Relieve Knee Arthritis Pain At Home With These Easy Self-Treatments

Can Physical Therapy REALLY Help Knee Arthritis Pain?

That's one of the most common questions that I get from new patients.

The short answer is that physical therapy CAN help knee arthritis pain if you're doing the RIGHT kind of physical therapy.

Watch video below to learn how you can do your own manual physical therapy at home and make a big difference rather quickly in your knee arthritis pain.

Knee Arthritis Guide Prevent or Delay Knee Replacement More 4 Life Physical Therapy St. Louis MO 63011 Gladly Serving Ballwin, Manchester, Chesterfield, Des Peres, Ellisville, and St. Louis County

Can Physical Therapy Help Knee Arthritis Pain?

Many people have trouble wrapping their head around how doing exercises can help their knee arthritis because arthritis is inside your joints, it's not in your muscles.

But keep in mind, there's a difference between radiological knee arthritis and clinical knee arthritis pain.

There have been numerous studies with widely varying results comparing people who have knee pain and people who have knee arthritis.

The ranges of overlap range anywhere from as low as 15 to as high as 81 percent.

But what it does go to show is they don't necessarily match up.

Just because you have knee pain doesn't necessarily mean that you have knee arthritis, and just because you have knee arthritis doesn't  mean that you're going to have knee pain.

Furthermore, if you do have knee arthritis and you happen to have knee pain, it doesn't necessarily mean that the arthritis is the cause of the knee pain.

Now knee arthritis itself doesn't have to be painful.

It's often abnormalities of movement that cause that arthritis to create inflammation inside your joints. And that inflammation can cause knee pain.

So if you can keep your knee joints moving properly, you can prevent inflammation and thus knee pain.

How To Stop Knee Arthritis Pain

So how do you get your knee joints moving properly in order to stop knee arthritis pain?

Well, you first have to understand the biomechanics of your knee joints.

Biomechanics Of Your Knee Joints

Now many people think of the knee like a hinge joint that just moves back and forth along a single axis of rotation.

But your knee joint actually has 6 degrees of freedom.

What that means is that it can rotate around 3 axes and also translate around 3 axes.

So while your knee joint is mostly a hinge joint, it's a really complex hinge joint.

3 Compartment Of The Knee Joint

There are three different compartments in your knee, and you can have arthritis in any and/or all of those.

The 3 compartments of the knee joint are:

  • Inner (medial) compartment
  • Outer (lateral) compartment
  • Kneecap (patellofemoral) compartment

Usually it's either the patellofemoral compartment and/or the medial compartment that are the most common sources of knee arthritis pain.

Manual Physical Therapy For Knee Arthritis Pain

So here are some ways that you can use manual physical therapy to improve the tiny accessory motions of your knee joints.

Manual physical therapy means using your hands, or a therapist using their hands.

Accessory motons are  the small rotations around the axis and the small side-to-side movements besides just bending and straightening your knee.

Believe it or not, by improving these accessory motions of your knee, sometimes you can make big differences in your knee arthritis pain rather quickly.

Manual Physical Therapy To Improve Knee Arthritis Pain When Straightening The Knee

So let's first talk about the just very basic accessory movements that happen in your knee.

When you straighten your knee, your tibia (lower leg bone) rolls forward like this but it also kind of glides forwards.

If you're having difficulty or pain straightening your knee because of knee arthritis, it's not usually a hamstring problem.

That's particularly true if you can't straighten your knee when you're  walking  or when you're laying down.

If you can't get your knee to lay all the way flat, that's not a hamstring problem.

That's because your hamstring is not all the way stretched unless your hip is close to 90 degrees with your knee straight.

hamstring flexibility test

So if you have a true joint problem that's keeping you from straightening your knee, here's something simple you can do to help.

Manual Physical Therapy For Knee Arthritis Pain When Straightening Knee

Take a rolled up towel and put it underneath your knee.

You actually want to put it just below the knee, underneath the tibia (lower leg bone).

You want to have enough towel there that it kind of fills the gap between the table and your knee.

That way when you go to apply pressure, the towel is stabilizing the tibia just below the knee joint.

Now when you go into knee extension, your tibia is going to glide forwards, and your femur is going to glide backward.

Additionally, when you get into the last few degrees of knee extension or knee straightening, your tibia rotates outwards a little bit into external rotation.

To do the technique take one hand and put on your femur (thigh bone). Use that handd to press down toward the table while rotating your thigh inward.

Joint mobilization to improve knee extension

At the same time, your other hand should be on the towel stabilizing your tibia while twisting the tibia outward.

It's a very small motion... about an eighth of an inch.

Repeat tiny oscillations of this movement for about 30 seconds to a minute.  Then see if you can straighten your knee a little more by making the towel roll smaller.

Repeat as needed until you get no further progress in your knee straightening.

Manual Physical Therapy For Knee Arthritis Pain When Bending Knee

Now what about bending?

Bending the knee usually doesn't affect people with knee arthritis quite as much as you would think.

It's not that often when you get into positions of full knee bending, but occasionally you do have to get in positions where you're getting out of a car and you need to bend your knee a little bit more.

Or you're climbing stairs and you need to be able to bend your knee a little bit more.

Or you're squatting down and you need to get more bending out of your knees.

In those situations, there are times when you need a little bit more knee bending than the 90 degrees that you would need to sit.

A very common physical therapy exercise that people do to improve knee bending is doing just a heel slide where you pull your leg up with a towel.

Heel Slide For Knee Arthritis Pain

But that treats this like a simple hinge joint where it's just rotating like a hinge on your door.

But again, there's rolling and gliding that happen at the same time when bending your knee.

When you bend your knee, your tibia also glides backwards.   As you start getting into further degrees of bending, it starts to rotate inwards as well.

Joint mobilization to improve knee flexion in people with knee arthritis pain

To do the joint mobilization technique, bend your knee up to the point where you can comfortably.

Then take your opposite hand and place it on the front of the tibia. You're going to use this hand to rotate the tibia inward.

At the same time, you want to translate the tibia backward perpendicular to the long axis of the tibia using the other hand.

Do small oscillations for 30 seconds or a minute.

This should not hurt!

After you've done that, see if you can bend your knee just a little bit more.

Just take up the slack and go to a new end range.

Then repeat again for 30 seconds to a minute.

Just keep repeating that process, doing the little oscillations and then taking up the slack until you feel like you get to a point where you're no longer improving.

Side-To-Side Manual Physical Therapy Treatments For Knee Arthritis Pain

Now what about side-to-side motions of the knee?

If you twist your leg inwards or if you overpronate your foot when walking, that creates some twisting and shearing at the knee joint. Sometimes, that can cause your tibia to either shift inwards or shift outwards on your thigh.

To assess which direction the problem is, the easiest way is just to slide your hands along the inside and outside of the knee joint.

If you feel for an offset as you slide from the femur to the tibia, then the tibia has likely shifted.

To fix that, just sit with your leg bent and then just push on what sticks out.

Lateral Glide of Tibia (to improve medial tibial shift)

If your tibia (lower leg bone) has shifted inward then, place one hand on the inside fo the tibial and one hand on the outside of the femur (thigh bone).

Knee joint mobilization lateral glide of tibia

Push the tibia outward and the femur inward.

You can also do this sitting in a chair.

Lateral tibial glide

Medial Glide of Tibia (to improve lateral tibial shift)

If your tibia has shifted outward, the technique is just the opposite.

Place one hand on the outer side of the tibia and one hand on the inner side of the femur.

Knee mobilization medial glide of tibia

Then press your hands in opposite directions.

You can do this sitting as well.

Medial tibial glide

Manual Physical Therapy For Patellofemoral Knee Arthritis Pain

Now the final compartment that we haven't talked about yet is that patellofemoral compartment.

The patellofemoral joint is the joint between your kneecap and your thigh bone.

Normally, as you straighten your knee, the kneecap moves upward. Conversely, as you bend your knee, the kneecap moves downward.

Patellar Glide To Improve Knee Straightening

Therefore, if your knee won't straighten all the way, then put a towel roll behind the knee to fill the gap. Cup your fingers around the bottom part of your kneecap.

Patellar superior glide joint mobilization

Then pull our kneecap (patella) towards you.  Oscillate for 30 to 60 seconds.

This to helps to improve knee extension or straightening.

Patellar Glide To Improve Knee Bending

If your knee won't bend, then put your hands along the top of the kneecap and push it toward your foot.

Patellofemoral joint inferior glide

Patellar Tilt Mobilization

Another common problem you might see is that the kneecap might point outwards or squint outwards a little bit.

If your kneecap is tipped outward, then put a little bit of pressure with your palm on the inner side of the kneecap while lifting up on the outer side of the kneecap with the fingers of your other hand.

Medial patellar tilt mobilization for kneecap arthritis pain

And this is good for people who have patellofemoral pain or knee arthritis pain in the patellofemoral joint.

It is also good for people who have IT band syndrome, which is a common thing that can cause your kneecap to tilt outwards.


So those are some manual physical therapy treatments that you can use to help relieve knee arthritis pain.

Using these self-treatments is okay to manage minor knee arthritis pain.

However, if your knee arthritis pain is really bad, then it's a good ideas to see a manual physical therapist to get this done in person.

Need Help For Knee Arthritis Pain?

If you're in the St. Louis area and need help for knee arthritis pain, we'd be happy to help you here at More 4 Life.

Just tap the button below to request an appointment with one of our manual physical therapy specialists.

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