What causes knee pain, and how physiotherapy treats it
Stairs, kneeling, squatting and the first mile of a run are the usual complaints. The cause is often somewhere other than the knee, which is what an assessment is for.
The knee tells you where, not why
Pain at the front, around or under the kneecap, that shows up on stairs, on hills, when getting out of a low chair or after a long spell sitting with the knee bent. That is the most common presentation by a distance.
Pain on the inside or outside of the joint, often after a twist or a change in activity. Pain behind the knee, sometimes with a feeling of fullness. Stiffness first thing that eases as you move. Swelling, which can be obvious or can just be a knee that feels tight in a way the other one does not.
Then there are the mechanical descriptions people give: it clicks, it grinds, it gives way, it catches. Clicks and grinding on their own are usually nothing to worry about and are common in perfectly healthy knees. Giving way and true locking are worth mentioning specifically at the assessment.
Load, strength and what changed recently
Most knee pain that arrives without an accident is about load outpacing capacity. Something changed: more running, a new class, a house move, a fortnight of laying flooring, or a period of much less activity followed by a sudden return to it. The knee was fine at the old level and is not at the new one.
Where the strength sits matters as much as the amount of load. Hip, thigh, calf and ankle strength can all influence how the knee handles stairs, walking and squatting, so the assessment looks beyond the painful spot. Calf strength and ankle range feed into the same chain.
Twisting injuries can involve the ligaments or the meniscus, the cushioning cartilage inside the joint. Osteoarthritis becomes more common with age and is very often manageable: it is a reason to build strength around the joint rather than a reason to stop using it. Knee pain in runners has its own patterns and its own page.
What treatment looks like here
Knees respond well to a plan that builds strength progressively while keeping you doing as much as you can tolerate. The strategy is almost never to stop everything and wait.
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Assessment
What provokes it, what changed in the weeks before it started, whether there was a specific incident, and what you want to get back to. Then movement and strength testing through the knee, hip and ankle, and watching how you squat, step down and walk.
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Hands-on treatment
Soft tissue work and joint mobilisation where they help settle symptoms and restore movement, particularly in a stiff knee. This is the supporting act rather than the main event for most knee problems.
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Progressive strength work
The part that changes things. Quadriceps, glute and calf work built up over weeks, with the load managed so the knee is challenged without being flared. Fewer exercises, done properly and progressed on a schedule, beat a long list.
Typical aims are stairs without thinking about them, a walk or a run without paying for it the next day, and a knee that tolerates more than it did. Timescales vary a good deal, and you will get an honest estimate rather than an encouraging one.
What to do while you wait for an appointment
Keep moving, but adjust the dose. Reduce the specific things that provoke it, such as deep squats, hills, stairs taken quickly or long runs, and keep the activity that does not. Flat walking and cycling on a low resistance are often tolerated when running is not.
Some discomfort during activity that settles within a day is generally acceptable. Pain that builds through the following 24 hours or leaves the knee swollen is a sign the dose was too high, so drop it and build again more slowly.
Ice can help a swollen knee feel more comfortable, and a pharmacist can advise on suitable pain relief. If the knee is unreliable on stairs, use the handrail and lead with the good leg going up, the sore leg going down. That is a temporary measure, not a habit worth keeping.
General guidance only. Which of these applies depends on what is actually driving your knee pain.
Knee symptoms that need urgent care or a GP
- Go to an urgent treatment centre or an emergency department if you cannot put weight through the leg after an injury, the knee swelled up within an hour of a twist or an impact, the joint looks deformed, or the knee locks and will not straighten. Those need assessing before rehabilitation begins.
- Seek urgent medical advice if the knee is hot, red and swollen and you feel unwell or feverish, which can indicate infection in the joint. Also seek urgent advice for a swollen, painful, warm calf, particularly after surgery, a long flight or a period of immobility, since that can be a blood clot.
- See a GP if knee pain follows a recent operation and is not going to plan, or comes with unexplained weight loss or night pain that wakes you consistently. If an assessment here turns up something that belongs with a GP or a consultant, you will be told plainly rather than sold a course of treatment.
Book an assessment for your knee
Appointments usually available within days, weekdays to 20:00 and Saturday afternoons from 14:00. No GP referral needed. Shop 2, 4-6 Roumelia Ln, Boscombe, Bournemouth BH5 1EU.
Call Deborah WhatsApp Rehab after surgery Call, text or WhatsApp 07305 447682