The Escalating Prevalence of Knee Pain in Females: A Systematic Review of Multifactorial Contributors

Abstract

Background: Knee pain is a leading musculoskeletal complaint worldwide and is reported more frequently by females than males across almost all age groups. This growing trend poses a substantial burden on healthcare systems and significantly impacts quality of life and physical functioning.

Objective: To systematically review the evidence on factors contributing to the increasing frequency of knee pain in females and discuss implications for physiotherapy and rehabilitation practice.

Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, PEDro, and Google Scholar for studies published between 2005 and 2024. Eligible studies included randomized controlled trials, observational studies, and systematic reviews examining contributing factors to knee pain in females. Methodological quality was assessed using the PEDro scale and the Newcastle–Ottawa Scale.

Results: Fifty-eight studies met the inclusion criteria. The most frequently identified contributing factors were hormonal influences, anatomical and biomechanical differences, obesity, physical inactivity, occupational exposure, sports-related overuse, footwear habits, and psychosocial stressors. Females demonstrated greater susceptibility to patellofemoral pain syndrome, knee osteoarthritis, and ligamentous injuries.

Conclusion: The increasing frequency of knee pain in females results from a multifactorial interaction of intrinsic and extrinsic factors. Physiotherapy interventions focusing on strength training, neuromuscular control, weight management, education, and psychosocial support are essential in prevention and rehabilitation strategies.