Understanding knee pain: from injuries to osteoarthritis.

Terra Osteopathy
Aug 25
3 min read

Knee pain is one of the most frequent complaints in physiotherapy practice. It can affect anyone, from young athletes to older adults, and it has many different causes. The knee joint is complex and essential for movement, which makes it vulnerable to both traumatic injuries and long-term wear. In this article, we will explore the different types of knee pain, how they develop, and how physiotherapy can help.

Acute Knee Pain After Trauma

Many patients first experience knee pain following a sudden injury, often during sports or an accident. These are usually acute conditions, involving ligaments, cartilage, or menisci. Pain often comes with swelling, bruising, and difficulty moving.

During the acute phase, the body begins a natural repair process. With proper care and rehabilitation, many injuries can heal effectively. However, when left untreated, a trauma can evolve into chronic pain that limits daily life.

Chronic Knee Pain and Instability

If knee pain lasts more than 12 weeks, it is generally considered chronic. One of the most common long-term problems is instability. A severe ligament injury, such as a grade 3 ligament tear, can cause the knee to feel loose or unstable.

Instability makes daily activities difficult—walking, climbing stairs, or turning quickly may trigger pain or fear of falling. Over time, this instability can sensitize the joint, increasing pain perception. Clinical examination, combined with orthopedic tests, helps determine which structures are involved and guides the right treatment plan.

“My Knee Is Worn Out”: Osteoarthritis and Misconceptions

One widespread belief is that knee pain always means the joint is “worn out.” While knee osteoarthritis is indeed common, its symptoms need to be distinguished from other conditions. Typical signs of osteoarthritis include morning stiffness—a feeling of “unlocking” that improves as the day goes on. This is the opposite of tendinitis, where pain increases with activity and improves with rest.

Research also shows that many people over the age of 40 have degenerative changes visible on imaging—even if they have no symptoms at all. In other words, structural changes do not always equal pain.

What Osteoarthritis Really Is

Osteoarthritis is best described as a remodeling of the joint surface rather than a complete destruction of cartilage. Importantly, cartilage itself does not contain nerves, meaning pain does not come directly from cartilage loss.

A common myth is: “Your bones are touching, that’s why it hurts.” In reality, pain often comes from sensitization of the joint capsule, the fibrous tissue surrounding the knee. Age-related muscle loss, especially in the quadriceps, also contributes to pain and instability. Strengthening exercises and restoring full mobility are key elements of treatment.

Thoughts, Pain, and Function

Another important factor in knee pain is the role of thoughts and medical images. When patients see an X-ray or MRI showing degeneration, it can create fear and amplify pain signals in the nervous system. Pain is not just a mechanical issue; it is also influenced by how the brain interprets signals from the joint.

This is why physiotherapy management includes not only exercises and manual therapy, but also education and reassurance. Helping patients understand that imaging findings do not always mean disability is a powerful step toward recovery.

Conclusion

Whatever your age, knee pain should not be ignored. The knee is a vital joint for mobility, and proper care can restore function and improve quality of life. With physiotherapy, the combination of mobility, strengthening, and guided activity offers an effective strategy for pain management.

👉 If you suffer from knee pain, don’t wait until it limits your life. Book a consultation today, and together we’ll build a recovery plan that brings you back to movement, strength, and confidence.

Book your session today!