By Ed Voss, Specialist Physiotherapist for active aging.
Knee pain is one of the common knocks on the door as we get older — but simply putting this down to age isn’t the whole story, and it doesn’t mean you must accept it and reduce your activity.
Degenerative knee conditions span a spectrum from a mild ache and stiffness to persistent pain, swelling and difficulty with walking, stairs or getting up from a chair. Symptoms often worsen after prolonged sitting (“start-up” stiffness), can improve briefly with gentle movement, but may flare after long walks, hills or gardening. Many of my clients are surprised that such symptoms are highly manageable with the right approach. NICE
What you’re likely to see in clinic.
People typically report pain either on the inside or outside of the knee or behind the kneecap, with reduced confidence on uneven ground, and feeling like their leg muscles are getting weaker – particularly the quadriceps in the front of the thigh – which can make steps or hills feel like more effort. There may be visible swelling or altered walking patterns, and, importantly, fear of making things worse which can lead to avoiding activity and subsequent deconditioning. A GP may sometimes describe this as “wear and tear”; while the name is accurate, it’s not a sentence — there are effective, evidence-based options to reduce pain and keep you active. NICE+1
Physiotherapy: what really helps
- Targeted, bespoke exercise – Strengthening (especially of the quadriceps and hip muscles), aerobic conditioning (walking, cycling, swimming) and neuromuscular work form the backbone of treatment. A large systematic review shows exercise reduces pain and improves function across the spectrum of knee osteoarthritis. Tailoring the dose, progression and type of exercise to the person’s goals and tolerance is essential. PMC+1
- Manual therapy (used alongside exercise) – Hands-on techniques (joint mobilisations, soft-tissue work) can give short- to medium-term pain relief, improve movement and make exercise easier to perform. Evidence supports manual therapy as an adjunct – it’s best delivered by an experienced physiotherapist and combined with an active plan. PMC+1
- Pacing and activity modification – Learning to balance activity and rest (pacing) prevents the “boom-and-bust” pattern where a big activity may trigger a prolonged flare-up of pain. Small changes – breaking jobs into shorter phases, using a walking pole or supportive shoe, and planning gentle warm-ups before setting off for a walk or starting some gardening – may help keep you moving without provoking pain. Educational strategies and self-management are also core recommendations. PMC+1
- Weight management and general activity — Losing even modest weight reduces knee load and symptoms, whilst keeping overall fitness up improves long-term outcomes. National and European guidance stress physical activity, weight management and simple aids (walking poles, footwear) as core non-surgical care. jrheum.org+1
Practical takeaways
If a GP has brushed off your knee as “age-related”, ask about physiotherapy referral — it’s not just about painkillers: exercise, pacing, manual techniques and small lifestyle changes often produce measurable improvement and help people remain active. Early, individualised physiotherapy may give you the best chance of staying mobile and doing the things you enjoy. MDPI+1
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Ed graduated from Birmingham University with an MSc in Physiotherapy in 2009.
He is an HCPC and CSP registered Physiotherapist who has worked in the NHS, private practice and in sport both in the UK and New Zealand, and he now specialises in working with people over the age of 50 who value their health and want to keep as active as possible for as long as possible.
In his spare time, you’ll find Ed spending time with his wife and two children, out running the local trails with his dog, or if he’s really lucky, out on the golf course.
Ed grew up in Stroud, the son of a local GP and he knows and loves the local communities in the Five Valleys and beyond. Being able to give back to the people of this wonderful part of the world is something that Ed considers a huge privilege.
For further information, visit Ed’s website by clicking HERE or Email: edvossphysio@gmail.com Call: 07542 940478
