I can’t tell you the number of times a new client comes to Life’s Work Physical Therapy to see me, and they are completely terrified of their new diagnosis: “I have osteoarthritis of my knee. My pain will NEVER go away and I am only 55. How could this happen?” And on it goes. Many times, clients believe that knee pain caused by osteoarthritis is something they have to live with and that there is nothing they can do. What an awful feeling! I am hear to tell you that there is SO much you can do at any age, at any stage, to reduce the pain, improve the function and extend the life left in your knee with osteoarthritis.

So first, what is osteoarthritis of the knee?

drawing with captions of kneeAs I’ve mentioned in my prior blogs, osteoarthritis is a somewhat natural progression of aging. It is the wear and tear, or the “miles” you’ve put on your hyaline cartilage. At birth, hyaline cartilage is pristine and beautiful cartilage that lines the ends of all your bones. It has no nerve supply so it can’t hurt. As we age or if we’ve suffered with a knee injury, the hyaline cartilage can thin or even wear through. This is osteoarthritis of the knee. The cartilage on the ends of the bones around the knee wears and tears. (See femur cartilage in the diagram to the left.) When this happens, the knees don’t work as well, the knees may swell, you begin to walk funny and stiffer, your muscles get weaker and your flexibility decreases. All of these factors cause knee pain, which typically leads clients into their physical therapist’s office.

Here are the classic symptoms of osteoarthritis of the knee:

  1. Swelling: Regardless of the stage of osteoarthritis, most clients have some swelling. It’s noted around your kneecap by visual inspection or by gently pressing the fluid on the outside of your knee and watching it protrude on the inside of the knee. Swelling is also felt as “tightness” when you attempt to fully bend the knee. Even small amounts of swelling de-activate your lower quadriceps muscle. This causes further problems and pain at the knee.
  2. Stiffness, especially after being sedentary: Most of my clients with osteoarthritis of the knees complain that after sitting to watch a movie, or sometimes first thing in the morning, their knees are really stiff. This is a classic sign of osteoarthritis of the knee. When you are sedentary, swelling settles into your knees making them stiff and sore. Try moving every 20 minutes while watching a movie and see if this improves the stiffness.
  3. Pain on the front or sides of your knee when using stairs, inclines, and during prolonged walking: It’s common to feel pain in the knees with weight-bearing activities if you have osteoarthritis of the knee. Sometimes my clients have no pain during the activities listed above, but significant pain and swelling afterwards. While the osteoarthritis is part of the cause, we often find that muscle weakness, poor movement patterns and stiffness play a large part too.

Physical Therapy for Knee Osteoarthritis

Over the past 20 years of my career, I’ve spent countless hours educating clients and doctors alike that physical therapy is an excellent choice for reducing osteoarthritis pain in the knees. Just because you’ve lost some of your cartilage doesn’t mean your knees should hurt all the time or that you need to have a total knee replacement right away. And if you are on track for a total knee replacement, physical therapy is essential for getting you ready for surgery. Total knee replacement surgery does not correct for muscle weakness, stiffness, and poor balance or movement disorders. We work with our clients BEFORE total knee replacement surgery to get their bodies ready. After surgery, the recovery process is quicker and less painful. Some clients are so happy with the results of their physical therapy that they postpone total knee replacement surgery indefinitely.

Here are a few tips and tricks for successful physical therapy treatment for your knee osteoarthritis:

man laying down doing hyperextension exercises

  1. Reduce swelling
  2. Ensure that your knees have adequate hyper-extension
  3. Walk symmetrically and without a limp
  4. Stand on both feet with knees nearly straight, avoid “propping” your painful knee
  5. Ensure that your lower quadriceps are strong
  6. Maintain full hip and core strength


Before you undergo expensive tests and unnecessary procedures, find a great physical therapist in your area. He/she will be able to successfully treat your knee pain from osteoarthritis with a comprehensive program. A program, by the way, that is like medication….if you want it to work, you need to do it at the prescribed dosage!

If you are in the Portland, Oregon area, feel free to contact us, call our office at 503-295-2585 or visit us online at www.lifesworkpt.com. If not, please visit apta.org to find a physical therapist in your area, and read my blog on How to Find a Good PT. Once you find a physical therapist you like, keep him or her on your team for life. A good physical therapist can make all the difference in your knee pain and how your knee osteoarthritis progresses as well as how the rest of your body performs as it ages!

I wish you all the best in finding relief from your knee pain. Thank you for reading, and as always we love hearing from you. Subscribe to our blogs if you’d like to get notices of new posts delivered directly to your Inbox. Simply visit our blog page and follow the instructions on the top right-side of the page.  

Kind regards,