Knee Pain: Common Causes, Exercises and Treatment Guide

Knee pain affects people of all ages and can significantly impact mobility and quality of life. Understanding the cause is essential for effective treatment. This comprehensive guide covers common causes, exercises, and treatment strategies for knee pain.

Common causes of knee pain

Osteoarthritis

• Most common in over 50s
• Gradual onset
• Morning stiffness
• Pain with activity
• Improves with movement

Meniscus tears

• Cartilage tear in knee
• Locking or catching
• Swelling
• Pain with twisting
• Common in sports or degenerative

Ligament injuries

• ACL, PCL, MCL, LCL tears
• Usually traumatic
• Swelling
• Instability
• Reduced movement

Patellofemoral pain

• Pain around or behind kneecap
• Worse with stairs, squatting
• Common in younger people
• Often related to muscle imbalance

Tendinopathy

• Patellar or quadriceps tendon
• Pain below or above kneecap
• Worse with jumping, running
• Gradual onset

Bursitis

• Inflammation of fluid sac
• Swelling
• Tender to touch
• Pain with kneeling

Red flags — seek urgent medical attention

• Severe pain after injury
• Knee gives way repeatedly
• Cannot weight bear
• Severe swelling
• Deformity
• Hot, red, swollen knee with fever

Initial management

POLICE protocol

• Protection: Avoid aggravating activities
• Optimal Loading: Gentle movement, not complete rest
• Ice: 15-20 minutes, 3-4 times daily
• Compression: Support bandage if swollen
• Elevation: Raise leg when resting

Pain relief

• Paracetamol regularly
• Ibuprofen if suitable
• Topical gels
• Ice therapy

Exercises for knee pain

Quadriceps strengthening

Static quads

1. Sit with leg straight
2. Tighten thigh muscle
3. Push knee down into floor
4. Hold 5 seconds
5. 10 reps, 3 times daily

Straight leg raises

1. Lie on back, one knee bent
2. Tighten thigh of straight leg
3. Lift leg to height of bent knee
4. Hold 5 seconds
5. 10 reps, 3 times daily

Sit-to-stand

1. Sit on chair
2. Stand up without using hands
3. Sit back down slowly
4. 10 reps, 3 times daily
5. Progress to lower chair

Hamstring strengthening

Hamstring curls

1. Stand holding support
2. Bend knee, bringing heel towards buttock
3. Lower slowly
4. 10 reps each leg, twice daily

Hip strengthening

Hip abduction

1. Stand holding support
2. Lift leg out to side
3. Keep body upright
4. 10 reps each leg, twice daily

Hip extension

1. Stand holding support
2. Take leg straight back
3. Do not lean forward
4. 10 reps each leg, twice daily

Calf strengthening

Calf raises

1. Stand holding support
2. Rise up on toes
3. Lower slowly
4. 10-15 reps, twice daily
5. Progress to single leg

Stretches for knee pain

Quadriceps stretch

1. Stand holding support
2. Bend knee, hold ankle
3. Pull heel towards buttock
4. Hold 30 seconds
5. Repeat 3 times, twice daily

Hamstring stretch

1. Sit with leg straight
2. Lean forward from hips
3. Reach towards toes
4. Hold 30 seconds
5. Repeat 3 times, twice daily

Calf stretch

1. Stand facing wall
2. Step back with one leg
3. Keep heel down
4. Lean into wall
5. Hold 30 seconds
6. Repeat 3 times each leg, twice daily

Activity modification

Walking

• Continue walking if possible
• Reduce distance if painful
• Use walking stick if needed
• Wear supportive shoes
• Avoid uneven ground initially

Stairs

• Use handrail
• Lead with good leg going up
• Lead with painful leg going down
• Take one step at a time

Work and daily activities

• Avoid prolonged kneeling
• Take regular breaks from sitting
• Use cushion if sitting low
• Avoid deep squatting initially

Weight management

If overweight, losing weight helps:

• Reduces load on knee
• Decreases pain
• Improves function
• Slows arthritis progression
• Even small weight loss helps

Treatment options

Physiotherapy

Joint Pain & Muscle Injury Treatment provides:

• Accurate diagnosis
• Personalized exercise programme
• Hands-on treatment
• Activity modification advice
• Progression guidance
• Return to sport planning

Medication

• Paracetamol for pain
• NSAIDs for inflammation
• Topical gels
• Supplements (glucosamine, chondroitin)

Injections

• Corticosteroid injections
• Hyaluronic acid
• Temporary relief
• Allow engagement with physiotherapy

Surgery

• Arthroscopy (keyhole)
• Realignment procedures
• Knee replacement
• Usually after conservative treatment fails

Preventing knee pain

Maintain strength

• Regular leg strengthening
• Quadriceps and hamstrings
• Hip and calf muscles
• 2-3 times weekly

Stay active

• Regular low-impact exercise
• Walking, swimming, cycling
• Maintain healthy weight
• Avoid prolonged inactivity

Proper footwear

• Supportive shoes
• Replace worn shoes
• Consider insoles if needed
• Avoid high heels regularly

When to seek professional help

Consider physiotherapy if:

• Pain not improving after 2 weeks
• Pain affecting daily activities
• Knee giving way
• Swelling persisting
• Stiffness limiting movement
• Unsure of diagnosis
• Want personalized treatment

Recovery expectations

Acute injuries

• Improvement within 2-6 weeks
• With appropriate treatment
• Consistent exercises essential

Chronic conditions

• Gradual improvement over months
• Ongoing management needed
• Exercise long-term
• Flare-ups possible

Arthritis

• Cannot cure
• Can manage symptoms well
• Exercise crucial
• Quality of life can be good

The bottom line

Managing knee pain effectively requires:

• Accurate diagnosis
• Appropriate pain management
• Regular strengthening exercises
• Activity modification
• Weight management if needed
• Patience with recovery
• Professional guidance when needed

Most knee pain improves with conservative treatment, especially exercise. The key is strengthening the muscles around the knee, staying active within limits, and seeking professional help if not improving.

About the author

Lizzie Thornton is a specialist community physiotherapist with over 15 years of experience treating knee pain and musculoskeletal conditions. She is HCPC registered and a member of the Chartered Society of Physiotherapy. Lizzie provides home physiotherapy visits across Staffordshire Moorlands and Cheshire East.

View Lizzie's profile