Knee injuries are a common issue our osteopaths see and knee pain can be debilitating and have a real impact on your day to day life. The knee is a very important joint in the leg for helping transfer force through our lower extremities up into the rest of our bodies. There are two joints in the knee: the femoral – tibial joint and the femoral – patella joint, as well as four main ligaments and the surrounding muscles. We require all of these structures to work harmoniously together for our knees to function optimally.

Different Types of Knee Pain and Problems

A Woman with Knee Injury clutching her knee

Pain in the knee can be produced from the cartilage, the ligaments or the muscles / tendons. In some cases, the symptoms someone is feeling is due to a combination of these structures being inflamed and irritated. This is why it is important to understand what the cause of your symptoms is, so you can treat them in the most effective and efficient way.

Knee Pain

Knee pain can be acute (of a sudden onset) and this is most commonly due to trauma e.g. skiing, football or trampolining. Often with these injuries, pain is felt instantly and it can be difficult to weight bear through the affected leg. Or your symptoms may have started more gradually and you have started to notice that your knee gets sore and achy after a particular activity or after you’ve been sat for a while, but these symptoms can then settle and because of this people have often had these symptoms for longer.
Pain in the knee can be felt either locally – these patients can point to a specific point on the knee where they feel the pain or it can be felt diffusely around the whole joint. Where your pain is located and what movements aggravate your symptoms help our osteopaths identify which structures in your knee are causing your pain so they can provide you with an accurate diagnosis.

Common causes of pain in the knee:

  • Pain after overusing or overstretching
  • Unstable knee joint
  • Pain between kneecap and shin
  • Pain and stiffness in knees
  • Mild swelling
  • Warm and red knees
  • Pain when bending knees

Knee Problems

Our osteopaths will take a thorough case history during your appointment and the information you give helps them identify the cause of your pain. The most common knee problems our osteopaths see are:

  • Sprained and Strained Ligaments
  • Cartilage Tears and Damage
  • Tendonitis
  • Arthritis
  • Bursitis
  • Dislocation

To read more about these knee injuries, please see below.

Causes of Knee Pain and Problems

Understanding your symptoms and identifying what structures are causing your knee pain is key to treating your symptoms effectively and helping to prevent them from reoccurring in the future. Our osteopaths try to get as much information as they can during the case history and examination to provide them with a thorough understanding of your pain.

Below is some more thorough information about the common knee problems our osteopaths see:


Osteoarthritis is a degenerative process where the cartilage becomes damaged and is often associated with getting older. As the cartilage becomes damaged, the joint can become painful and stiff. More strain is placed on the surrounding ligaments and muscles which can cause them to become sore and uncomfortable. Rheumatoid arthritis is another condition that can affect the knee joint. This auto-immune condition causes joint inflammation which can produce pain, swelling and stiffness in joints throughout the body including the knee.

Sprained Ligaments

The symptoms of a sprained ligament can vary from mild to severe. The severity of the sprain is graded depending on the level of damage there is to the ligament. There are 3 grades to ligament sprains:

  • Grade 1: mild structural damage with slight localised tenderness. There isn’t any instability to the joint
  • Grade 2: Partial rupture of the ligament, with swelling and tenderness. There may be mild joint instability.
  • Grade 3: Complete rupture of the ligament, with significant swelling, bruising and tenderness. You would expect joint instability with a grade 3 ligament sprain.

In the knee the ligaments are integral to the joint stability and mobility so even a mild injury to one or more of the ligaments can trigger pain and discomfort.

Tendonitis / Tendinopathy

Tendonitis (Tendinopathy) occurs when there is degeneration of the collagen in the tendon producing pain and symptoms The symptoms usually start after excessive loads are repeatedly placed on the tendon during activities. Patella tendinopathy is a common issue in the knee and is when the tendon that attaches your quadriceps muscle to your tibia (shin bone) becomes symptomatic. This tendon runs over the top of your kneecap (patella) and characteristically produces pain just below the patella. The symptoms often start gradually and the symptoms can be sporadic, usually aggravated by loading movements and movements that place more demand on the knee extensor muscles.


This can refer to either a patella dislocation, which is when the knee cap dislocates to one side of the knee joint, or a multi-joint dislocation, which is when at least 2 of the ligaments rupture within the knee joint allowing movement to occur between the femur (thigh bone) and the tibia (shin bone). These injuries are often caused by significant trauma to the knee. Our osteopaths generally see people who have had dislocations which have been relocated & who are suffering with pain around the affected joint.


Bursitis is when there is inflammation of the bursa – a small fluid-filled sac that helps reduce friction between the muscles/tendons and the bones. We have bursas in all of our joints, but the knee is a commonly affected one. Bursitis can be caused by overuse or repetitive use of a joint or from trauma, such as a fall and the main symptoms are localised swelling, heat and pain.


The cartilage is the tissue that covers the ends of the bones. It’s strong and slippery and its function is to reduce the friction within the joint. In the knee, there is also another type of cartilage – the meniscus that helps us shock absorb. Both of these types of cartilage can become injured and the common symptoms are pain, stiffness, clicking/popping and swelling. The treatment approach for cartilage injuries depends on which type of cartilage is affected.

Treatment of Knee Pain and Problems

When an osteopath is treating knee pain, the treatment approach depends on the cause of the patient’s symptoms. The osteopathic approach to knee pain usually uses a combination of massage and joint articulation to help reduce inflammation, and pain and improve mobility. By reducing muscle tension through soft tissue techniques and providing you with a tailored exercise plan, we can help create better muscle balance around the joint.

If your pain is being produced by osteoarthritis although the arthritic changes are irreversible, osteopathic treatment can help keep the soft tissues (muscles, tendons, ligaments) working in a more balanced way, which can make day-to-day activities more comfortable. Our osteopaths can provide you with a tailored exercise program, to help strengthen your muscles, which can help them function as optimally as possible.

Having pain in the knee can also start affecting other joints in our bodies especially if walking is uncomfortable. We naturally try and shift our weight off the affected leg and this can start to impact the ankle, hip or lower back. Our osteopaths may examine and treat the surrounding joints because allowing these areas to function better can help reduce the pain in the knee more quickly and get you back to doing what you enjoy faster!

Can an Osteopath Help with Knee Pain and Problems?

Yes! For our osteopaths, knee pain is a common issue that comes up regularly in the clinic. Your osteopath will begin by taking a thorough case history from you and then they will examine your knee to see which structure(s) are causing your symptoms. Our osteopaths may also examine other joints in your body, to see if those areas could be contributing to your knee pain. If our osteopaths think you need further examination such as a scan to establish a diagnosis, they will help you with this next step.

Depending on your diagnosis, our osteopaths may use a combination of massage and joint articulation to help alleviate your symptoms. Western Acupuncture (dry needling) is a technique our osteopaths use and its aim is to release myofascial trigger points helping muscles relax, be less painful and improve their range of movement. Our osteopaths will also advise you on what the best exercises are for you to help stretch and strengthen around the knee joint to help prevent your symptoms from reoccurring in the future.

Is knee pain affecting your day-to-day life? Then why not get in touch today to see whether we could help you understand what is causing your symptoms and help you live more comfortably!