation

• Faster answers and earlier relief
  

For non-traumatic knee pain (no fracture, infection, or sudden instability), starting with PT is both appropriate and evidence-supported.

What a PT Evaluation Looks at That Imaging Can’t

At Nashville Physical Therapy & Performance, a knee evaluation goes beyond the knee itself.

We assess:

• Hip and ankle mobility

• Strength and load tolerance

• Walking, squatting, and stair mechanics

• Activity history and training patterns

• How your knee responds to movement—not just rest

  
  

This allows us to identify why your knee hurts—not just where.

Why Early PT Leads to Better Outcomes

Starting PT early can:

• Reduce pain faster

• Improve confidence in movement

• Prevent compensation patterns

• Avoid unnecessary injections or procedures

• Keep small issues from becoming chronic problems
  

Waiting often leads to:

• Deconditioning

• Increased stiffness

• Heightened sensitivity

• Longer recovery timelines
  

Common Knee Diagnoses That Respond Well to PT

Physical therapy is often the first-line treatment for:

• Patellofemoral pain

• Early osteoarthritis

• Tendon irritation (patellar or quadriceps)

• Meniscus-related pain without locking

• Overuse injuries

• Post-activity swelling or soreness
  

In many cases, surgery and injections are not indicated—and strength-based rehab leads to better long-term outcomes.

When Imaging Is Appropriate

There are times when medical imaging or physician referral is necessary, such as:

• Significant trauma

• Sudden inability to bear weight

• Locking or true instability

• Signs of infection

• Symptoms that do not improve with appropriate rehab

  
  

A physical therapist is trained to recognize these red flags and guide you appropriately if they arise.

Reset How You Approach Knee Pain in 2026

Knee pain doesn’t automatically mean damage. It doesn’t mean you’re “wearing out." And it doesn’t mean you need to stop moving.

Often, it means your knee needs better support, smarter loading, and targeted strength.

Starting with physical therapy gives you clarity, direction, and a plan—without unnecessary delays.

Ready for Answers About Your Knee?

If knee pain is limiting your workouts, daily activities, or confidence in movement, a physical therapy evaluation can help you understand what’s going on and what to do next.

At Nashville Physical Therapy & Performance, we help active adults address knee pain early so they can keep doing the things they enjoy—without fear or frustration.