KNEE PAIN 

Knee pain physio follows the same logic as back pain: figure out why it hurts, calm it down, then rebuild strength and function so it doesn’t come back.

1. *Figure out the cause*

Physios first check what’s going on in the knee and around it:

- *Where it hurts*: Front = often patella/quadriceps issue. Inside/outside = meniscus, MCL/LCL. Behind = hamstring, calf, or Baker’s cyst.

- *Mechanism*: Did it start after running, twisting, a fall, or gradually with desk work?

- *Movement test*: Squat, step down, single-leg balance. Weak hips/glutes are a huge driver of knee pain even when the knee itself looks fine.

- *Swelling, locking, giving way*: Signs you might need imaging or an ortho referral.

2. *Acute phase: reduce pain and swelling*

If it’s hot, swollen, or sharp with movement:

- *Unload*: Reduce aggravating activity, but avoid complete rest. Gentle range of motion keeps the joint healthy.

- *Manual therapy*: Joint mobilizations, soft tissue work on quads, IT band, calves.

- *Compression & elevation*: Help with swelling. Ice if it feels good, but it’s optional.

- *Taping/bracing*: Sometimes used short-term for patella tracking or ligament support.

3. *Strength and control phase*

This is where most knee issues resolve. The knee is a hinge, so it suffers when hips, quads, and ankles aren’t doing their job.

- *Quads*: Straight leg raises, terminal knee extensions, Spanish squats for patellar tendinopathy.

- *Glutes & hips*: Clamshells, band walks, single-leg bridges. Weak glute med = knee caves in during squats/walking.

- *Hamstrings*: Hamstring bridges, Nordic eccentrics if it’s a tendinopathy.

- *Calves/ankle*: Calf raises, ankle mobility. Stiff ankles increase load on the knee.

- *Neuromuscular control*: Balance drills, step downs, slow eccentrics to teach the knee to control load.

4. *Functional phase*

Get you back to walking stairs, running, hiking, squatting without pain.

- *Load progression*: Start with slow tempo, partial range, then build to full range and faster movement.

- *Plyometrics*: Hops, bounds, landing mechanics for sports.

- *Gait retraining*: Small tweaks to running/walking pattern can offload the knee.

5. *Common conditions and what physio targets*

- *Patellofemoral pain*: Strengthen VMO, glutes, improve tracking. Avoid deep squats/lunges until it calms.

- *IT Band syndrome*: Hip abductor strength, TFL/glute tension release, running form check.

- *Meniscus injury*: Depends on tear type. Many do well with quad/hip strength and load management.

- *ACL rehab*: Pre and post-surgery, heavy focus on quad strength and landing mechanics.

- *Osteoarthritis*: Strength + aerobic exercise is gold standard. It reduces pain and improves function.

What actually works

Research is clear: *progressive strengthening + exercise therapy* beats passive treatments long-term. Ultrasound, laser, and passive modalities help a bit short-term, but won’t fix it alone.

Red flags to get checked

- Knee locked and can’t straighten

- Sudden swelling after injury

- Can’t bear weight

- Knee feels unstable/giving way with minor activity

If you tell me where your knee hurts, what makes it worse, and how long it’s been going on, I can give you a specific exercise progression to start with.

What kind of knee pain are you dealing with?

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