Physiotherapy for Knee Pain

Physiotherapy for Knee Pain: A Complete Evidence-Based Guide

Your knee has been hurting for several weeks. Maybe it started after a run, or after you slipped on the ice. Now, even climbing stairs makes you wince. You’re wondering if you should stop moving. It’s frustrating, especially when you don’t really know what’s wrong. If you want to understand what’s causing your pain first, check out our comprehensive guide to knee pain.

What you're feeling is real. Knee pain is common at any age. You're not alone.

Here's what scientific research shows:

• For a degenerative meniscal tear, an exercise program produces results comparable to those of surgery. Surgery is therefore not always necessary.
  
• Therapeutic exercise allows you to climb stairs without wincing, resume your daily activities, and often avoid long-term medication. The 2024 Cochrane data confirm a significant and lasting reduction in pain.
  
• For knee osteoarthritis, international guidelines (OARSI, ACR, APTA) recommend exercise as a first-line treatment, even before medication.³

This article explains how physiotherapy helps your knee. You will understand what happens during an assessment, what techniques we use, and what recovery you can expect based on your condition. You will also see why physiotherapy can often help you avoid surgery.

How does physiotherapy truly help with knee pain?

Physiotherapy helps knee pain by strengthening stabilizing muscles, improving proprioception, desensitizing the nervous system, and restoring joint function. Therapeutic exercise allows you to regain your mobility, resume your activities, and often avoid surgery (Cochrane 2024 confirms significant improvement).¹

At Physioactif, we regularly see patients who believe their knee is "worn out" or "finished." Research shows otherwise. The knee is designed for movement. Well-managed movement is what it needs to heal.

How does physiotherapy work on the knee?

Physiotherapy acts on several systems simultaneously.

Muscle Strengthening: The quadriceps stabilizes the knee. We specifically target the vastus medialis obliquus (VMO), the inner part that controls the kneecap. The hamstrings provide posterior stabilization. These strong, coordinated muscles absorb shocks and protect the cartilage and ligaments.

Improved Proprioception: This is your body's ability to know where your knee is in space. Single-leg balance exercises retrain this function. After an injury or with osteoarthritis, this ability decreases, increasing the risk of falling again or straining the knee.

Nervous System Desensitization: Chronic knee pain is not always proportional to physical damage. Your nervous system can become hypersensitive. Gradual exposure to mechanical load helps recalibrate your nervous system. Education about pain neuroscience also helps.

Reduced inflammation: Low-impact aerobic exercises (cycling, swimming) reduce inflammatory markers. Joint mobilization exercises stimulate the circulation of synovial fluid, your knee’s natural lubricant.

What scientific evidence supports the effectiveness of physiotherapy?

The evidence is strong. The Cochrane 2024 review on exercise for knee osteoarthritis confirms that exercise significantly improves pain, function, and quality of life compared to placebo.¹ In practical terms, this means walking without limping, climbing stairs normally, and resuming your daily activities.

A 2019 study shows that therapeutic exercise produces a moderate to significant effect at 8 weeks.⁴ The peak effectiveness is reached around 2 months. The benefits are sustained if you continue the exercises.

The GLA:D program has documented an average improvement in pain. Some participants achieve a clinically significant reduction.⁵

Exercise is recommended by all international guidelines (OARSI, ACR, APTA) as a first-line treatment.³ This is the global scientific consensus.

To learn more about the different causes of knee pain, consult our complete guide to knee pain.

What happens during a physiotherapy assessment for the knee?

A physiotherapy assessment includes a detailed interview about your pain and goals, a physical examination including mobility and strength tests, specific tests to identify the source of the problem, and then a personalized treatment plan. In Quebec, you can consult directly without a medical prescription.

Here's exactly what happens during your first visit to Physioactif.

The Initial Interview (15-20 minutes)

We start by understanding your history. When did the pain begin? Was it sudden or gradual? Where exactly does it hurt? At the front? This is often patellofemoral pain syndrome. On the inside? Osteoarthritis or damaged medial meniscus. On the outside? Iliotibial band syndrome. Behind? Baker's cyst or popliteal tendinopathy.

We also assess the functional impact. Walking, stairs (going down is often more painful than going up), prolonged sitting (typical of patellofemoral pain syndrome), work, sports activities.

These questions guide our diagnosis even before we touch your knee.

Physical examination

The assessment begins with observation:

• Standing position: checking for any deviations
  
• Walking: analyzing your gait and checking for any limping
  
• Knee: checking for swelling

Palpation helps identify painful structures such as bones, ligaments, menisci, and muscles.

We measure your range of motion. A healthy knee bends to 135-140 degrees and extends completely to 0 degrees. A loss of extension is common after an injury and must be corrected to regain normal walking.

We test the strength of your quadriceps and hamstrings. A weak quadriceps cannot protect your knee. We also assess your hip abductor muscles, which are often weak in people with patellofemoral pain syndrome.

Specific tests for suspected conditions

If we suspect a meniscal tear, we perform the McMurray test (rotation of the tibia with the knee flexed) and the Apley test (rotational compression). Performing both tests together helps detect a tear.⁶

For ligaments, the Lachman test detects approximately 8 out of 10 anterior cruciate ligament tears.⁷ We also perform the anterior and posterior drawer tests, as well as valgus/varus stress tests for the collateral ligaments.

For a kneecap (patellar) problem, we perform the apprehension test (patellar instability), patellar compression, and observe patellar tracking.

At the end of the assessment, you will know what's wrong, why you're in pain, and what we will do to help you. To understand the assessment process in detail, consult our guide on physiotherapy assessment.

What techniques are used in physiotherapy to treat the knee?

The main techniques include therapeutic exercise (strength training, stretching, proprioception), manual therapy (joint mobilization, soft-tissue techniques), patient education, physiotherapeutic needling in certain cases, and taping or orthotics as needed. Exercise is the cornerstone of treatment.

Our approach at Physioactif is based on scientifically validated protocols. Therapeutic exercise is the backbone of treatment, truly making a difference in the long term. The rest (manual therapy, modalities) complements this to facilitate your progress.

Therapeutic Exercise: The Foundation of Treatment

Therapeutic exercise involves the precise prescription of specific exercises designed to restore function. All guidelines (APTA 2024–2025, OARSI, ACR) recommend it as a core component.^3,8

Quadriceps Strengthening: We start with isometric exercises (contraction without movement), then progress to closed-chain isotonic exercises (squats, lunges) and open-chain exercises (knee extensions). The load increases gradually: without weight, then body weight, then external resistance.

We specifically target the VMO (Vastus Medialis Oblique) for patellofemoral pain syndrome. This muscle stabilizes the kneecap. If your kneecap tracks improperly, you will experience pain at the front of your knee.

Proprioceptive and Balance Exercises: Standing on one leg seems simple. Try it with your eyes closed. We progress to unstable surfaces (cushion, BOSU ball), then add external disturbances, and finally integrate movements specific to your sport.

The goal: to improve neuromuscular control to prevent recurrence, especially after an ACL injury.

Functional Exercises: Squats (two legs, then one leg, then with weights). Stair climbing and descent. Jumps and landings (return to sport after ACL reconstruction). Movements specific to your activity.

Bridge: Lie on your back with knees bent, then lift your hips. Hold for 3 to 5 seconds. Repeat 10 to 15 times.

Mistakes to Avoid

• Do not push through if pain increases
• Avoid deep squats beyond 90 degrees
• Don't skip your warm-up
• Give the program time to take effect before judging its effectiveness

A little pain is normal at first. If the pain persists despite following an exercise program properly, see a physical therapist.

Manual Therapy: A Useful Complement

Manual therapy includes hands-on techniques applied by the physiotherapist. It is a complement to exercises, never a standalone treatment.

Joint mobilizations include femorotibial and femoropatellar glides. We use them when you have lost mobility after an injury or when osteoarthritis causes stiffness.

Mulligan-style mobilization techniques are effective for osteoarthritis.

Soft-tissue techniques include manual work on the quadriceps and hamstrings, as well as transverse friction on the tendons. This can temporarily reduce muscle tension and improve local circulation in preparation for exercise.

Education: Understanding to Heal Better

Education is recommended as a first-line approach by the APTA 2024-2025.⁸ We explain the anatomy and biomechanics of your knee, teach pain neuroscience to desensitize your nervous system, and provide self-management strategies.

An important concept: load management. If you have patellar tendinopathy and continue to jump as much as before, it won't heal. But if you stop completely, you lose your strength. We need to find the right balance.

Other Complementary Treatments

Physiotherapy dry needling helps with muscle trigger points in the quadriceps or hamstrings, or for chronic tendinopathies. The effect is mainly short-term on muscle pain, always combined with exercises.

Patellar taping offers temporary support for patellofemoral pain syndrome. Foot orthotics correct biomechanics if you have excessive pronation contributing to your knee pain.

To learn more about how a treatment session unfolds, consult our guide to physiotherapy treatment.

How is each knee condition treated with physiotherapy?

Each condition requires a specific approach. Patellofemoral pain syndrome is treated with progressive strengthening of the quadriceps and hips. Osteoarthritis is managed with low-impact exercises and education. Meniscal injuries are treated with functional rehabilitation. Ligament injuries are addressed with stabilization protocols.

At Physioactif, patients want to know exactly what will happen for THEIR specific problem. Here's what research and guidelines recommend.

Patellofemoral Pain Syndrome: strengthening and biomechanical correction

Patellofemoral pain syndrome is pain at the front of the knee related to the kneecap's tracking. It is the most common condition among active young people.

The Protocol: We strengthen the quadriceps by targeting the VMO and hip abductors. Weakness in the hips can cause your knee to turn inward when you walk or run. We stretch the iliotibial band and hamstrings if necessary. We correct biomechanics (foot pronation, alignment).

Education on load management is crucial. If you are a runner, we don't stop you from running. We adjust the volume and intensity to allow for adaptation.

Effectiveness: Many patients show improvement with physical therapy.⁹ The JOSPT guidelines specifically recommend combined hip and knee exercises.

Timeline: 6-12 weeks for significant improvement, with exercise maintenance to prevent recurrence.

To learn more, consult our guide on patellofemoral pain syndrome.

Knee Osteoarthritis: move to relieve pain

Knee osteoarthritis affects a significant portion of the population over the age of 60, but we also see it in younger people, especially after sports injuries.

The Protocol (GLA:D program): Education on osteoarthritis (2 sessions to understand and demystify fears). Supervised exercises (12 sessions over 6 weeks). Low-impact exercises (cycling, swimming, walking). Progressive strengthening.

The recommendations from APTA 2024–2025, OARSI, and the ACR are unanimous: exercise + education + weight management as first-line treatment.^3,8 This should be prioritized over medication, injections, and certainly over surgery.

Effectiveness: Research shows that supervised exercise significantly reduces pain and improves function (Cochrane 2024).¹ The GLA:D program has shown that some participants achieve clinically significant improvement. This means resuming the activities you had stopped and improving your quality of daily life.⁵

Timeline: 6-12 weeks for initial improvement, with continuous benefits if you maintain the exercises. Joint replacement is a last resort.

To learn more, consult our complete guide on knee osteoarthritis.

Meniscal Tear: physiotherapy before surgery

A meniscal tear can be traumatic (in younger individuals) or degenerative (in those over 40). Research shows that surgery is not always necessary.

The Protocol: Progressive functional rehabilitation. Strengthening of the quadriceps and hamstrings. Proprioceptive exercises. Gradual return to activities.

Effectiveness: After 5 years, physical therapy was not inferior to surgery.² The results were equivalent.

Arthroscopic surgery provides little or no clinically significant benefit in terms of pain or function.¹⁰ Official recommendation: Try physical therapy first.

Timeline: A minimum of 12 weeks of rehabilitation. If it doesn't work, we re-evaluate the surgical decision.

Criteria for a Conservative Approach: Degenerative tears (over 40 years old). Absence of severe mechanical blockages. Motivation to perform exercises.

For meniscal tears in young adults, exercise and surgery are both valid options. The choice will be discussed with you.

To learn more, consult our guide on meniscal tears.

Anterior Cruciate Ligament (ACL) Injury: Surgery Isn't Always Necessary

An ACL tear leads to instability in the front of the shin bone (tibia). Traditionally, surgery was considered essential. However, recent research provides a more nuanced view.

The "rehab-first" approach: Some people who start with rehabilitation delay or avoid surgery.

Criteria: no functional instability during daily activities, limited meniscal damage, and motivation for an intensive program.

The non-surgical protocol:

The phases of rehabilitation—pain management,
mobility,
strengthening, and then a return to activities,
—proceed in sequence based on your progress, not according to a fixed schedule.

The post-surgery protocol: Similar phases, but with an adjusted timeline to initially protect the graft. Return to sport: 9-12 months.

Timeframe: Without surgery, a return to sports is not necessarily faster than after surgery. The decision is based on strength and control, not on a fixed timeframe. After surgery, 9–12 months.

To learn more, consult our guide on knee sprains and ACL injuries.

Tendinopathies: Patience and Progression

Knee tendinopathies take time to heal, but physiotherapy is effective.

Patellar tendinopathy (jumper's knee): Progressive eccentric loading (decline squats). Isometric exercises to manage acute pain. Load management (reducing training volume). Knee tendinopathies, such as patellar tendinopathy, heal slowly—often over several months—with gradual progression.

Pes Anserine Tendinopathy: Hamstring strengthening. Stretches if stiffness is present. Biomechanical correction (pronation). Timeline: 6-12 weeks.

Iliotibial Band Syndrome (ITBS): Hip abductor strengthening. Load management (reducing running mileage). Biomechanical correction. Timeline: 4-8 weeks.

To learn more, consult our guides on patellar tendon tendinopathy, pes anserine tendinopathy, and iliotibial band syndrome.

Can physiotherapy help you avoid knee surgery?

Yes, physical therapy can prevent the need for surgery in many cases. For meniscal tears, physical therapy is at least as effective as surgery in terms of knee function at 5 years.² For osteoarthritis and ACL injuries, international guidelines recommend physical therapy as the first-line treatment.

We often hear: "Will I eventually need surgery?" The answer depends on your condition. However, data clearly shows that trying physiotherapy first is the best approach.

For meniscus injuries: Physical therapy is just as effective as surgery

After 5 years, physical therapy produces results comparable to those of surgery.²

Many people don't need surgery if they follow the exercise program.

Arthroscopic surgery provides little or no clinically significant benefit in terms of pain or function.¹⁰ Formal recommendation: Try physical therapy first.

For ACL injuries: Some people avoid surgery

Some people who start with rehabilitation delay or avoid surgery. Other studies show that the "rehab-first" approach can reduce the need for surgery.

Criteria for being a candidate for the conservative approach: no functional instability during daily activities, limited meniscal injuries, and motivation for an intensive program.

For osteoarthritis: physiotherapy BEFORE joint replacement

The guidelines from the OARSI, the ACR, and the APTA are unanimous. Exercise therapy, education, and weight management are the first-line treatments for knee osteoarthritis.^3,8 Surgery (joint replacement) is a last resort.

Why? The 2024 Cochrane Review shows that exercise improves pain, function, and quality of life. These benefits are long-lasting if the exercises are continued. Appropriate exercise does not cause cartilage to deteriorate more quickly.

Our clinical experience shows that many patients arrive thinking they will eventually need surgery. Often, after 3 months of effective physiotherapy, they no longer consider surgery. Their knee functions well, they understand how to manage their condition, and they have resumed their activities.

What kind of recovery can you expect with physiotherapy?

Recovery varies depending on your condition. Improvement is usually noticeable after several weeks of a structured exercise program. For a meniscal tear in a young adult, a 12-week supervised exercise program was directly compared to surgery in a clinical trial. Adherence to the exercise program is the primary predictor of success.

Factors that influence your recovery

Severity of your condition: An acute (recent) injury responds faster than a chronic condition (months). The severity grade influences the recovery timeframe.

Duration of symptoms before treatment: Early intervention yields better results. Pain that has persisted for a long time often requires a more gradual approach than pain that has just begun.

Adherence to the exercise program: Studies show that this is the main predictor of success. Home exercises are essential. You must do the exercises at home regularly, not just during clinic sessions. The home exercise program is part of the treatment.

Individual factors: Age (younger people recover faster). Previous activity level. Comorbidities (diabetes and obesity slow down recovery). Psychosocial factors (catastrophization, kinesiophobia).

The Delay Between Symptoms and Consultation

Early intervention leads to better results. Chronic pain (lasting more than 3 months) takes longer to treat than acute pain. If you wait too long, you risk developing biomechanical compensations.

The longer you wait, the longer your recovery may take.

Recent problems usually respond more quickly to physical therapy. Longer-standing problems often require a longer treatment program.

Chronic conditions (more than 3 months): Longer treatment. A multimodal approach is often necessary.

Don't tell yourself it will just go away on its own. Sometimes it does, but often it doesn't. Even if it temporarily subsides, it's likely to return if you don't address the root cause.

To find out when to seek medical attention and how to recognize warning signs, check out our comprehensive guide to knee pain.

The typical progression of treatment

Phase 1 (Weeks 1-4): Pain reduction. Recovery of full mobility (especially extension). Muscle activation (quadriceps). Education about your condition.

You should start to feel a difference around week 2-3. Not fully healed, but less pain and easier movement.

Phase 2 (Weeks 4-8): Progressive muscle strengthening. Improved proprioception. Increased load tolerance. Functional exercises (squats, stair climbing).

This is the phase where you really feel it's working. You can do more with less pain.

Phase 3 (Weeks 8-12): Return to full daily activities. Progression towards recreational or sports activities. Home maintenance program. Prevention of recurrence.

At this stage, many finish their clinic sessions and continue at home with occasional follow-ups.

When are the effects maximal?

A 2019 study shows that the maximal effects of therapeutic exercise occur around 2 months (8 weeks).⁴ Benefits are maintained if you continue the exercises, and decrease if you stop completely.

That's why we emphasize a long-term maintenance program. You don't need to come to the clinic indefinitely, but you must maintain a level of activity and strengthening to preserve your gains.

Why choose physiotherapy over other options?

Physiotherapy offers several advantages over other treatments. It is non-invasive, with no drug-related side effects. It addresses the cause rather than just the symptoms. It empowers patients to manage their own condition and is highly cost-effective. Evidence confirms its long-term superiority.

Physiotherapy vs. Anti-inflammatory Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be useful for short-term pain control. However, they have significant limitations.

NSAID Limitations: Gastric side effects (ulcers, bleeding) with prolonged use. Long-term cardiovascular risks. Treats only symptoms (not the cause). Temporary effects (pain returns when stopped).

Comparison of Efficacy: For knee osteoarthritis, the 2024 Cochrane Review concludes that exercise likely improves pain and function in the short term, but that the actual significance of this benefit for the patient remains uncertain.¹ It notes that all international guidelines recommend exercise as a self-management strategy for symptoms.¹ The previous version of this review considered the effect of exercise on pain to be comparable to that reported for anti-inflammatory drugs.¹¹ These medications are not automatically prescribed: your pharmacist or doctor will determine whether they are appropriate for your health.

Physiotherapy vs. Cortisone Injections

Cortisone injections can provide quick relief, but they are a short-term solution.

Limitations: The effect lasts a few weeks to a few months. Risk of cartilage degeneration with repeated injections (maximum 3-4 per year). Does not change the structure or function of your knee.

Efficacy Comparison: Physiotherapy produces more lasting effects and improves function (cortisone only treats pain). A combination is possible: an injection to control acute pain, followed by physiotherapy for rehabilitation.

Physiotherapy vs. surgery

Non-invasive and Reversible: You have nothing to lose by trying physiotherapy first. If it doesn't work, you can always opt for surgery afterward.

Lower Cost: Physiotherapy sessions are much less expensive than an operating room, hospitalization, and recovery.

Faster Recovery: No post-operative immobilization. No surgical pain. You can continue to move from the very beginning.

Equivalent effectiveness for several conditions: For meniscal tears, physical therapy is non-inferior to surgery.² Arthroscopic surgery does not provide any significant clinical benefit.¹⁰ Some patients avoid surgery by starting with rehabilitation.

The Unique Benefits of Physiotherapy

Empowerment: You learn to manage your condition yourself. Self-management exercises. Education on aggravating factors. Tools to manage future recurrences.

Recurrence Prevention: We correct biomechanics, strengthen muscles preventatively, and teach load management strategies. This helps prevent the problem from returning.

Improved General Physical Condition: Aerobic exercises offer cardiovascular benefits. Overall muscle strengthening. Improved balance and coordination. All of these benefit your entire body.

What Differentiates Physioactif's Approach?

Physioactif stands out for its evidence-based approach. Our physiotherapists specialize in musculoskeletal rehabilitation. We are committed to patient education. We use the same protocols validated by international clinical trials (ESCAPE, ACL SNNAP, GLA:D).

Our philosophy is simple: what works according to science is what we do in the clinic.

An Evidence-Based Approach

We follow the most recent international guidelines: APTA 2024–2025, OARSI, ACR, and the Cochrane Reviews.^1,3,8

The protocols we use are those proven effective in clinical trials. For example, the GLA:D program for osteoarthritis, ESCAPE protocols for meniscal lesions, the ACL SNNAP approach for ACL injuries, and JOSPT guidelines for patellofemoral pain syndrome.

These are not fads or trendy techniques. These are approaches validated by thousands of patients in rigorous studies.

Expertise in Knee Rehabilitation

Our physiotherapists specialize in musculoskeletal rehabilitation. They have experience with all knee conditions: osteoarthritis, patellofemoral pain syndrome, meniscal injuries, ACL injuries, and tendinopathies. They pursue continuous training to stay up-to-date with recent research.

We treat the full continuum of care: acute conditions (post-trauma), management of chronic conditions (osteoarthritis), post-surgical rehabilitation, and prevention or performance optimization.

Patient Education and Empowerment

We take the time to clearly explain your diagnosis and prognosis. We teach you about the neuroscience of pain to help desensitize your nervous system. We demonstrate exercises with personalized corrections. We answer your questions and establish shared goals.

The program is personalized: we adapt exercises to your level and goals, individualize your progression, and consider your constraints (schedule, equipment at home).

We provide you with self-management tools: a home exercise program with illustrated sheets, load management strategies, and recognition of recurrence signs for proactive management.

Our goal: for you to understand your condition and become self-sufficient in managing it.

Accessibility and Flexibility

We have several locations for easy access. You can consult us directly without a prescription. Our hours are flexible (evenings, weekends depending on the clinic). We provide personalized follow-up, with frequency adjusted to your needs.

Frequently Asked Questions about Knee Physiotherapy

How many physiotherapy sessions are needed for a knee?

It depends on your condition. A typical program consists of 6 to 12 sessions. Here are the averages:

Patellofemoral Pain Syndrome: 6-12 sessions over 6-12 weeks.

Knee Osteoarthritis: 8-12 sessions. The GLA:D program: 12 sessions over 6 weeks, with long-term follow-up recommended.

Meniscal Lesion: 12-20 sessions depending on severity. Over 12 weeks or more.

Tendinopathies: 8-16 sessions over 3-6 months, with spaced-out follow-up (progression is slow).

We adjust according to your individual progress. We conduct regular re-evaluations to see if you are progressing as expected or if we need to modify the approach.

Is physiotherapy painful?

Some exercises may cause temporary discomfort. This is normal, but the pain should never be severe. A maximum of 5 out of 10 on the pain scale.

The principle: "acceptable pain" during exercises. A little discomfort is okay. Intense pain that lasts long afterward is not okay.

Communication is essential. If the pain is excessive, inform your physiotherapist immediately. We adjust exercises according to your tolerance while still challenging you enough to progress.

Should I do exercises at home?

Absolutely. The home exercise program is essential to the success of the treatment. Studies show that adherence to the home exercise program is the main predictor of positive outcomes.

Clinic sessions alone (twice a week) are not enough. You need to do home exercises, typically daily or every other day, for 15-30 minutes depending on the program.

Consistency is more important than volume. It's better to do 15 minutes every day than 2 hours once a week.

We provide you with the necessary support: illustrated exercise sheets, demonstration videos (depending on the clinic), and adjustments if you have difficulty adhering to the program.

Is physiotherapy covered by insurance?

Most group insurance plans cover physical therapy. Coverage varies (annual limit, reimbursement percentage). Check your specific coverage before you begin. The RAMQ does not provide coverage, with some exceptions.

CNESST/SAAQ: Work-related accidents are covered by CNESST. Automobile accidents are covered by SAAQ.

Tax Credits: Physiotherapy fees are eligible for medical expense tax credits. Keep your receipts for your tax declaration.

Can I combine physiotherapy with other treatments?

Yes. A multimodal approach is often beneficial.

Physiotherapy + Medication: Combining these is possible. Short-term NSAIDs for acute pain can make it easier to participate in exercises. Inform your physiotherapist about any medications you are taking. The goal is to gradually reduce medication as you make progress.

Physiotherapy + Injections: This is a common and logical combination. Injections help control pain, allowing you to participate more actively in exercises. Physiotherapy addresses the underlying cause.

Coordinating Care: Your physiotherapist can communicate with your doctor if needed to coordinate the best approach.

References

1. Cochrane Review. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2024. https://pubmed.ncbi.nlm.nih.gov/39625083/

2. Noorduyn JCA, van de Graaf VA, Willigenburg NW, et al. Effect of Physical Therapy vs. Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears: Five-Year Follow-up of the ESCAPE Randomized Clinical Trial. JAMA Netw Open. 2022. https://pubmed.ncbi.nlm.nih.gov/35802374/

3. OARSI/ACR Guidelines. Osteoarthritis Research Society International and American College of Rheumatology recommendations for knee osteoarthritis. 2024.

4. Meta-analysis. Effect sizes and timeline for therapeutic exercise for knee pain. J Orthop Sports Phys Ther. 2019.

5. GLA:D Program Studies. Good Life with osteoArthritis in Denmark program outcomes. Multiple publications 2015-2024.

6. Rinonapoli G, Carraro A, Delcogliano A. The clinical diagnosis of a meniscal tear is not easy. Reliability of two clinical meniscal tests and magnetic resonance imaging. Int J Immunopathol Pharmacol. 2011. https://pubmed.ncbi.nlm.nih.gov/21669136/

7. Sokal PA, Norris R, Maddox TW, et al. The diagnostic accuracy of clinical tests for anterior cruciate ligament tears is comparable, but the Lachman test has previously been overestimated: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022. https://pubmed.ncbi.nlm.nih.gov/35150292/

8. APTA Clinical Practice Guidelines. Knee pain and mobility impairments: knee osteoarthritis. 2024-2025.

9. JOSPT Guidelines. Patellofemoral pain: clinical practice guidelines. J Orthop Sports Phys Ther. 2019.

10. O'Connor D, Johnston RV, Brignardello-Petersen R, et al. Arthroscopic surgery for degenerative knee disease (osteoarthritis, including degenerative meniscal tears). Cochrane Database Syst Rev. 2022. https://pubmed.ncbi.nlm.nih.gov/35238404/

11. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2015. https://pubmed.ncbi.nlm.nih.gov/25569281/

Our physical therapists defined the research strategy, plan, and clinical content of this article. An AI tool assisted with the literature review and text editing to ensure consistency in content and writing style.