Question 1

Knee Osteoarthritis

Accepted Answer

What is Knee Osteoarthritis?

Osteoarthritis (OA) is a common condition which can affect any joint, but commonly the knee. The cartilage which protects the surface of your joints get worn/damaged which causes friction and prevents the joint from moving smoothly.

The joint can become swollen and inflamed, the joint can change shape and the muscles can feel weaker.

The knee joint is made up of three main compartments, the medial tibiofemoral joint (inner aspect of the knee), the lateral tibiofemoral joint (outside aspect of the knee) and the patellofemoral joint (where the knee cap moves across the front of the femur).

Sometimes knee osteoarthritis affects one compartment of the joint rather than all three.

Causes:

• Normal age-related changes.
 • Previous injury to the area.
 • Repetitive activity/physical job.
 • Family history.
 • High Body Mass Index.
 • It is more common in people over the age of 50.

Symptoms:

• Early morning stiffness in the knee, in the morning for 30 minutes or more.
 • Instability.
 • Swelling.
 • Reduced movement in the knee, particularly bending the knee.
 • Reduced ability to complete activities of daily living.
 • Pain in the knee.
 • Putting weight through the affected knee.

Treatment:

Most commonly a physiotherapist will be able to make a diagnosis of knee osteoarthritis through an assessment of your knee and talking to you about your symptoms.

Sometimes it may be necessary to complete an X-RAY of the knee, however this dependent on your duration of symptoms and/or if you have trialled physiotherapy rehabilitation with limited improvement.

The most common methods of treatment will include: 
 • Physical activity.
 • Weight loss.
 • Strengthening exercises.
 • Advice/education regarding osteoarthritis.
 • Pain relief - please speak to your GP regarding medication.

If you fail to respond to physiotherapy treatment, sometimes the following options may be appropriate:
 • Steroid injection into the knee joint.
 • Orthopaedic opinion if you have limited improvement with conservative management.

Exercises:

Please see the video below for exercises for osteoarthritis of the knee and hip:
https://vimeo.com/358855732

Further Resources:

• Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme (https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme)

• Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you (https://www.northyorks.gov.uk/healthy-living/healthy-you)

• Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions (https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions)

• Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes)

• Arthritis UK, have also developed an exercise page where you can follow step by step exercises to help with your Knee Osteoarthritis. Please click the link below: https://www.arthritis-uk.org/information-and-support/living-with-arthritis/health-and-wellbeing/exercising-with-arthritis/exercises-for-healthy-joints/exercises-for-the-knees/(https://www.arthritis-uk.org/information-and-support/living-with-arthritis/health-and-wellbeing/exercising-with-arthritis/exercises-for-healthy-joints/exercises-for-the-knees/)

• Versus Arthritis OA Knee Booklet 
https://www.versusarthritis.org/media/24020/osteoarthritis-of-the-knee-august2021.pdf (https://www.versusarthritis.org/media/24020/osteoarthritis-of-the-knee-august2021.pdf)

• National Institute for Health and Care Excellence - Guidelines for knee osteoarthritis. Please click the link here: Recommendations | Osteoarthritis in over 16s: diagnosis and management | Guidance | NICE (https://www.nice.org.uk/guidance/ng226/chapter/Recommendations#non-pharmacological-management)

Last reviewed Jan 2026. To be reviewed Jan 2027.

Question 2

Acute Meniscal Injuries

Accepted Answer

What is an acute meniscus injury?

There are two menisci in each knee. They are shock absorbing cartilages and sit between your shin and thigh bone. One on the inside and one on the outside of your knee. The meniscus is needed for joint stability and lubrication.

A acute meniscus injury is caused usually by a tear or irritation in the meniscus tissue. Because the meniscus has poor blood supply, rehabilitation including strengthening, is very important for healing.

Generally those who are younger, will have meniscus pain related to an injury.

If your pain started after a minor/no injury, it is likely your pain is related to degenerative meniscus. For more information, please see information on degenerative meniscus pain page.

Causes:

• Twisting the knee whilst putting weight through it, most commonly in football/netball. 
 • A direct impact on the knee.

Symptoms:

• Pain around the knee.
 • Swelling around the knee.
 • Clicking.
 • Lack of knee movement and reduced ability to complete activities of daily living.
 • Locking (the joint becomes stuck in one position).
 • Giving way.

Treatment:

Most commonly a physiotherapist will be able to make a diagnosis of an acute meniscus tear through an assessment of your knee and talking to you about your symptoms.

Things you can do to help yourself in the first week following a meniscus injury to your knee:

• Protection:  During the first few days after an injury, you should rest the injured joint.  After 72 hours, gentle movement can be started.  If walking is difficult or painful, a stick or crutch may help.

• Although it might be painful, it is important to maintain movement in your knee to avoid stiffness. Placing no weight through the joint at all is rarely useful.

• Ice: Applying ice with gentle compression using a bandage may help with pain relief and reducing swelling around your knee.

• Elevation:  Placing the knee higher than your hip whilst lying or sitting will help the swelling reduce.

• Use of over the counter pain relief if necessary to enable to keep mobile. (Speak to your local Pharmacist if you are unsure about what you can take).
 
The most common methods of treatment will include:

• Physical activity.
 • Weight loss.
 • Strengthening exercises.
 • Advice/education regarding meniscus injuries.
 • Pain relief - such as anti-inflammatory medication - please speak to your GP regarding medication.

If you fail to respond to physiotherapy treatment, sometimes the following options may be appropriate:

• Steroid injection into the knee joint.
 • Orthopaedic opinion if you have limited improvement with conservative management.

Sometimes it may be necessary to complete an X-RAY of the knee, however this dependent on your duration of symptoms and/or if you have trialled physiotherapy rehabilitation with limited improvement.

If an X-RAY shows no degenerative changes such as osteoarthritis, it may be appropriate to complete an MRI for surgical planning. Most symptoms will settle down with time, exercise and rehabilitation, therefore these options are recommended as first line treatment. 
 
In most cases, meniscal tears can be managed without surgery.

Exercises:

Further Resources:

• Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme (https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme)

• Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you (https://www.northyorks.gov.uk/healthy-living/healthy-you)

• Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions (https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions)

• Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes)

Last Reviewed Jan 2026. To be reviewed Jan 2027.

Question 3

Degenerative Mensicus Pain

Accepted Answer

What is Degenerative Meniscus Pain?

There are two menisci in each knee. They are shock absorbing cartilages and sit between your shin and thigh bone. One on the inside and one on the outside of your knee. The meniscus is needed for joint stability and lubrication. Because the meniscus has poor blood supply, rehabilitation including strengthening, is very important for healing.

Degenerative meniscus tear/irritation is generally related to pain that started after a minor injury or no injury.  Like grey hairs and wrinkles, they are a normal part of the ageing process, as the meniscus tissues change and become more vulnerable to injury. Degenerative meniscus tears are often associated with knee osteoarthritis. They most commonly occur over the age of 35.

More than a third of people over the age of 50 will have one – but they do not all have symptoms. Sometimes you may have degenerative meniscus but have no pain.

Most degenerative meniscal tears don’t cause symptoms and are just as likely to be present in people with and without knee pain. The pain may fluctuate and resolve with time

Causes:

• Usually from a slow and quiet onset where you may have no or a very minor injury (Eg. stumble, twisting).

The following reasons increase your risk of a degenerative meniscus tear:

• Being male.
 • Work related kneeling.
 • Squatting.
 • Sitting for long periods.
 • Stair climbing.
 • Having a body mass index over 25.

Symptoms:

• Pain around the knee (usually the inside aspect or the outside aspect).
 • Swelling around the knee (usually a occurring a few hours after the injury).
 • Clicking.
 • Lack of knee movement and reduced ability to complete activities of daily living.
 • Locking (the joint becomes stuck in one position).
 • Giving way.

Treatment:

Most commonly a physiotherapist will be able to make a diagnosis of degenerative meniscus pain through an assessment of your knee and talking to you about your symptoms.

Things you can do to help yourself in the first week following a meniscus injury to your knee:

• Protection:  During the first few days after an injury, you should rest the injured joint.  After 72 hours, gentle movement can be started.  If walking is difficult or painful, a stick or crutch may help.

• Although it might be painful, it is important to maintain movement in your knee to avoid stiffness. Placing no weight through the joint at all is rarely useful. Using some walking aids in the short term may be helpful to offload some weight through the knee.

• Ice: Applying ice with gentle compression using a bandage may help with pain relief and reducing swelling around your knee.

• Elevation:  Placing the knee higher than your hip whilst lying or sitting will help the swelling reduce.

• Use of over the counter pain relief if necessary to enable to keep mobile. (Speak to your local Pharmacist if you are unsure about what you can take).
 
The most common methods of treatment generally 1 week post injury will include:

• Physical activity.
 • Weight loss.
 • Strengthening exercises.
 • Advice/education regarding meniscus injuries.
 • Pain relief - please speak to your GP regarding medication. In the early stages 1-3 weeks, anti-inflammatory medication is not recommended however beyond this time frame, it may help to ease your symptoms.

If you fail to respond to physiotherapy treatment, sometimes the following options may be appropriate:

• Steroid injection into the knee joint.
 • Orthopaedic opinion, if you have limited improvement with conservative management.

Do I need a scan?

Sometimes it may be necessary to complete an X-RAY of the knee to rule out other causes and determine the severity of osteoarthritis. However this is dependent on your duration of symptoms and/or if you have trialled physiotherapy rehabilitation with limited improvement.

Guidelines suggest unless you are suddenly unable to straighten your knee, a serious cause of pain is suspected, or a knee joint replacement is needed, MRI scans are usually unhelpful, and it can lead to unnecessary treatment

Do I need surgery?

Surgery is not always needed for degenerative meniscal tears because, unlike sudden injuries in younger people, these tears usually happen as part of the normal ageing process. Many people find that with simple treatments like exercise therapy, activity modification, and pain relief, their symptoms improve just as much as they would with an operation. In fact, research has shown that physiotherapy can be just as effective as surgery for many patients, without the risks or recovery time that come with an operation. That’s why surgeons often recommend trying non-surgical options first.

Exercises:

Further Resources:

• Nuffield Joint Pain Programme - A six month programme which is designed to help you self-manage your joint pain, with access to Nuffield Facilities and lifestyle advice and exercise sessions. You can refer yourself. Please click the link here: https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme (https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme)

• Active North Yorkshire - Healthy You - 12 week free weight loss programme and gym access. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/healthy-living/healthy-you (https://www.northyorks.gov.uk/healthy-living/healthy-you)

• Active North Yorkshire - Exercise Classes. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes (https://www.northyorks.gov.uk/active-north-yorkshire/exercise-classes)
 • 
 • Active North Yorkshire - MSK Hub: The MSK Hub is a free 12 week programme to help support working people that have a reduced ability to work due to musculoskeletal joint pain. You can refer yourself. Please click the link here: https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions (https://www.northyorks.gov.uk/active-north-yorkshire/lifestyle-and-wellbeing-sessions/help-musculoskeletal-conditions)

Last Reviewed Jan 2026. To be reviewed Jan 2027.

Question 4

Anterior Cruciate Ligament (ACL) Tear

Accepted Answer

What is an Anterior Cruciate Ligament tear?

COMING SOON.

Causes:

COMING SOON.

Symptoms:

COMING SOON.

Treatment:

COMING SOON.

Exercises:

COMING SOON.

Further Resources:

For more information on this, click here (www.harrogatehealthhub.co.uk/acl)

Question 5

Medial Collateral Ligament (MCL) and Lateral Collateral Ligament Injuries

Accepted Answer

The knee ligaments give the bones of the knee stability by helping to keep them together.

There are two main sets of ligaments in your knee. The collaterals, which run down the sides of your knee and the cruciate ligaments, that are inside the knee.

Lateral Collateral Ligament (LCL):
The lateral collateral ligament  is located on the outside of the knee . 
What causes a LCL Injury?
The LCL can be damaged if your knee is forced inwards too much.

Medial Collateral Ligament (MCL): 
The medial collateral ligament is on the inside of your knee.

Causes:

What causes a MCL Injury ? 
A MCL Injury of the knee is usually a result of a jumping or twisting injury or falling on a bent knee e.g a fall in skiing  when been tackled . 
Although a number of these injuries are not related to sport and can be from a sudden twisting of the knee or repeated trauma to the knee  putting stress on the ligament which can change the elasticity of the ligament.

Symptoms:

• Swelling around the knee
 • A Pop sound at time of injury 
 • Pain
 • Instability (feeling of knee giving way)
 • Locking and catching of the knee

Treatment:

•  Protection:  During the first few days after an injury, you should rest the injured joint.  After 72 hours, gentle movement can be started.  If walking is difficult or painful, a stick or crutch may help.
 • Although it might be painful, it is important to maintain movement in your knee to avoid stiffness. Complete non-weightbearing rest is rarely useful.
 • Ice: Applying ice with gentle compression using a bandage may help with pain relief and reducing swelling around your knee. Click here (undefined)to download an information sheet
 • Elevation:  Placing the knee higher than your hip whilst lying or sitting will help the swelling reduce.
 •  Use of over the counter pain relief if necessary to enable to keep mobile. (Speak to your local Pharmacist if you are unsure about what you can take)
 •  Exercise can help. Click here to download an exercise sheet.

If your knee does not start to improve within 2-3 weeks or you are concerned then seek further advice from a health professional. In some cases, following an in-depth examination, further investigation maybe necessary to decide on the best treatment plan.

Exercises:

Click below to download MCL exercise sheet 
Level 1 - Early stage exercises for a MCL injury

Level 2 - Mid / Late stage exercises for a MCL injury

Further Resources:

Question 6

Patella Instability/Dislocation

Accepted Answer

What is Patella/quadriceps Tendinopathy?

Patella (Kneecap) dislocations are a common injury.

The Patella usually moves within a grove (Trochlea) and sometimes it comes out of that grove causing the kneecap to dislocate this can also cause damage to the muscles and ligaments around the knee.

Most commonly, the patella relocate its self but in some cases may need a health care professional to help.

Causes:

·         Direct blow to the knee
·         Sports injury
·         Hypermobility

Symptoms:

·         Swelling
·         Pain
·         Stiffness when moving the knee

Treatment:

Firstly, the kneecap must be relocated; in some cases you might be given a brace to wear, this will only be for a short period.

If symptoms do not improve and the kneecap continues to dislocate you may need to see an Orthopaedic specialist.

Physiotherapy exercises are the best form of rehabilitation for kneecap dislocation and you should expect symptoms to improve in 6-12 weeks.

Exercises:

Click below for exercises 
Level 1 - Early stages

Level 2 - Mid-Late stages

Further resources:

Question 7

Patellofemoral Pain Syndrome

Accepted Answer

The Patellofemoral joint (PFJ) is the joint between the knee cap and the thigh bone. Problems with the PFJ can lead to pain anywhere around the knee.

Causes:

1. Too much loading too quickly eg. Hill walking on holidays, or taking up new sports. Repetitive bending and kneeling can make it worse.
2. Anything that can affect the knee cap sliding correctly e.g flat feet, knocked knees etc
3. Injury e.g falls

Symptoms:

• Does not usually come on with trauma. More common after activity you have not done much of before....e.g walking, stairs or cycling.
 • Pain is usually to the front of the knee.
 • The pain may get worse the more you walk or go up or down stairs
 • It is more common in people over the age of 30
 • More common in overweight people.
 • A diagnosis is made by your clinical history. A scan would not normally show very much

Treatment:

1. Exercise helps to keep the muscles strong so they will support the joint  and help improve your symptoms. 
2. Stretching the muscles will also help. Keep thigh, calf and hamstrings muscles as flexible as possible (see below).
3. Avoid sustained activity/positions e.g sitting for long periods/ doing repetitive exercises as these can provoke the pain.

Exercises:

Stretching the Hamstrings.
https://static.wixstatic.com/media/undefined
https://static.wixstatic.com/media/undefined
 Hold the stretch for 10-12 seconds and then release. You should feel a pull to the back of your leg when you stretch. Stop if the stretch is painful. 
Stretching the Quadriceps.
https://static.wixstatic.com/media/undefined
Hold the stretch for 10-12 seconds and then release. You should feel a pull to the front of your leg when you stretch. Stop if the stretch is painful. 
Stretching the calf muscles.
https://static.wixstatic.com/media/undefined
https://static.wixstatic.com/media/undefined

Hold the stretch for 10-12 seconds and then release. You should feel a pull to the  of your lower leg when you stretch. Stop if the stretch is painful.

Further Resources:

Question 8

Patella/Quadriceps Tendinopathy

Accepted Answer

What is Patella/quadriceps Tendinopathy?

Causes:

Symptoms:

Treatment:

Exercises:

Further Resources:

Knee Pain

Please see the information below regarding different types of knee surgery:

Considering a knee replacment?

Considering ACL Reconstruction Surgery?

Medical Disclaimer