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Protecting your knees: Expert advice from a physiotherapist

Megan Nel, Senior Orthopaedic Physiotherapist at Cromwell Hospital, shares expert advice on how to protect your knees and reduce the risk of osteoarthritis.

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Understanding your knees

The knee is a hinge joint made up of three bones: the thigh bone (femur), shin bone (tibia), and kneecap (patella). These bones are connected by ligaments, which help stabilise the joint and control movement. There are four main ligaments in the knee: two on the sides (collateral ligaments) and two deep inside the joint (cruciate ligaments), which cross each other to provide stability.

The knee is a complicated joint that is prone to injury. Due to this knee pain can be a symptom of many different conditions.

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What is osteoarthritis?

Osteoarthritis is a degenerative joint condition where the cartilage that cushions the ends of bones gradually wears away. This can cause pain, swelling, and reduced mobility.  

It most commonly affects: 

  • knees 
  • hips 
  • hands 
  • spine (neck and lower back) 

Knee osteoarthritis is particularly common. Nearly 30 percent of people over the age of 45 show signs of it on X-rays, and half of those experience significant symptoms. 

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How physiotherapy can help

A physiotherapist can assess your joint movement, strength, and biomechanics, aiming to help restore movement and improve function. Exercise can help to manage the symptoms of osteoarthritis and help to maintain your physical and mental well- being. The goals of an exercise programme are to: 

  • strengthen muscles around the knee 
  • improve joint mobility and stability 
  • reduce joint stress and inflammation 
  • enhance balance and coordination 
  • support long-term joint health and quality of life

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When undertaking an exercise programme:

  • Focus on consistency rather than intensity. 
  • Include balance and coordination exercises, such as Pilates or tai chi.
  • Stay active with low-impact movement.
  • Modify exercises if pain increases.
  • Seek early physiotherapy support if symptoms appear.
  • Don’t ignore persistent pain or swelling.
  • Don’t perform deep squats or lunges if you have symptoms. 

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Weekly exercise plan for healthy knees

(Three to five days per week)

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Weekly exercise plan for healthy knees

Warm-up (five to 10 minutes):

  • gentle walking or cycling
  • dynamic stretches, such as leg swings and hip circles

Strengthening (10 to 15 minutes)

Focus on the quadriceps, hamstrings, glutes, and calves:

  • straight leg raises: two sets of 15 reps 
  • mini squats: two sets of 10 reps 
  • step-ups (low step): two sets of 10 reps per leg 
  • bridges: two sets of 15 reps 
  • wall sits (short duration): two reps of 20 seconds 

Flexibility and mobility (10 minutes)

Hold each stretch for 20 to 30 seconds and repeat twice:

  • supine hamstring stretch with strap
  • wall calf stretch
  • lying quadriceps stretch (edge of bed)
  • standing hip flexor stretch

Aerobic and neuromotor training (15 to 30 minutes)

  • walking on flat surfaces 
  • swimming or water aerobics 
  • cycling (stationary or outdoor)
  • mind-body exercises such as Pilates, tai chi, or yoga 

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Pain relief techniques

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Lifestyle and at-home strategies

  • Use the RICE protocol (Rest, Ice, Compression, Elevation) for flare-ups or post-exercise soreness.
  • Apply heat therapy before exercise to ease stiffness.
  • Maintain a healthy weight. Every extra kilogram can increase knee joint pressure up to four times during activities like stair climbing.

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Supportive tools, including:

  • knee braces or sleeves for stability – in some cases, a brace can offload one side of the joint to relieve pain and support exercise
  • cushioned insoles to reduce joint impact
  • walking aids, such as a stick if needed for balance

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Complementary therapies

  • Acupuncture may help with chronic pain.

  • Massage therapy can reduce stiffness and improve circulation.

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When to get expert support

If knee pain is persistent or affecting your daily life, early intervention is essential.  

At Cromwell Hospital, our expert physiotherapists offer tailored exercise programmes to support joint health and manage osteoarthritis. We also provide access to specialised equipment including braces, insoles, and walking aids to support your recovery and mobility. 

Book a consultation today and take the next step toward protecting your knees and improving your quality of life.  

Find out more about physiotherapy >

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