Physiotherapy in Parktown North
Knee pain, and what is actually behind it
Most knee pain is not a damaged knee. It is a knee being asked to do more than the hip, the foot and the training plan are currently letting it handle — and that is a much more fixable problem than the word “cartilage” suggests.
Does this sound familiar
Knee pain that brings people in
- An ache at the front of the knee on stairs, hills or after sitting for a long time
- Sharp pain on the outside of the knee that starts at the same point in every run
- Pain just below the kneecap with jumping, squatting or plyometrics
- A knee that has felt unreliable or swollen since a twist or a fall
- Stiffness and aching that has crept up over years
- A knee that has been operated on and still is not right
What happens
How this is treated
Every patient is different, but the shape of the work is consistent — and you will always be told what is happening and why.
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Step 1
Find the source
Where exactly it hurts, what provokes it and what changed beforehand narrows it down fast. The examination then checks the joint, the ligaments and the hip and foot above and below it.
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Step 2
Settle the irritation
Load adjusted rather than stopped, hands-on treatment, taping and dry needling where they help, so you can keep moving while it calms.
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Step 3
Build the capacity back
Progressive strength for the quadriceps and the hip, which carries much of the load the knee has been taking.
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Step 4
Back to what you do
Stairs, running, the sport or the hike you came in wanting to return to, built up to on measured progress.
Worth knowing
Where it hurts is most of the diagnosis
At the front, around or behind the kneecap, worse on stairs and after sitting, is usually patellofemoral pain — one of the most common knee complaints in active adults and teenagers. It is a loading problem rather than wear and tear, and it responds well to strengthening the quadriceps and the hip.
On the outside, coming on at a predictable distance into a run, especially downhill, is typically iliotibial band syndrome. Stretching the band itself does little; addressing load and hip control does a great deal.
Just below the kneecap, in someone who jumps, is usually patellar tendinopathy. Like other tendon problems it improves with graded loading and gets worse with complete rest followed by a sudden return.
After a twist, with swelling, locking or giving way, raises the question of a ligament or meniscus injury, and that is examined for specifically. Some of those need an orthopaedic opinion, and you will be told plainly if yours is one of them.
Worth knowing
What about arthritis?
Knee osteoarthritis is common past middle age, and international guidelines consistently put exercise and education at the centre of treatment, ahead of injections or surgery for most people. That is not a consolation prize: strengthening around an arthritic knee reliably reduces pain and improves function for many patients.
An X-ray report that mentions “degenerative changes” describes something present in plenty of knees that do not hurt at all. It is a starting point for the conversation, not a verdict.
Worth knowing
How long does knee pain take to settle?
It depends on the cause. Iliotibial band and patellofemoral pain commonly improve over roughly four to eight weeks of consistent work; tendon problems are often measured in months. You will get an honest estimate after the first assessment, and it will be revised out loud if it turns out to be wrong.
Before you book
Questions patients ask about this
Usually not as a first step. Most knee pain is diagnosed from the history and the examination, and an MRI is most useful when a significant ligament or meniscus injury is suspected or the knee is not behaving as expected. If that is the case, Rikki will say so and tell you who to see.
Rarely completely. Most running-related knee pain does better with modified training — less volume, fewer hills, shorter efforts — than with full rest, which tends to let the pain come straight back the moment you return.
Yes, and it is a large part of what the practice does. See post-operative rehabilitation for ACL reconstruction and knee replacement timelines, and home visits for the weeks you cannot drive.
Painless clicking on its own is very common and usually nothing to worry about. Clicking with pain, swelling, locking or the knee giving way is different and worth having examined.
Also treated here
Related to this
Post-operative rehab
The weeks after surgery decide the result.
Read more about Post-operative rehabNext step
Book an appointment
Book online at any hour, or send a WhatsApp if you would rather describe the problem first and be told honestly whether physiotherapy is the right call.