Knee pain: common causes, what helps and how physiotherapy works

The knee carries your body weight with every step, stair and squat, so it is no surprise that knee pain is one of the most common problems physiotherapists treat. In many cases, the right exercise and some changes to daily activity make a big difference.

Common causes

Osteoarthritis

Very common from middle age onwards. The knee may feel stiff in the morning or after sitting, ache with activity, and sometimes swell. It often goes through better and worse phases. Osteoarthritis is not simply "wear and tear" that only gets worse: strength, weight and activity all affect how it feels, and many people improve a lot with exercise.

Pain at the front of the knee

Pain around or behind the kneecap, worse on stairs, squatting, kneeling or after sitting for a long time. Common in younger, active people and those who have suddenly increased exercise. It usually responds well to strengthening the hip and thigh muscles and adjusting activity.

Injuries

A twist during sport or a fall can injure a ligament or the cartilage (meniscus). Signs include swelling soon after the injury, the knee giving way, or locking. These need assessment.

Other causes

Tendon problems, inflammation, and pain referred from the hip or back can all cause knee pain.

What you can do yourself

• Stay active within comfort. Walking, cycling and swimming are usually well tolerated.

• Strengthen the muscles around the knee (see below).

• Pace activity. Spread harder tasks through the day rather than doing everything at once.

• Manage weight if you carry extra; it reduces the load on the knee with every step.

• Supportive footwear for walking.

• Ice or heat for 15 to 20 minutes can ease pain.

Simple exercises to start with

Do these slowly, within comfort, most days. Stop if one causes sharp pain.

• Thigh tightening: sitting with your leg straight, tighten the muscle on the front of your thigh, pushing the back of the knee down. Hold 5 seconds, 10 times.

• Straight leg raise: lying on your back with the other knee bent, tighten your thigh and lift the straight leg a short way. 10 times.

• Sit to stand: stand up from a firm chair and sit back down slowly, using your hands if needed. 8 to 10 times.

A physiotherapist can tailor these and progress them as you get stronger.

How physiotherapy helps

A physiotherapist will examine your knee, hip and how you move, explain what is likely causing the pain, and build a plan, usually including:

• strengthening exercises for the thigh and hip muscles

• exercises for movement and balance

• hands-on treatment to ease pain and stiffness

• advice on activity, footwear and pacing

• a home programme, progressed over the weeks

Progress is often measured with things that matter to you, like climbing stairs or walking distance.

See a doctor promptly if

• the knee is hot, red and very swollen, especially with fever

• you cannot put weight on the leg after an injury

• the knee locks and will not straighten

• there is severe pain after a fall

• the calf is swollen, tender and warm

Find a physiotherapist for knee pain

Search for physiotherapists who treat knee pain near you on PhysioDesk Reach, compare fees and reviews, and contact them directly.

This article is general information, not medical advice.