Knee Pain Physiotherapy

Introduction

Knee pain is one of the most common reasons people seek physiotherapy, affecting up to 1 in 4 adults at some point in their lives. It can appear suddenly after a twist, fall, or sporting moment, or develop gradually with everyday activities like climbing stairs, sitting for long periods, running, or getting up from a chair.

Because the knee plays such a central role in walking, work, sport, and daily life, pain in this area can quickly become frustrating and limiting. The good news is that most knee pain responds very well to the right physiotherapy approach, helping restore confidence, strength, and comfortable movement again.

Anatomy & Biomechanics of the Knee

The knee is a strong yet adaptable joint designed to bend, straighten, and absorb load during walking, running, jumping, and changes in direction. Rather than being a simple hinge, it relies on a combination of bones, cartilage, ligaments, and muscles working together to keep movement smooth and controlled.

Key structures involved include:

• Tibiofemoral joint: Between the thigh bone (femur) and shin bone (tibia), handling most of the load.
• Patellofemoral joint: Where the kneecap (patella) glides as the knee bends and straightens.
• Cartilage & Ligaments: Providing cushioning and stability during high-impact movement.

Pain often develops not because something is "damaged," but because certain tissues are temporarily overloaded, movement patterns change, or strength and control are reduced. This is why targeted rehabilitation is so effective.

What Causes Knee Pain (Acute vs Chronic)

Acute onset

Acute knee pain often starts with a specific moment, such as twisting the knee during sport, landing awkwardly from a jump, slipping, or lifting something heavy while the knee is bent. The knee may feel painful, swollen, or unstable at first, but this does not automatically mean serious damage has occurred.

Chronic onset

Chronic knee pain is very common and tends to build up over time. It may develop with prolonged sitting, frequent stair use, long-distance running, repeated squatting at work, or returning to exercise too quickly after a break. Often, there is no single clear cause — instead, small stresses accumulate faster than the knee can adapt.

Common Symptoms

• A dull ache or sharp pain around the front, inside, outside, or back of the knee.
• Stiffness, especially after sitting or first thing in the morning.
• Discomfort when climbing stairs, squatting, kneeling, or standing from a chair.
• A feeling of weakness, instability, or reduced confidence in the knee.
• Occasional swelling or tightness.

Common Diagnoses

Common knee-related diagnoses include:

• Patellofemoral pain syndrome: Pain around or behind the kneecap, often related to load.
• Meniscus irritation or tear: Cartilage changes inside the knee.
• Knee osteoarthritis: Normal joint changes that don’t always cause functional loss.
• Ligament sprains: Stretching or irritation of stabilising ligaments (ACL, MCL, LCL).
• Tendinopathy: Tendon-related pain linked to repetitive loading.

How Physiotherapy Can Help

Physiotherapy for knee pain starts with a thorough assessment of your symptoms, daily activities, and how your knee moves during functional tasks. We create a tailored program that focuses on:

• Hands-on therapy: To reduce pain and improve joint movement.
• Rehabilitation exercises: To restore strength, control, and load tolerance across the hip, knee, and ankle.
• Education: Confidence-building around safe movement and progressive return to activity.

At our Mayville practice, we help patients across Pretoria return to walking, working, and exercising with confidence.