Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 30 October 2026.
The knee catches on the MRT stairs, again when you stand up from the office chair, and you have been stretching it for weeks. Stretching is not wrong. On its own it is usually not enough, and which exercise helps depends on where the knee hurts.
Does physiotherapy help knee pain?
For most knee pain without a fracture, a locked joint or an infection, yes. Exercise is the first treatment clinical guidelines recommend for knee osteoarthritis and for pain around the kneecap.1,2 The exercises that do most of the work strengthen the thigh and hip muscles. Stretching adds comfort and range. Which exercises suit you depends on where it hurts and what set it off.
Key takeaways
- Exercise is the first treatment guidelines recommend for knee osteoarthritis and pain around the kneecap.
- Strengthening the thigh and hip does most of the work; stretching adds comfort and range.
- Where the knee hurts decides which exercises fit: front, inside, outer side or back.
- A knee that locks, gives way repeatedly, or swells fast after a twist needs a doctor before exercise.
- Strength is measured against your other leg, because pain settling does not mean strength has returned.
Why stretching alone often stalls
The usual thinking goes like this: the knee feels tight, so stretch the tight part and it will loosen. For a few days it does. Then the stairs hurt again.
Most knee pain is a load problem. The knee is taking more than the muscles around it can absorb, so the joint and the tendons take the rest. A stretch changes how the knee feels for an hour. It does not change how much load the thigh and hip can take. When we measure, the painful side is usually the weaker side, often by a margin you cannot feel in daily life.
So the pattern repeats. You start taking the stairs one leg at a time. You stop squatting to pick things up and bend from the back instead. The badminton racquet stays in the cupboard. None of it hurts enough to stop you, and all of it is the knee asking for strength rather than another stretch.
Knee exercises by where it hurts
| Where it hurts | Usually | Start with | Add as it settles |
|---|---|---|---|
| Front of the knee, around or behind the kneecap. Worse on stairs, squats and after sitting | Patellofemoral pain (knee cap pain) | Straight leg raise, side leg raise, quadriceps stretch | Half squat to a comfortable depth, step-ups |
| Just below the kneecap, worse jumping and landing | Patellar tendinitis | Holds against a wall at a depth that is comfortable | Half squat, then slower and deeper squats |
| Whole knee, stiff in the morning, aches after walking, often over 50 | Knee osteoarthritis | Straight leg raise, sit to stand from a chair, calf raise | Half squat, step-ups, walking or cycling a little further each week |
| Inside or along the joint line after a twist | Meniscus injury | Straight leg raise, gentle bending within comfort | Half squat, then step-ups and single-leg work |
| Outer side of the knee, comes on at the same point in a run | IT band irritation | IT band and hip stretch, side leg raise | Single-leg balance, step-downs |
| Behind the knee | Back of knee pain | Hamstring and calf stretches | Calf raise, bridges |
After an ACL or meniscus operation, or a knee replacement, your surgeon’s protocol decides what you do and when. The ACL page sets out the stages.
How to do them
- Straight leg raise. Lie on your back, other knee bent. Tighten the front of the thigh, keep the knee straight, and lift the leg to the height of the other knee. Lower slowly.
- Side leg raise. Lie on your side, bottom knee bent. Lift the top leg with the toes pointing forward, not up. You should feel it at the side of the hip.
- Half squat. Feet hip width apart, hold a counter if needed. Sit back as if onto a high chair, only as deep as is comfortable, and stand up. Knees stay in line with the second toe.
- Sit to stand. From a firm chair, arms crossed, stand up and sit down slowly. Use a higher seat to begin with.
- Calf raise. Hold a counter, rise onto the balls of both feet, lower slowly. Progress to one leg.
- Quadriceps stretch. Standing, holding a wall, bend the knee and bring the heel toward the buttock until the front of the thigh stretches. Keep the knees together.
- Hamstring stretch. Heel on a low step, knee straight, lean forward from the hips with a straight back until the back of the thigh stretches.
- IT band and hip stretch. Standing, cross the sore leg behind the other and lean your hips toward the sore side until the outer hip stretches.
How much, and how often
| Type | Typical starting dose |
|---|---|
| Stretches | Hold 30 seconds, 3 times each side, once or twice a day |
| Strengthening | 3 sets of 10 to 15, every other day |
| Pain during exercise | Mild discomfort, up to about 3 out of 10, that settles by the next morning is generally acceptable. Pain that is worse the next day means the load was too much: drop back a step |
| When to progress | When the current level feels easy for a week: add depth, slow it down, or move to one leg |
| How long before it helps | Most people notice a change after 6 to 8 weeks of consistent strengthening |
When to see a doctor before exercising
- Call 995 for a swollen, painful calf with chest pain or breathlessness.
- Go to the emergency department now if you cannot take any weight on the leg after an injury, or the knee is hot, red and swollen with a fever.
- See a doctor the same day if the knee swelled up within a few hours of a twist, it is locked and will not straighten, or the calf is swollen and painful.
- See a doctor soon if the knee keeps giving way, the pain wakes you at night, or it has not improved after six weeks of exercise.
What a knee physiotherapy appointment adds
Finding the real problem is half the battle. Treating it is the other half. A physiotherapist measures what you cannot measure at home: thigh and hip strength against your other leg, how the knee tracks on a step, how the foot and hip load it. Then most of the appointment is treatment, with hands-on work and exercise at a load the knee can take. You leave knowing which stage you are in, what is limiting the knee, and a written plan.
Knees at Phoenix Rehab are seen by Fairuuz Saleh (ACL reconstruction and return to sport, over 1,000 cases since 1997), Ching Yee (around 200 total knee replacements since 2016), Shiv Mohan Banka and Zita Sham. Every appointment is one to one with the physiotherapist for the full 45 minutes, no therapy assistants. More on knee physiotherapy at Phoenix.
Questions about knee exercises
Should I stretch or strengthen for knee pain?
Both, but strengthening matters more. Stretches ease tightness and help range. Strengthening the thigh and hip muscles is what guidelines recommend for knee osteoarthritis and pain around the kneecap, because it lets the muscles take more of the load off the joint.
Is it okay to exercise with knee pain?
Usually, yes. Mild discomfort during exercise that settles by the next morning is generally acceptable. If pain is worse the next day, reduce the load. If the knee locks, gives way, or swelled quickly after an injury, see a doctor before exercising.
How long do knee exercises take to work?
Most people notice a change after six to eight weeks of consistent strengthening, done every other day. Stretching can make the knee feel easier sooner, but strength takes weeks to build.
Sources: 1. National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226), 2022. 2. Crossley KM et al. 2016 Patellofemoral pain consensus statement. Br J Sports Med 2016;50:839-843.
Where are you with this right now?
1. It is settling on its own
Most knee pain that started with a specific moment settles over six to twelve weeks. Swelling that comes and goes with activity, and an ache after a long day, are usual in that window. If it is improving month on month and you can walk, take stairs and sleep, it is behaving normally. You do not need us for this, and we would rather say so.
2. It has stopped improving
You go down stairs one leg at a time. You have stopped squatting to pick things up. You test it before you trust it.
Pain settling is the first thing that happens, not the last. Quadriceps strength is the last thing to come back, and it does not come back on its own. That is the gap worth measuring, and it is not measured by how you feel on the day.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the ACL Reconstruction Recovery Program, or knee physiotherapy if you are not sure which applies to you.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
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