Accurate diagnosis for precise treatments
Experienced physiotherapists with 10–20+ years in clinical practice
Thorough assessment to identify any contributing factors
Manual therapy to relieve pain and get you moving
Strengthening and proprioceptive rehabilitation to get you back on your feet
Knee osteoarthritis becomes more and more common as we age and becomes one of the more common conditions that we treat in our clinic. Just because there is wear and tear in the joint doesn't mean you can't have improvements of that you have to go straight to knee replacement surgery.
Many people are able to significantly reduce their pains through treatment, exercise and strengthening, especially when combine with lifestyle changes like diet and weight management. International osteoarthritis guidelines support structured exercise and education as core treatments for knee OA.
Meniscal tears are common especially when twisting from a deep squat or in conjunction an ACL or MCL injury. Not all meniscal tears require surgery, particularly degenerative meniscal tears in middle-aged and older adults.
Research and clinical guidelines support exercise-based management for many degenerative meniscal presentations. However, traumatic tears, significant locking, major swelling or instability should be assessed carefully
Physiotherapy for knee pain should be specific to the person, not just the diagnosis. A good knee assessment looks at your symptoms, medical history, injury history, movement, strength, function and goals.
Your physiotherapy treatment may include:
Home-based exercise can also be useful. A 2024 systematic review and meta-analysis found that home exercise can help reduce pain and disability in people with hip and knee osteoarthritis, which is important for patients as it continues their rehabilitation and progress at home.
Knee strengthening exercises are commonly used in physiotherapy, but the right exercises depend on your pain, strength, age, activity level and diagnosis.
A knee rehab program may include isolated strengthening for the quads, hamstrings, glutes, adductors and calves. Or multijoint exercises including squats, step-ups or lunges through to unstable or dynamic movements including jumping or running. Careful progression is the key, and depending on your condition and your strength deficits or movement limitations, will depend where you will start.
For patellofemoral pain, which is often felt around or behind the kneecap, international consensus recommendations support exercise therapy, particularly a combination of hip-focused and knee-focused exercises.
For patellar tendinopathy, progressive loading is usually central. The research you provided highlights heavy slow resistance training, eccentric loading and staged load management as useful approaches for tendon-related knee pain
Knee pain can be complex and management can be difficult
Manual therapy, including joint mobilisation, manipulation where appropriate, and soft tissue techniques, can help reduce pain and improve movement, particularly in the early stages. Used where it adds value rather than as a standalone treatment within physiotherapy.
Exercises have been proved to be one of the most effective treatment mechanisms in rehabilitating a knee. Programs are tailored to your assessment findings and progressed over time through clinical rehabilitation.
Often knee pain can come on from a sudden increase in load or training volume, careful management of this volume is important to help maintain your fitness or keep you training towards your goal, loading the knee enough to improve but yet not overdoing it.
Great for both those with degenerative knees, where exercises can be performed to help strengthen the knee, but yet not aggravate the knee. Also great for those past the initial stages of rehabilitation and need to get work fit, match fit or to help get the to the next level.
May be used where muscle tension or trigger points are contributing to pain. Typically used as an adjunct alongside exercise and physiotherapy within acupuncture and dry needling.
Helpful where there is a significant muscular component. Often used alongside physiotherapy to reduce tension and support recovery through remedial massage.
For more complex or long-standing presentations, particularly where general conditioning or health factors are involved. Provides supervised, progressive exercise beyond the early rehab phase through exercise physiology.
Knee pain when squatting or bending is one of the most common reasons people seek physiotherapy. It can be associated with patellofemoral pain, tendon irritation, meniscus irritation, osteoarthritis, reduced ankle or hip mobility, or poor load tolerance.
Knee pain with running does not automatically mean running is damaging your knees. A 2023 systematic review found that running was not clearly associated with worsening patient-reported outcomes or radiographic signs of knee osteoarthritis in the short term. Previous injury, surgery, body mass index, age and family history appear to be more relevant risk factors than running mileage alone.
For runners, treatment often involves:
The goal is not always complete rest. In many cases, the better strategy is finding the right level of activity while improving the knee’s capacity.
Pain behind the knee can be caused by several different issues. These may include hamstring or calf irritation, swelling within the knee joint, a Baker’s cyst, meniscus irritation, or referred pain from nearby structures.
Pain on the inside of the knee is often described as medial knee pain. It may be related to the meniscus, medial ligament, knee osteoarthritis, pes anserine irritation, or changes in how the knee is loaded during walking, squatting or running.
Pain on the outside of the knee may be linked with iliotibial band related pain, lateral joint irritation, lateral meniscus irritation, or hip and pelvic control during running and sport.
Written by Calum Fraser Physiotherapist