| What We Treat
Knee Osteoarthritis
The single most treatable joint in the body for arthritis. Strength work outperforms almost everything else, and many people avoid surgery entirely.
Overview
What It Is
Knee osteoarthritis involves change to the cartilage, bone and surrounding tissues. It is not simply wear and tear, and the amount of change on a scan correlates poorly with how much pain someone has. The evidence for exercise is stronger here than for almost any other joint, and quadriceps strength is the most consistent predictor of function.
Tap a structure, or use the buttons, to see what may be involved.
Not Simply Wear and Tear
Changes on a scan correlate poorly with pain. People with severe imaging can be comfortable, and mild imaging can be very symptomatic.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
Morning Stiffness
Easing within about thirty minutes, unlike inflammatory arthritis.
Pain on Stairs
Particularly going down, which loads the joint most.
Worse After Activity
Building through the day rather than being worst at the start.
Swelling
Intermittent, often after a longer walk or a change in activity.
Grinding or Crunching
Very common, and not in itself a sign of damage.
Giving Way
Usually from quadriceps weakness rather than instability.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Previous Injury
Meniscal or ligament injury substantially raises risk, often decades later.
Quadriceps Weakness
Both a consequence and a driver, which is why it is the treatment target.
Body Weight
Each kilogram is multiplied several times through the knee when walking.
Genetics and Age
Non-modifiable, but they raise the value of everything that is.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- A hot, red, swollen knee with fever — infection must be excluded urgently
- Sudden locking or inability to straighten the knee
- Rapid deterioration over weeks rather than years
- Night pain that consistently wakes you, with weight loss
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Will exercise wear my knee out faster?
No. This is the commonest fear and it is unfounded. Loading maintains cartilage health, and inactivity is associated with worse outcomes.
My scan says bone on bone — is exercise pointless?
Not at all. Imaging correlates poorly with symptoms. People with severe changes on X-ray can be comfortable and active, and people with mild changes can be very symptomatic.
Do I need a replacement?
Not necessarily, and not yet. A properly delivered twelve-week strength programme changes the picture for many people and is worth doing before deciding.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.