Almost everyone will suffer from some kind of knee pain in their life, it is a really worrisome pain as unlike many joints in the body, it is almost impossible to completely offload. This creates a feedback loop where the symptoms actually feel worse and the pain quickly becomes debilitating.

The knee is a seemingly simple hinge joint but is in fact quite complex with multiple bones, tendons and ligaments all having to work together in multiple planes. Something else which feeds into pain is the sounds that the knee can make. These are normally noticed at first going up stairs once we have left the teenage years behind. They can be heard as creaking, scraping or clicking and these noises are perfectly normal and in a normal knee have no association with pain. Unhelpful language such as bone on bone contact, worn out, inflamed or other over medicalised terms can often add to the concern. It is easy to fall in the trap of seeing the joint as worn out and the only possible solution being surgery or replacement of the joint, especially if friends or family have had these outcomes already, it is easy to become depressed or anxious because knees are very important to everyday life and are vital for independent mobility.

Knee pain can be separated into traumatic and non traumatic. In traumatic there is a clear mechanism of injury be it through twisting or impact and injury to the tissues is possible and needs to be excluded so will not be talked about further here.In non traumatic injury, it is normal, with a little bit of digging, to identify a cause. This cause will normally be loading biassed but is often masked by other issues. Weight is something that readily comes to mind when talking of load but more subtle factors such as changing shoes, moving house, new job or new sports are easy to overlook. Something as simple as working from home and only having a toilet upstairs increases load by the amount of stair climbs completed in a day.Weight could be separately categorised into weight gain and weight carried, walking instead of driving to work and carrying a small bag is often discounted as it is a positive and healthy step, but it is an increase in load. Weight gain is also sometimes hard to pin down as it doesn’t happen overnight. A person might gain 5 kg over a year but the pain only comes on in the last week, the last kg gain is the one that creates the overload but because it has been gradual it can be overlooked. If you can identify the cause yourself then you can start to help yourself by trying to reduce load, sometimes this seems impossible but climbing stairs one at a time instead of stepping through, or reducing speed both reduce load in something which may be unavoidable.

Often exercise gets the blame for knee pain but stopping exercise is definitely something which would not be advised. It may need to be temporarily modified until the pain comes under control but it is important to stay engaged, especially in exercise or sports which help create a happy life.Normally this is where we suggest some helpful exercises to help you get better on your own but often in the case of the knee, a certain amount of reassurance is needed that there is not something more serious going on. If you cant stand from a chair, climb stairs, stand, sit or kneel pain free then it is worth getting checked out so you can plan your recovery. The work of muscles above and below the knee have a large impact on the function of the knee and often it is only during a thorough assessment that deficiencies are identified.