The purpose of this research is to examine changes in pain sensitivity during high fatigue exercise, low fatigue exercise, and no treatment in individuals who are currently experiencing knee pain. Dosing dynamic resistance exercise intensity based on fatigue level is a novel, clinically feasible method. Dynamic resistance exercise at a high intensity (75% 1 repetition maximum (RM)) produces significant hypoalgesia at local sites compared to no treatment; however, dosing intensity based on 1RM can be challenging to implement in the clinical setting. Fatiguing endurance tasks produce local and systemic reductions in pressure pain threshold with low intensity isometric exercise completed until failure resulting in the largest exercise induced hypoalgesia effects. Fatigue may be an important mediator in pain response to exercise.

Inclusion Criteria:

• Experiencing knee pain symptom intensity rated as 3/10 or higher in the past 24 hours

Exclusion Criteria:

• non-English speaking
• history of knee surgery or fracture within the past 6 months
• history of quadriceps tendon rupture
• history of a chronic pain condition, such as fibromyalgia
• systemic medical conditions that affect sensation, such as uncontrolled diabetes or neurological conditions
• blood clotting disorder, such as hemophilia
• known presence of cardiovascular, pulmonary, or metabolic disease
• current use of tobacco products
• contraindication to the application of ice, including blood pressure over 140/90 mmHg, -conditions that cause hives or blood in urine when exposed to cold, and any reductions in blood flow to arms or legs.
• not physically ready to exercise without a medical exam as indicated by the Physical Activity Readiness Questionnaire + (PAR-Q+)
• pain during active knee range of motion 0-90 degrees (examined during screening)
• Pregnant
• unable to attend 4 sessions

Investigator administering Pressure Pain Threshold will be blinded to the intervention.