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Knee Osteoarthritis Physiotherapy

Osteoarthritis of the knee (knee OA) is the inflammation and wearing away of the cartilage on the bones that form the knee joint (osteo=bone, arthro=joint, itis=inflammation) and a very common cause of knee pain.

The diagnosis of knee OA is based on 2 primary findings:

  • radiographic evidence of changes in bone health (through medical images such as X-ray and magnetic resonance imaging [MRI])
  • and an individual’s symptoms (how you feel).

Approximately 14 million people in the United States have symptomatic knee OA. Although more common in older adults, 2 million of the 14 million people with symptomatic knee OA were younger than 45 when diagnosed, and more than half were younger than 65.

Other arthritis resources:

What is Osteoarthritis of Knee?

Knee osteoarthritis (knee OA) is a progressively worsening disease caused by inflammation and degeneration of the knee joint that worsens over time. It affects the entire knee joint, including

  • bone
  • cartilage
  • ligaments
  • muscles

Its progression is influenced by

  • age
  • body mass index (BMI)
  • bone structure
  • genetics
  • muscle strength
  • and activity level

Knee OA also may develop as a secondary condition following a traumatic knee injury such as

Depending on the stage of the disease and whether there are associated injuries or conditions, knee OA can be managed by our senior physiotherapists. Unfortunately, severe or advanced cases may require corrective knee surgery.

How Does knee osteoarthritis Feel like?

Individuals who develop knee OA may experience a wide range of symptoms and limitations based on the progression of the disease.

Patients start to experience knee osteoarthritic pains when the cartilage covering the bones of the knee joint wears down. Areas where the cartilage is worn down or damaged exposes the underlying bone.

This exposure of the bone/bony surfaces allows increased stress and compression to the cartilage, and at times bone-on-bone contact during movement, which also increases pain experience.

To make matters worst, because the knee is a weight-bearing joint,

  • your activity level
  • type
  • duration

of your activities usually have a direct impact on your symptoms. Symptoms may be worse with weight-bearing activity, such as walking while carrying a heavy object.

Symptoms of knee osteoarthritis may include:

  • Worsening pain during or following activity, particularly with walking, climbing, or descending stairs, or moving from a sitting to standing position
  • Knee pain, knee joint pain or knee joint stiffness after sitting with the knee bent or straight for a prolonged period of time
  • A feeling of popping, cracking, or grinding when moving the knee (termed medically as "crepitus")
  • Swelling following activity
  • Tenderness with touch along the knee joint

Usually these painful knee symptoms do not occur suddenly or all at once, but instead develop gradually over time. In fact, sometimes individuals do not recognize they have osteoarthritis because they cannot remember a specific time or injury that caused their symptoms.

If you have had worsening knee pain for several months that is not responding to rest or a change in activity, it is best to seek the advice of a medical provider.

How Is It Diagnosed?

Knee OA is diagnosed by 2 primary processes. The first is based on your report of your symptoms and a clinical examination.

Our senior physiotherapists will ask you questions about your medical history and activity. We will perform a physical exam to measure your knee's

  • movement (range of motion)
  • strength
  • mobility
  • and flexibility

You might also be asked to perform various movements to see if they increase or decrease the pain you are experiencing.

The second tool used to diagnose knee OA is diagnostic imaging.

We may refer you to an orthopedic surgeon, who will order X-rays of the knee in a variety of positions to check for damage to the bone and cartilage of your knee joint.

If patients have more severe joint damage is suspected, an MRI may be ordered to look more closely at the overall status of the joint and surrounding tissues, and patient may potentially have to consider total knee replacement surgery.

Blood tests also may be ordered to help rule out other conditions that can cause symptoms similar to knee OA (such as rheumatoid arthritis or gouty arthritis or other issues)

how our senior physiotherapists can help you

Once you have received a diagnosis of knee OA, we will design an individualized treatment program specific to the exact nature of your condition and your goals.

Your knee physiotherapy treatment program may include:

Range-of-motion exercises

Abnormal motion of the knee joint can lead to a worsening of OA symptoms when there is additional stress on the joint. We will assess your knee’s range of motion compared with expected normal motion and the motion of the knee on your uninvolved leg.

Your range-of-motion exercises will focus on improving your ability to bend and straighten your knee, as well as improve your flexibility to allow for increased motion.

Muscle strengthening

Strengthening the muscles around your knee will be an essential part of your rehabilitation program. Individuals with knee OA who adhere to strengthening programs have been shown to have less pain and an improved overall quality of life.

There are several factors that influence the health of a joint: the quality of the cartilage that lines the bones, the tissue within and around the joints, and the associated muscles. Due to the wear and tear on cartilage associated with knee OA, maintaining strength in the muscles near the joint is crucial to preserve joint health.

For example, as the muscles along the front and back of your thigh (quadriceps and hamstrings) cross the knee joint, they help control the motion and forces that are applied to the bones.

Strengthening the hip and core muscles also can help balance the amount of force on the knee joint, particularly during walking or running. The “core” refers to the muscles of the abdomen, low back, and pelvis.

A strong core will increase stability throughout your body as you move your arms and legs. We will assess these different muscle groups, compare the strength in each limb, and prescribe specific exercises to target your areas of weakness.

Manual therapy

We're trained in manual (hands-on) therapy.

Our senior physiotherapists will gently move your muscles and joints to improve their

  • motion
  • flexibility
  • strength

These techniques can target areas that are difficult to treat on your own. The addition of manual therapy techniques to exercise plans has been shown to decrease pain and increase function in people with knee OA.


Compressive sleeves placed around the knee may help reduce pain and swelling. Devices such as realignment and off-loading braces are used to modify the forces placed on the knee.

These braces can help "unload" certain areas of your knee and move contact to less painful areas of the joint during weight-bearing activities. Depending on your symptoms and impairments, we will help determine which brace may be best for you.

Activity recommendations

We're trained to understand how to prescribe exercises to individuals with injuries or pain. Since knee OA is a progressive disease, it is important to develop a specific plan to perform enough activity to address the problem, while avoiding excessive stress on the knee joint.

Activity must be prescribed and monitored based on the type, frequency, duration, and intensity of your condition, with adequate time allotted for rest and recovery. Research has shown that individuals with knee OA who walked more steps per day were less likely to develop functional problems in the future.

We will consider the stage and extent of your knee OA and prescribe an individualized exercise program to address your needs and maximize the function of your knee.

Physiotherapy Treatment Modalities For Pain Relief

We may recommend therapeutic modalities for pain relief, such as

If Surgery Is Required

The meniscus (the shock absorber of the knee) may be involved in some cases of knee OA. In the past, surgery (arthroscopy) to repair or remove parts or all of this cartilage was common.

Current research, however, has shown that—in a group of patients who were deemed surgical candidates for knee OA with involvement of the meniscus—60% to 70% of those who first participated in a physical therapy program did not go on to have surgery.

One year later, those results were unchanged. This study suggests that knee physiotherapy may be an effective alternative for people with knee OA, who would prefer to avoid surgery.

Sometimes, however, surgical intervention, such as arthroscopy or a total knee replacement, may be recommended. There are many factors to consider when determining the appropriate surgical treatment, including the

  • nature of your condition
  • your age
  • your activity level
  • your overall health

We will refer you to an orthopedic surgeon to discuss your surgical options.

Should you choose to have surgery, our senior physical therapists can assist you prior to and following your surgery. Physiotherapy treatment you require following surgery will depend on a variety of factors such as

  • the type of surgery performed
  • your level of function
  • fitness prior to surgery

Contrary to popular belief, surgery is not the easy choice; you will still require treatment following your surgery to maximize your level of function.

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Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.


  • Cupping TCM
  • Auricular Therapy TCM
  • Herbal TCM Medicine & Supplementation


Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.


All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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