A feeling of tightness or stiffness in the knee may feel painful, but some people experience knee tightness with no pain. It can occur as a result of overuse, injury, or age-related wear and tear.

This article outlines some common causes of tightness in the knee and their associated symptoms. It also provides some treatment options for alleviating tightness in the knee.

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Strengthening the upper leg muscles may help support and protect the knee joint. Step-ups can strengthen the knee and relieve tightness.

Below are some common causes of tightness in the knee.

Meniscal tear

The menisci are two crescent shaped pads of cartilage inside the knee joint. They help cushion the knee joint and allow smooth and flexible movement of the knee.

Injuries or tears to the menisci can happen during sport or as a result of general wear and tear.

A person may hear or feel a “pop” when their meniscus tears. Other common symptoms of a meniscal tear include:

  • pain, swelling, or tenderness around the knee
  • a feeling that the knee locks, gets stuck, or does not fully straighten
  • pain when fully bending the knee, such as when squatting

Treatment

According to the American Academy of Orthopedic Surgeons, the treatment a doctor recommends will depend on a number of factors, including:

  • the location and severity of the tear
  • the person’s age
  • their activity levels
  • their symptoms

In some cases, this injury may require surgery.

Ligament or tendon injury

Ligaments and tendons are bands of fibrous connective tissue. Ligaments connect bones to other bones, whereas tendons connect muscles to bones.

Injuries to the ligaments or tendons of the knee most often occur during sports or other physical activities.

Ligament or tendon injuries can cause the following symptoms:

  • knee pain, knee swelling, or both
  • pain when fully straightening or bending the knee
  • a feeling that the knee is unstable or about to give way

Treatment

Treatments for ligament or tendon injuries depend on the extent of the damage. A doctor may recommend:

  • wearing a knee brace to help stabilize and protect the knee joint
  • trying muscle-strengthening exercises
  • doing gentle stretches

Some ligament and tendon injuries require surgical intervention by an orthopedic surgeon to restore stability to the knee joint.

Arthritis

There are two main types of arthritis that can cause tightness in the knee: osteoarthritis and rheumatoid arthritis.

Osteoarthritis

According to the Centers for Disease Control and Prevention (CDC), osteoarthritis is the most common type of arthritis in the United States, affecting over 32.5 million adults.

It occurs when the cartilage that helps cushion a joint breaks down, eventually causing bone to rub against bone.

Osteoarthritis typically leads to the following symptoms:

  • joint inflammation and swelling
  • joint pain
  • joint stiffness, particularly after sitting or lying down for a period of time

Treatment

Although there is currently no cure for knee osteoarthritis, the following may help ease the symptoms:

  • losing weight (when appropriate) to reduce load bearing on the knee joint
  • physiotherapy, which can help strengthen the muscles around the knee joint
  • taking medication to help treat joint inflammation and pain, such as nonsteroidal anti-inflammatory drugs

If these treatments do not improve a person’s symptoms, an orthopedic surgeon may recommend a partial or total joint replacement (which is surgery to replace a damaged joint with an artificial joint) or osteotomy (which is surgery that involves realigning the bone either above or below the knee to shift the load bearing of the joint away from the damaged area).

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition in which the immune system mistakenly attacks healthy cells within the body. This condition primarily affects the joints, but it may also affect other body tissues.

According to the CDC, rheumatoid arthritis can cause chronic pain and stiffness within the joints. The condition often affects both knees.

Treatment

There is currently no cure for rheumatoid arthritis. However, medications called disease-modifying antirheumatic drugs can help slow the progression of the condition.

The following self-help measures may also help reduce pain and improve joint function:

  • increasing physical activity levels
  • losing weight (when appropriate)
  • quitting smoking

Arthrofibrosis

Arthrofibrosis of the knee, or stiff knee syndrome, occurs when too much scar tissue builds up around the knee joint. The condition can develop following knee surgery.

Symptoms of arthrofibrosis include pain, swelling, and warmth in the knee joint. People with this condition may also walk with a bent knee or a limp.

Treatment

Early on, mild forms of arthrofibrosis are manageable with physiotherapy. However, more advanced cases with significant stiffness often require surgery to remove the scar tissue and improve range of motion.

A person should see a doctor if they experience severe or persistent tightness in the knee. Some other symptoms that may indicate the need for medical attention include:

  • pain or swelling around the knee joint
  • locking or painful clicking of the knee joint
  • a feeling that the knee is about to give way
  • an inability to bear weight on the affected leg

The doctor will ask about the person’s symptoms and conduct a physical examination of the knee. They may also order one of the following tests:

  • Imaging tests: An X-ray or MRI scan may help reveal structural irregularities or injuries of the knee.
  • Joint aspiration: This is a procedure that involves using a needle and syringe to remove fluid from inside the knee joint. A laboratory technician will then analyze the sample to determine the cause of the knee problem.
  • Knee arthroscopy: This is a type of keyhole surgery that involves inserting a tiny camera into the knee joint to examine the cartilage and other tissues inside the knee.

Strengthening the upper leg muscles may help support and protect the knee joint.

Below are some simple home exercises that can help strengthen the muscles and relieve tightness in the knee.

Straight-leg raise (sitting)

To perform the straight-leg raise in a sitting position:

  1. Sit on a chair and straighten one leg out in front, so that it raises upward.
  2. Hold the position for 10 seconds.
  3. Slowly lower the leg back down.
  4. Repeat these steps 10 times on each leg.

People can also perform this exercise while lying on the floor.

Muscle stretch

The following exercise may help prevent the loss of full knee extension:

  1. Lie flat on the floor with one leg straight out in front and the other bent at the knee.
  2. Place a rolled-up towel beneath the ankle of the straightened leg.
  3. Push the back of the straightened knee firmly toward the floor.
  4. Hold for 5 seconds.
  5. Repeat these steps at least five times on each leg.

Stepups

This exercise requires the use of stairs or a step platform:

  1. Step onto the stair or step platform with the right foot, then bring the left foot up to meet it.
  2. Step down with the right foot, then step down with the left foot.
  3. Repeat the exercise, but start with the left foot this time.
  4. Repeat these steps as many times as feels comfortable.

Some home remedies may help ease tightness and stiffness. The sections below will outline some home remedies in more detail.

PRICE therapy

PRICE stands for protection, rest, ice, compression, and elevation.

  • Protection: This means taking a break from physical activities that could cause further knee strain or injury.
  • Rest: This can reduce the risk of further injury and allow damaged tissues to heal.
  • Ice: This can help reduce swelling and inflammation. A person should wrap the ice in a cloth before applying it to the skin.
  • Compression: This may help limit swelling and inflammation.
  • Elevation: Keeping the knee raised above the level of the heart may reduce swelling.

Regular exercise

As often as possible, a person should choose low impact physical activities that are more gentle on the joints.

Some examples include:

Tightness in the knee can occur as a result of injury to the tendons, ligaments, or cartilage inside the knee. In some cases, it may be a symptom of an underlying medical condition.

Anyone who experiences tightness in one or both knees should see a doctor for diagnosis and appropriate treatment.

Performing simple strengthening exercises may help build up the muscles around the knee joints. This will help support the knee and protect against the likelihood of further injury.