Knee Pain

Common causes of knee pain

• Osteoarthritis — stiffness after rest, pain on stairs and squatting, sometimes swelling after activity.
• Patellofemoral pain — pain around or behind the kneecap, worse on stairs, squatting and prolonged sitting.
• Meniscus injuries — pain on twisting, sometimes catching, locking or giving way.
• Ligament injuries — instability after a specific incident, often with swelling soon afterwards.
• Tendinopathy — pain at the front of the knee below the kneecap, common in running and jumping sports.
• Iliotibial band problems — pain on the outer knee, typically in runners and cyclists.
• Referred pain from the hip or lower back, which is easy to miss if only the knee is examined.

Why strength matters more than anything else

For the large majority of knee problems, the single most effective intervention is progressive strengthening — the quadriceps in particular, plus the glutes, hamstrings and calf. Strong muscles absorb load that would otherwise pass through the joint surfaces, and improve the control that keeps the knee tracking properly.

Weakness develops remarkably fast. A few weeks of limping or reduced activity produces measurable quadriceps loss, and it does not return by itself once the pain settles. This is the main reason knee pain recurs: the pain resolved, the weakness did not, and the joint went back to being under-supported.

Strengthening is dosed to what your knee currently tolerates and progressed steadily. Some discomfort during exercise is acceptable; pain still elevated the next day means the dose was too high.

Assessment and treatment

Assessment covers knee range and swelling, specific tests for the ligaments and meniscus, strength testing, how the kneecap tracks, and how you move through squatting, stairs and walking. The hip and ankle are examined as part of the knee assessment, not as an optional extra.

Treatment combines that strengthening programme with manual therapy where stiffness is limiting movement, swelling management where relevant, technique correction for stairs and squatting, taping or bracing where it genuinely helps in the short term, and activity modification that keeps you moving rather than stopping you.

When to seek prompt medical review

• A knee that locks and cannot be straightened.
• Marked swelling appearing within an hour of an injury.
• A knee that gives way repeatedly under normal walking.
• Inability to bear weight after an injury.
• A hot, swollen knee with fever, which needs urgent medical assessment.