Massage therapy · Kitchener–WaterlooKnee Osteoarthritis

Osteoarthritis (OA) is commonly referred to as wear and tear arthritis. It is a condition where the cartilage that cushions the ends of the bones in the knee gradually wears away. When this happens, the protective space between the bones gets smaller and the bones can end up rubbing on each other, without the shock-absorbing benefits of the cartilage. This causes pain, swelling, stiffness and a decreased ability to move, as well as the formation of bone spurs (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2023).

Even though age is a major risk factor for osteoarthritis of the knee, younger people can get it as well (American Academy of Orthopaedic Surgeons, n.d.). For some people, osteoarthritis may run in families. For others, it can follow an injury to the knee or develop in a joint damaged by another condition such as rheumatoid arthritis or gout, and being overweight also increases the risk (NHS, 2023).

Osteoarthritis is the most common form of arthritis in the UK, and the knees are one of the areas most often affected. Even though it can occur in younger people, a family doctor or nurse practitioner may suspect osteoarthritis if you are aged 45 or older and have joint pain that gets worse the more you use the joint. Women tend to be more prone to the condition than men (NHS, 2023).

But What Exactly Happens During Knee OA in Simple Terms?

Usually due to wear and tear, or an injury to the joint, the protective cartilage in the knee gets worn or damaged. When this cartilage wears out, the bones can rub on each other without any cartilage to protect them. The joint can become swollen and painful. The body tries to protect the area by laying down bone, and the joint enlarges. Osteophytes (bony growths, also called bone spurs) form, and the capsule around the joint thickens. This causes stiffness, swelling and pain (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2023). As the condition worsens, people often look for medical help, which may include therapy, medicines or surgery.

Knee Osteoarthritis Anatomy

How to Treat Knee Osteoarthritis

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• As you grow older, the ability of your cartilage to heal tends to decrease.
• Keeping to a healthy weight is one of the best things you can do. In one study of overweight older adults with knee osteoarthritis, each pound of weight lost reduced the load on the knee by about four pounds with every step when walking (Messier et al., 2005).
• Jobs or exercise that put frequent strain on the knees and force them to bear an excessive load, such as a lot of squatting, kneeling or heavy lifting, can increase the risk of osteoarthritis (NHS, 2023).
• If you have knee osteoarthritis, switching from high-impact activities such as jogging or tennis to lower-impact ones such as swimming or cycling lets you stay active while putting less stress on your knee (American Academy of Orthopaedic Surgeons, n.d.).
• Osteoarthritis can develop in joints that have been damaged by another condition, such as rheumatoid arthritis or gout (NHS, 2023).

Knee osteoarthritis is a long-term condition, so I treat it as steady, ongoing care rather than a quick fix. My aim is to ease pain and stiffness now, and build the strength around your knee so it supports you better for the long haul. A flared, swollen knee is kept comfortable; a calmer, stiff knee is moved and loaded.

I start by assessing how your knee moves, the strength of your thigh, hip and calf, and how you walk, get up from a chair and manage stairs.

Hands-On Treatment

• Massage through the thigh, calf and hip, easing tension in the muscles that cross the knee and the ones compensating for it
• Gentle rocking for an irritable knee and, on calmer days, gentle joint and kneecap mobilisation within comfort
• Gentle stretching, including contract-relax stretches
• Warm applications for a stiff knee, or cool ones if it has flared, and I'll show you how to use heat or ice at home

Strength and Movement

• We start with simple muscle tightening, such as pressing the back of the knee down
• Then sit-to-stands, step-ups, wall slides and mini-squats, kept pain-free during and after, plus hip work and gym-based progressions if you lift
• Low-impact fitness such as swimming and cycling
• A home programme to keep the knee moving as much as you comfortably can

Day to Day

1. American Academy of Orthopaedic Surgeons (n.d.) Arthritis of the knee. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-knee/ (Accessed: 7 October 2026).
2. NHS (2023) Osteoarthritis. Available at: https://www.nhs.uk/conditions/osteoarthritis/ (Accessed: 7 October 2026).
3. National Institute for Health and Care Excellence (2022) Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226). Available at: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations (Accessed: 7 October 2026).
4. Messier, S.P., Gutekunst, D.J., Davis, C. and DeVita, P. (2005) 'Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis', Arthritis & Rheumatism, 52(7), pp. 2026–2032. doi: 10.1002/art.21139