Knee Pain
Several quite different problems share the name. The treatment depends entirely on which one you have: which is what an assessment is for.
Common symptoms
- , Pain at the front of the knee, worse on stairs
- , Swelling after activity
- , Giving way or instability
- , Locking or catching
- , Stiffness after sitting
Common causes
- , Increased running volume, particularly on sand
- , Weak hip and gluteal muscles altering knee mechanics
- , Osteoarthritis and age-related change
- , Twisting injuries to ligament or meniscus
- , Impact or a fall
Which knee problem is it?
Front-of-knee pain in a runner, an arthritic knee in a sixty-year-old, and a twisted knee that swelled within the hour are three different conditions with three different treatments. Grouping them as “knee pain” is why so much treatment misses.
Assessment sorts them quickly: how it started, how it swells, what it does on stairs, whether it locks, and how the hip and ankle behave.
The hip is often the culprit
For running-related front-of-knee pain, the driver frequently sits above the joint. Weak gluteal muscles allow the thigh to rotate inward on landing, which loads the kneecap poorly. Strengthening the hip resolves what months of icing the knee did not.
On this coast, add surface. Runners moving onto beach sand (softer, uneven, cambered) change their mechanics substantially, and knees that were fine on tarmac start complaining within a few weeks.
After surgery
Post-surgical knees follow the surgeon’s protocol closely. The first six weeks matter more than any later period, because knees stiffen readily and are stubborn to free afterwards.
How we treat it
- , Assessment of hip, knee and ankle together
- , Progressive strengthening, glutes and quadriceps
- , Load and surface management for runners
- , Manual therapy for stiffness
- , Post-surgical rehabilitation to protocol
Typical recovery: 6–12 weeks for most overuse problems; longer after surgery
See a doctor urgently if you have
- !Inability to bear weight after injury
- !A knee that locks and will not straighten
- !Rapid marked swelling within an hour of injury
- !Fever with a hot, swollen knee
- !Obvious deformity after trauma
These are not physiotherapy problems. Go to a doctor or hospital rather than booking with us.
Treatments that help
Common questions
Is running on sand bad for my knees?
Not inherently, but it changes the demands considerably. Sand is softer on impact yet much harder on the calf and Achilles, and a sloping beach loads the two legs unequally. Problems usually come from switching to sand quickly rather than from sand itself.
I was told I have wear and tear. Is that it for running?
Usually not. Joint changes on imaging are extremely common and correlate poorly with pain. Most people with mild to moderate changes keep running with appropriate strength work.
Do I need surgery for a meniscus tear?
Often not. For degenerative tears in middle-aged and older adults, rehabilitation performs about as well as arthroscopic surgery in good trials. Traumatic tears in younger patients are a separate discussion.
Book a physiotherapist on the coast
Clinic appointments in Nyali, or a physiotherapist at your door from Mtwapa to Diani. Same-week slots.