Knee pain is a common problem for children and adults.

There are many different causes for knee pain at different stages of life although most will improve with simple management and will not require surgery.

Knee pain can be related to the joint or soft tissue structures including the ligaments or tendons. The hip and foot position can also contribute to knee problems.

Find out more about your knee pain in the other sections for further help.

Osteoarthritis is a normal, age related process affecting the knee joint. It is most common in adults over 55. The joint space will narrow and the knee becomes stiff. This can affect movement and mobility.

Commonly pain and stiffness is worse after prolonged rest or prolonged activity. Often this stiffness can be worse in the morning and may last up to half an hour.

Although many people associate osteoarthritis with a joint replacement, this is only needed in the most severe cases.

Most often knee osteoarthritis can be self-managed well with physical activity, weight loss and specific exercises.

Click Here to see some exercises that our physiotherapists would recommend to help with movement of your knee.

This leaflet provides information, answers and self-help strategies regarding the condition:

Knee Osteoarthritis


Watch these three short videos of an internationally-respected physiotherapist explaining knee osteoarthritis, also known as OA, and why it hurts.

Watch these three short videos addressing some of the questions you might have about physical activity, weight loss and other strategies to help your knee pain due to osteoarthritis (OA).

For a summary of this information, the Provide Physiotherapy Outpatients Service have created a short educational video on knee osteoarthritis including links to additional support services that you can refer yourself to.

To create your own exercise programme at a level you can tolerate based on what you like and what you need, Click Here. Alternatively, go straight to the exercise inventory for beginner and more advanced knee and hip exercises and get started today!

If you want to learn more about your knee osteoarthritis, watch these short educational videos to get some simple advice and information to help you better manage your knee pain.

Although if you are looking for a more structured education and exercise programme to improve the management of your knee osteoarthritis, Click Here to access a free NHS online programme called ESCAPE-pain, which consists of 12 sessions over a 6 week period you can complete from home.

For help with weight loss, visit Essex Wellbeing Service or Click Here for more information on how losing weight can help to reduce pain and disability related to osteoarthritis..

Click Here for further information on Osteoarthritis and ways to manage it effectively.

The patellofemoral joint is where the kneecap (patella) meets the upper leg bone (femur). Patellofemoral pain is commonly felt around or below the kneecap.

It is often aggravated when going up and down stairs and also when sitting or driving for prolonged periods. Pain can often be triggered by starting or increasing an activity such as running or jumping.

With these symptoms it is important to reduce the duration and/or the intensity of activities but complete rest is not advised.

Alongside activity modification, a strengthening programme targeting the lower limb can help.

Knee Pain After Injury

A muscle strain is an injury where a muscle is overstretched or torn.

The most common muscles injured that can cause knee pain are muscles in the thigh or calf region.

Muscle strains often happen during sports involving fast movements, muscles can also be pulled with as little as stepping down off a curb or lifting something fairly light.

Mild strains will have no visible symptoms but larger strains will have swelling, discolouration and you may feel a loss of strength. A ‘popping’ sensation and complete loss of strength may indicate a torn muscle.

These strains often get better by themselves as muscles are excellent healers although you are likely to need to reduce your usual levels of activity or sport initially, gradually restore the normal flexibility and strength of the muscle(s) involved before returning to your normal activities.

Click Here for advice on what to do in the early stages to help your pain, swelling and overall recovery and when to seek further support.

Ligaments help to keep the knee joint stable. Ligament injuries often involve direct force to the knee, sudden changes in direction or landing from a jump.

Swelling is a common symptom of a ligament injury if there has been a specific trauma.

A feeling of giving way can occur due to either pain or less commonly, reduced stability of the knee. This is normally due to pain affecting the function of the muscles around the knee. An exercise programme can help to restore this stability.

Management of this type of knee injury will depend on what ligament(s) has been injured and the severity of the injury so seek further help from a healthcare professional if your symptoms are not improving after a few weeks.

The menisci are C-shaped discs which cushion the knee. There are two menisci in each knee.

Meniscus injuries can be degenerative or traumatic. A traumatic tear generally occurs after a quick twisting leg movement with a fixed foot. This is common in sports such as football. Degenerative tears are very common as we get older alongside osteoarthritis.

Swelling is also a common symptom of a meniscus injury. A feeling of catching or a locking sensation is common and does not normally require surgery to correct this.

An exercise programme will help to restore the strength of the knee.

Management of degenerative meniscal injuries is very similar to how you would manage knee osteoarthritis so see this section for further help and support, including useful exercises to carry out at home.

Osgood Schlatter’s is a common problem in teenagers during a growth spurt.

Often there is localised swelling or a lump as well as pain below the kneecap where the thigh muscle attaches to the shin bone.

This is normally worse after repetitive activities such as running or gymnastics.

You will not usually need to stop sport completely but you may need to reduce the frequency or duration.

Stretching and strengthening the lower limb, particularly the quadriceps, can help.

This condition usually completely resolves once full growth has stopped and even before in some cases with no lasting problems of the knee in adulthood.

Self help

Evidence has shown that people who understand their Musculoskeletal health problem and take an active involvement to help themselves have a much better outcome.

Here are some really helpful leaflets, videos and useful links to other websites that have been approved by our physiotherapists so that you can start getting better with your knee pain today!

This information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment if required. All content is for general information purposes only.

Click Here to access our getUBetter app, which is an easy, safe and effective way to support your recovery.


Low Risk Musculoskeletal Pain
Knee Osteoarthritis


Knee Osteoarthis

Knee Osteoarthritis – Part 1 of Why does it hurt – is it “Bone on Bone”? A deep dive into the common misconception that you have pain because you have ‘bone on bone’ changes on X-ray.
Source: OA optimism

Knee Osteoarthis

Knee Osteoarthritis – Part 2 of Why does it hurt – is it wear and tear? Explaining another common misconception that your joints are “wearing and tearing” when you use them.
Source: OA optimism

Knee Osteoarthis

Knee Osteoarthritis – Part 3 of Why does it hurt – pain is more about sensitivity than damage. Discussing the changes in your joint are just part of the pain puzzle and that pain is complex and influenced by a number of factors.
Source: OA optimism

Knee Osteoarthis

Knee Osteoarthritis – Part 4. Overview on some of the things that you can do to help yourself.
Source: OA optimism

Knee Osteoarthis

Knee Osteoarthritis – Part 5. Looking into the idea of whether weight is essential to help yourself and how exercise and activity can still help even if you don’t lose weight.
Source: OA optimism

Knee Osteoarthis

Knee Osteoarthritis – Part 6. Talking about the benefits of exercise and activity even when painful and how you can do it safely.
Source: OA optimism

A short 90 second video on how pain is influenced by a number of factors using the cup analogy for pain

A short 90 second video on how pain is influenced by a number of factors using the cup analogy for pain
Source: Greg Lehman – Movement Optimism

Physiotherapy and Self-Management of Knee Osteoarthritis - A Patient's Experience

Watch this short video of a real patient's experience of how physiotherapy has helped her to cope with knee osteoarthritis and provided her with the knowledge and understanding needed to manage the condition herself.
Source: Dead Ready Productions

Provide Back to Activity Programme – Circuit exercises

Provide Back to Activity Programme – Circuit exercises

Provide Back to Activity Programme – Pilates exercises

Provide Back to Activity Programme – Pilates exercises

previous arrowprevious arrow
next arrownext arrow


Stiff and Painful Knee
Weak and Painful Knee – Stage 1
Weak and Painful Knee – Stage 2
Weak and Painful Knee – Stage 3
Weak and Painful Knee – Stage 4

Useful Links

  • Free-to-use NHS online programme and app to enable self-management and coping with arthritic knee pain using exercise
  • Excellent resource of educational videos and exercises to carry out for knee osteoarthritis to help yourself in the long term based on the latest evidence
  • Useful exercises to carry out at home to manage osteoarthritis of the knee. These exercises are designed to strengthen and stabilise the structures that support the knee.
  • An overview of Osteoarthritis, not just specific to the knee joint, including symptoms, diagnosis, treatment and learning better ways to live with the condition
  • Further information on patellofemoral pain syndrome, also known as Kneecap Pain, including symptoms, diagnosis, causes, treatment and outlook
  • Details on how knee pain can be self-treated at home and when to seek further help
  • Useful information and video explaining the different causes of knee pain
  • Nuffield Health Joint Pain Wellbeing Programme offers a free to join programme designed to help you self-manage chronic joint pain.

Further support

If your knee pain is still not improving despite following the advice and guidance provided on the website and you score a ‘Medium’ or ‘High Risk’ when completing the Is My Knee Pain Likely To Persist?, you may require further help and support from the Physiotherapy Service. Please click on the ‘Physiotherapy Self-Referral’ box to refer yourself to the service for further management of your back problem.

With all knee pain it is best to try to keep the knee moving as able and to continue your normal activities but in smaller amounts until you can resume them normally again. If you are finding it difficult to walk then using crutches or a walking aid may help.

Remember that most causes of knee pain are not due to anything serious, although there are rare cases where you would need to seek urgent medical help. Contact NHS 111 for immediate medical advice if you have any of the symptoms below:

  • you are unable to take any weight through your knee after trauma
  • your knee is badly swollen or has changed shape
  • you have a very high temperature, feel hot and shivery, and have redness or heat around the knee


Listen to your body. It is beneficial to find a type of exercise that you can continue to do. It is safe to work through a low level of pain. If a particular type of exercise is too painful then reduce or avoid this activity initially.

There is a poor link between changes visible on x-ray and symptoms of osteoarthritis. You can be in lots of pain but have minimal changes on x-ray and vice versa. Changes seen on X-ray does not mean you have to stop being active – Keeping active can help knee pain.

An x-ray is not necessary to diagnose arthritis. It is only needed if you are going to have joint replacement surgery. An x-ray can be useful if it is not obvious if the knee joint is contributing to your symptoms and your symptoms are lasting longer than 3 months.

Most people will never need a joint replacement and can manage their symptoms conservatively.

Physiotherapists are able to perform steroid injections for certain knee conditions including osteoarthritis. Whilst injections can be very effective in the short term, research shows medium to long term relief is not often achieved, and physiotherapy is the best long-term option for pain relief. Your physiotherapist will be able to discuss if an injection is appropriate if you are being seen within the Physiotherapy Outpatient Service.

Giving way is a common feeling most often associated with pain. It is not a sign of your injury being worse because of this.