The 5 Most Common Causes of Knee Pain in Women Over 50 — And What You Can Do About It

Knee pain after 50 is incredibly common, but here’s the truth most people don’t hear: it’s not just “aging,” and you absolutely do not have to live with it.

Women experience knee pain at higher rates than men—especially after menopause—because of hormonal changes, shifts in muscle mass, and how daily life impacts the joints. The good news? Most causes of knee pain are treatable with the right plan.

As a physical therapist at Valley Knights Physical Therapy, here are the five most common causes I see every single week—and what you can start doing today to feel better.

1. Osteoarthritis (the “wear and tear” joint)

Osteoarthritis is one of the biggest culprits of knee pain over 50. As cartilage thins, the knee loses some of its natural cushioning. This can cause:

• Stiffness in the morning

• Pain when you first stand up

• Swelling around the joint

• Increased soreness after activity

What helps: Contrary to popular belief, rest is not the answer. The real solution is getting the right muscles stronger—especially the quadriceps, hamstrings, and glutes—so the joint has better support.

Even small improvements can make stairs, walking, and standing feel easier.

2. Weak Hip and Glute Muscles (the silent cause no one talks about)

Many women focus on the knee itself, but knee pain often starts above the knee.

When the glutes and hips are weak, the knee collapses inward. This puts extra pressure on the joint, leading to:

• Pain on the inside or outside of the knee

• Pain with going down stairs

• Discomfort when standing up from a chair

What helps: Building hip and glute strength is one of the fastest ways to reduce knee pain.

A few PT favorites include:

• Bridges

• Side-lying leg raises

• Mini-squats

• Step-ups

3. Meniscus Irritation or Degeneration

The meniscus is a cartilage “shock absorber” in your knee. Over time, it can get irritated or develop small tears—especially if you spend years bending, squatting, or kneeling for work, gardening, or childcare.

Common symptoms include:

• Pain with twisting

• Getting stuck in certain positions

• Clicking or catching

What helps: Good news: Most degenerative meniscus tears do NOT need surgery. Physical therapy can significantly reduce pain and improve function through targeted strength and mobility work.

4. Patellofemoral Pain (“front of knee pain”)

This is one of the most common types of knee pain in women over 50.

It shows up as:

• Pain around or behind the kneecap

• Pain going up or down stairs

• Pain with squatting

• Knees cracking or popping

It often comes from muscle imbalance or changes in how the kneecap tracks over the joint.

What helps: A PT can evaluate how your knee moves and build a program that strengthens both the hips and the inner quads so your kneecap glides properly again.

5. Tendon Irritation (often mistaken for arthritis)

Tendons are the cord-like tissues that connect muscle to bone. As we get older, tendons become more sensitive, especially if we suddenly ramp up activity, walk on hills, or increase steps.

You might notice:

• Pain below the kneecap (patellar tendon)

• Pain along the outside of the knee (IT band involvement)

• Pain that warms up with movement but gets worse later

What helps: Tendons love progressive strengthening—slow, controlled exercise that teaches the tissue to tolerate load again.

When Should You See a Physical Therapist?

While occasional soreness is normal, you should consider PT if:

• The pain lasts more than 1–2 weeks

• You’re avoiding activities you love

• Your knee feels weak, unstable, or “gives out”

• You keep telling yourself “I’m just getting older”

You don’t have to live with knee pain. You don’t need a referral. And you don’t need to wait until it’s “bad enough.”

At Valley Knights Physical Therapy, I help women over 50 feel stronger, more mobile, and more confident in their bodies through personalized 1:1 sessions and our Wellness Program.

Ready to Fix Your Knee Pain?

If you’re dealing with knee pain and want a plan that actually works:

👉 Book a mobility screen or evaluation at Valley Knights PT Your knee will thank you.