What Is Your Knee Trying to Tell You?

A dull ache around or behind the kneecap that worsens with prolonged sitting, climbing stairs, or squatting is one of the most common presentations we see in clinic. Patellofemoral pain syndrome occurs when the kneecap is not tracking correctly through its groove, placing uneven stress on the surrounding tissue. It is particularly common in runners and active individuals, and responds very well to physiotherapy.

Knee osteoarthritis develops when the cartilage that cushions the joint gradually wears down, leading to pain, stiffness, and swelling — particularly after periods of rest or at the end of an active day. It is one of the most prevalent conditions we treat and, contrary to popular belief, exercise and physiotherapy are among the most effective tools for managing it and slowing its progression.

The ligaments of the knee provide stability and control during movement. A sprain or tear — most often to the anterior cruciate ligament (ACL) — typically occurs during a sudden change of direction, a landing from height, or a direct impact to the knee. These injuries can range from mild to severe, but with a structured rehabilitation programme, the majority of people make a full return to sport and daily activity.

The menisci are two crescent-shaped pieces of cartilage that sit between the thigh bone and shin bone, acting as shock absorbers and stabilisers for the knee joint. A tear can occur during a twisting injury or develop progressively with age and wear. Symptoms often include pain along the joint line, swelling, and a sensation of catching or locking in the knee. Many meniscus tears are successfully managed with physiotherapy alone.

The iliotibial band is a thick strip of connective tissue that runs along the outside of the thigh and crosses the knee. When it becomes tight or irritated — most commonly through repetitive activities like running or cycling — it can cause a sharp, burning pain on the outer side of the knee that worsens with continued movement. IT band syndrome is one of the most common overuse injuries we treat and is very responsive to physiotherapy.

Often referred to as jumper's knee, patellar tendinopathy involves degeneration or irritation of the tendon connecting the kneecap to the shin bone. It typically presents as pain and tenderness just below the kneecap, particularly during and after activities that load the tendon such as jumping, running, or deep squatting. A progressive loading programme designed by your physiotherapist is the most effective way to rehabilitate the tendon and return to full activity.

Small fluid-filled sacs called bursae cushion the structures around the knee and reduce friction during movement. When a bursa becomes inflamed — through repetitive pressure, a direct blow, or prolonged kneeling — it can cause localised swelling, warmth, and pain. Knee bursitis is highly treatable, and physiotherapy plays a key role in reducing inflammation, restoring movement, and preventing recurrence.

A sudden twist, stumble, or impact can overstretch the muscles or ligaments around the knee, resulting in pain, swelling, and reduced range of motion. While less severe than a full ligament tear, sprains and strains still benefit significantly from early physiotherapy to manage symptoms, restore normal movement patterns, and reduce the risk of the injury becoming a recurring problem.

Recovery following knee surgery — whether it is an ACL reconstruction, a partial or total knee replacement, or a meniscal repair — requires a carefully structured rehabilitation programme to restore strength, stability, and confidence in the joint. Our physiotherapists work alongside your surgical team to guide you through each stage of recovery, helping you return to the activities you love as safely and efficiently as possible.