Common symptoms
- Pain on stairs, squatting, sitting cross-legged or getting up from a chair
- Stiffness in the morning or after sitting, usually easing within 30 minutes
- Swelling, creaking or a feeling of the knee giving way
- Pain around or behind the kneecap with running or long sitting
Common causes
- Knee osteoarthritis: common from middle age, affecting the joint surfaces
- Pain around the kneecap (patellofemoral pain or “runner’s knee”)
- Ligament injuries, including ACL and MCL sprains
- Meniscus (cartilage) tears
- Tendon pain below the kneecap (patellar tendinopathy)
Knee osteoarthritis: what helps
Osteoarthritis is not simply “wear and tear” that inevitably gets worse. Pain often varies a lot over time, and strengthening exercise, staying active and, where relevant, reducing body weight are among the most effective treatments, recommended in international guidelines ahead of injections or surgery for most people.
Joint replacement remains an option for severe osteoarthritis that limits daily life despite good conservative care, and physiotherapy before and after surgery helps recovery.
How we treat it
- Progressive strength training for the thigh, hip and calf muscles
- Balance and movement training for stairs, squatting and walking
- Hands-on treatment and taping for short-term pain relief
- Activity planning: keeping you walking, playing or training at a level the knee tolerates
- Advice on footwear, weight management and home exercise
How many sessions will I need?
Knee pain programmes typically involve 6 to 12 sessions over 6 to 8 weeks, with a home exercise plan. Strength gains take time, so the most benefit is usually seen after 6 to 12 weeks of regular exercise.
When to see a doctor first
Please see a doctor or go to an emergency department, rather than booking physiotherapy, if you have:
- A hot, red, swollen knee with fever or feeling unwell
- Unable to put weight on the leg after an injury
- Rapid swelling within hours of an injury, or a knee that locks and will not straighten
- Calf pain and swelling, especially after surgery or a long journey
- Knee pain with unexplained weight loss or night pain that does not ease with rest
Frequently asked questions
Is walking good for knee osteoarthritis?
Yes, for most people. Regular walking within comfort keeps the joint healthy. If walking is painful, we can adjust distance, pace and footwear, and add strengthening so you can do more.
Should I avoid stairs and squatting with knee pain?
Not permanently. You may need to reduce them while pain settles, but the aim of physiotherapy is to strengthen the knee so you can do them comfortably again.
Can physiotherapy help me avoid a knee replacement?
For many people with knee osteoarthritis, exercise-based physiotherapy reduces pain enough that surgery is not needed or can be delayed. It cannot guarantee that, and severe cases may still need surgery.
Do knee supports or braces help?
Some people find a simple sleeve or brace helpful for comfort or confidence during activity. They support, rather than replace, strengthening exercise.
How long before exercise helps knee pain?
Some people feel better within a few weeks, but strength takes 6 to 12 weeks to build, so most benefit comes from sticking with the programme for at least that long.