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Knee Pain

Knee pain nobody has put a name to yet? You don’t need a diagnosis before you come in. Working out what’s actually driving it is the first job of the assessment — and it changes everything that follows.

Overview

What’s Actually Causing It?

The knee is a large joint with several distinct structures that can cause pain, and each behaves differently. Where the pain sits, what brings it on, whether it swells, and whether it gives way are the details that separate one cause from another. Most knee pain can be identified accurately from a careful history and examination, without needing a scan first.

Thigh bone Shin bone Kneecap

Tap an area of the knee, or use the buttons, to see what typically causes pain there.

Most common

Anterior Knee Pain

Aching around or behind the kneecap, worse on stairs, squatting, kneeling and after sitting for long periods. Usually a load and capacity issue rather than damage, and highly responsive to a structured strengthening programme.

Symptoms

What Your Physio Will Want to Know

These details do most of the diagnostic work before a hand is laid on your knee:

Exactly Where

Front, inside, outside, or behind — the location narrows the possibilities more than anything else.

Swelling and Its Timing

Immediate swelling after an injury suggests bleeding in the joint; slower swelling over a day suggests something different.

Locking or Catching

A knee that physically won’t straighten, or that catches, points towards something mechanical inside the joint.

Giving Way

True instability on turning is different from the knee buckling because the quadriceps is inhibited by pain.

Stairs, Squatting, Kneeling

Which of these hurt, and whether up or down is worse, is genuinely informative.

How It Started

A single twisting injury, a change in training, or a gradual build-up over months all point in different directions.

Causes & Risk Factors

The Usual Suspects

In a typical clinic week, most undiagnosed knee pain turns out to be one of these:

01

Patellofemoral Pain

The most common cause of front-of-knee pain across all age groups, and highly responsive to loading.

02

Knee Osteoarthritis

The most common cause overall in people over 50. Far more treatable than most people expect.

03

Meniscal Injury

Either a traumatic tear in a younger knee or a degenerative tear in an older one — two quite different problems.

04

Tendinopathy

Patellar or quadriceps tendon pain, typically following a change in jumping, running or lifting load.

05

Ligament Injury

Usually from a specific incident, with the MCL the most commonly injured and the ACL the most consequential.

How We Can Help You

Treatment & Management

The first appointment answers the question “what is this, and what will it respond to?” — and then gets straight on with treating it.

Thorough Assessment: A full history and examination, including specific tests for the meniscus, ligaments and patellofemoral joint, plus a screen of the hip and foot.
A Clear Explanation: You’ll leave knowing what your physio thinks it is, how confident they are, the likely timeline, and what would change that view.
Immediate Symptom Relief: Load modification, taping or bracing where useful, and hands-on treatment to take the edge off while the plan gets going.
A Loading Programme: Nearly every knee diagnosis improves with the right dose of the right exercise. The specifics differ; the principle doesn’t.
Return to Activity: Whether that’s stairs without wincing, getting back on the coastal path, or returning to sport, the plan works backwards from your goal.
Onward Referral: If imaging, injection or a surgical opinion is genuinely warranted, your physio will help you access it rather than leaving you to navigate it alone.

What the evidence says

Knee imaging is far less decisive than most people expect. Meniscal tears are present on MRI in around a third of people over 50 with no knee pain at all, and cartilage changes are near-universal with age — so a scan finding doesn’t automatically explain your symptoms.

This is why national guidance favours clinical assessment first, reserving imaging for situations where the result would genuinely change what happens next — a locked knee, a suspected significant ligament injury, or a failed course of good treatment.

When to Seek Help

Red Flags — Don’t Ignore These

Most knee pain is musculoskeletal and safe to treat. These features need medical assessment:

⚠ Seek prompt medical assessment if you notice:

  • A hot, red, swollen knee with fever or feeling generally unwell (possible joint infection — seek emergency care)
  • Inability to weight-bear after an injury, or an obvious deformity (possible fracture or dislocation)
  • A knee locked in a bent position that you cannot straighten
  • Calf pain, swelling, warmth or redness, particularly after surgery, immobility or long travel (possible clot — seek same-day assessment)
  • Constant, unrelenting night pain unrelated to position, with unexplained weight loss or a history of cancer

These symptoms can point to a cause that needs medical rather than physiotherapy assessment. Please don’t wait for a physiotherapy appointment — contact your GP, call 111, or attend A&E as appropriate.

Common Questions

Frequently Asked Questions

Do I need an MRI first?

Rarely. A careful assessment identifies the pattern in most cases, and scans of painful knees frequently show changes that are just as common in pain-free knees. If imaging would genuinely change the plan, you’ll be told so and helped to arrange it.

Should I rest it?

Complete rest usually backfires. Knees stiffen, quadriceps weaken quickly, and reduced capacity means the same activities hurt more later. The useful approach is modifying what specifically aggravates it while keeping the knee working.

Is running bad for my knees?

No. Long-term studies find recreational runners have lower rates of knee osteoarthritis than sedentary people, not higher. What causes trouble is sudden increases in load rather than running itself.

How long will it take?

It depends entirely on the cause. Patellofemoral pain often improves meaningfully within 6–12 weeks; a significant ligament injury runs on a much longer timeline. Getting the diagnosis right is what allows an honest answer.

Let’s Find Out What’s Actually Going On

One thorough assessment, a clear explanation, and a plan you can start straight away — without needing a diagnosis before you walk through the door.

Book Your Initial Assessment

This 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.