Month: November 2025

Understanding, Managing, and Moving Forward

Knee osteoarthritis (OA) is a common condition that can cause ongoing pain, stiffness, and difficulty with everyday activities. It affects the whole joint — including cartilage, bone, ligaments, and muscles — and is part of your body’s active response to small joint injuries over time. While it can be uncomfortable, OA is manageable and doesn’t always get worse. With the right approach, most people continue to live active, fulfilling lives.

Diagnosis and Outlook

Doctors often diagnose knee OA based on symptoms such as pain lasting more than three months, morning stiffness under 30 minutes, and difficulty with movement. X-rays are usually unnecessary because they don’t reliably reflect pain levels or guide treatment. For most people, OA remains stable, with occasional flare-ups that settle with time. Only a small number of people will ever need a knee replacement.

The Importance of Physical Activity

Many people with knee OA reduce their activity levels out of fear of making the pain worse. In fact, avoiding movement often increases stiffness, weakness, and discomfort over time. Staying active is one of the best things you can do for your joints, muscles, and overall health.

You don’t need intense workouts — small, regular movements make a big difference. Moderate-intensity activity means you’re breathing a little harder but can still speak in sentences. Examples include brisk walking, swimming, cycling, water aerobics, yoga, or doing household tasks more energetically.

Tips for increasing your daily activity:

• Take small steps — stairs instead of elevators, park further away, walk while talking on the phone.

• Avoid long periods of sitting; move every 30–60 minutes.

• Break activity into short bouts of 10 minutes or more.

• Gradually increase duration or intensity.

• Mix activities — walking, gardening, dancing, playing with grandchildren.

• Track steps or activity using a phone or monitor.

• Pace yourself and be kind to your body, even on “bad” days.

Managing Your Weight

Being overweight places extra stress on your knees — each kilogram of body weight can add about four kilograms of load on your knees during daily activities. Extra weight can also increase inflammation in the body, making pain and stiffness worse. Losing even a small amount of weight — 5–10% of your body weight — can reduce joint load, improve pain, increase function, and may delay or reduce the need for medications or surgery.

Tips for weight management:

• Combine regular physical activity with healthy eating habits.

• Set realistic goals and be patient; don’t give up if progress is slow.

• Eat mindfully: slow down, savour meals, and avoid eating when bored or stressed.

• Plan meals and snacks ahead, and keep a food diary.

• Drink water regularly and aim for sufficient sleep.

• Learn about healthy food choices and portion sizes.

• Engage friends, family, or a buddy for support and accountability.

• Handle holidays or special events by planning ahead — enjoy the event but make mindful choices.

Key points:

• Weight loss can noticeably reduce knee pain and improve function.

• Aim for 5–10% of your body weight to see meaningful benefits.

• Combining diet and exercise gives the best results.

Overcoming Common Barriers

Everyone faces challenges staying active or managing weight. Creative solutions can help:

• Time: Schedule activity like an appointment; short bursts count.

• Pain: Mild discomfort is normal; severe or prolonged pain requires adjustment.

• Fatigue: Exercise often increases energy and improves sleep.

• Motivation: Track progress, reward yourself, exercise with friends.

• Stress or emotional eating: Try music, social support, mindfulness, or walking instead of using food as a coping strategy.

The Bottom Line

Knee osteoarthritis does not mean you have to stop doing the things you love. Staying active, managing your weight, learning to manage pain, and seeking support from health professionals can help you live well with OA. Every small step counts toward stronger knees, reduced pain, and better overall health.

For additional information:

https://www.myjointpain.org.au

https://arthritisaustralia.com.au

https://www.msk.org.au/diet/

https://www.healthdirect.gov.au/sleep

The tibialis posterior (TibP) muscle runs along the inside of your shin and down to your mid foot. It functions to invert and plantarflex the foot and control your arch. This means it plays a big role with walking, running and balancing.

TibP tendinopathy will present with pain and stiffness on the inside of your ankle and/or foot. There may also be swelling present. TibP tendinopathy pain will warm up with activity but often feels worse after a period of resting. It is typically associated with an increase of activity or a recent change in activity.

Examples might include:
– Someone who just took up running or increased their km per week
– An athlete bought a new pair of shoes for their sport
– A switch to synthetic turf when historically playing on grass

Tendons stem from our muscles which attach them to bone. Tendinopathy is considered an overuse injury of tendons. This means that the tendon is not coping with the demands that is being placed on it. This leads to pain and dysfunction of that tendon.

Assessment
Physiotherapists will ask about the history of the pain which will provide clues into whether it is or isn’t TibP tendinopathy.

A physical exam will also be performed which may include:
– Double or single leg calf raise
– Jumping or hopping
– Muscle strength testing
– Palpation of the lower leg

Imaging?

Imaging (ultrasound or MRI) is not typically required for accurate diagnosis of this injury. This is because imaging is poorly correlated with symptoms; a study found that under ultrasound imaging, 48% of people showed TibP tendinopathy despite have no medial foot or ankle pain (Mills et al., 2020).

Some people also present with normal imaging despite having clinical
features of TibP tendinopathy. Imaging is likely only required if your physiotherapist suspects a bony injury.

Treatment and Management
TibP tendinopathy can be successfully managed with physiotherapy. It may involve a period of relative rest and concurrent strengthening exercises of the TibP and other muscles in the body.

– Isometric ankle inversion
– Single leg calf raises
– Eversion
– Toe raises
– Energy storage and release exercises (hopping, depth jumps, lateral bounds etc)
– Strengthening of proximal muscles (hip and knee strength)

Other management strategies involve:
– Topical or oral NSAIDs (anti-inflammatory medication)
– Soft tissue release of TibP and other muscles in the lower leg
– Joint mobilisations

Differential Diagnoses – If it isn’t TibP tendinopathy, what else could it be?
– Deltoid ligament injury
– Navicular bone injury
– Flexor hallucis longus tendinopathy
– Tarsal tunnel syndrome

The apophysis is a normal outgrowth on long bones where tendons or ligaments attach. These areas will continue to fuse and harden as children get older and their growth plates fuse.

Apophysitis is a condition of overuse and inflammation at these apophysis sites. It is the result of repetitive stress from activities/sport. These injuries will worsen with activity and improve with rest. Since the apophysis growth plate is still open, combined with the repetitive action of muscles, this makes these areas especially vulnerable to injury.

Some common overuse apophysis injuries include:
1. Osgood-Schlatter’s Syndrome (knee)
2. Sever’s Syndrome (heel)
3. Little League Elbow (elbow)
4. Iselin’s Syndrome (outside of the midfoot)

Osgood-Schlatter’s
This is apophysitis at the tibial tuberosity, or the bony bump at the top of your shin. This is where the quadriceps muscle attaches onto the shin via the patella tendon.

Signs and Symptoms
– Pain and/or swelling at the tibial tuberosity
– Pain at the knee when participating in sport/activity, especially running and jumping
– A recent growth spurt
– Symptoms resolve with rest

Sever’s
This is apophysitis of the calcaneus (heel bone). This is where the gastrocnemius and soleus muscles attach onto the foot via the Achilles tendon.

Signs and Symptoms

– Pain at the heel when participating in sport/activity, especially with running and jumping

– Pain and/or swelling at the heel

– A recent growth spurt

– Symptoms resolve with rest

Assessment
Physiotherapy assessment will begin with a subjective interview to gain insight into the history of the pain to determine if it is or isn’t apophysitis. Your GP may have requested an X-ray of the area which can help determine diagnosis, but it will sometimes come back normal.

The physiotherapist will look at:
– Squats
– Jumps and hops
– Calf raises
– Palpation of the painful area
– Muscle strength and length testing

Management
Apophysitis generally starts with a period of relative rest. Depending on the aggravating activities, other sports may be tolerated better in the meantime. For example, instead of going to soccer, riding a bike or swimming may be less painful.

Strengthening and stretching exercises are also essential to managing apophysitis. This might include stretching the quadriceps, hamstrings, calves and glutes. Strengthening of the affected muscles will also be key.

– Double leg glute bridges
– Theraband quad extensions
– Hip abduction exercises
– Squats or lunges
– Double or single leg calf raises

Other management strategies may include:
– Soft tissue mobilisation of the affected muscles

– Foam rolling or spikey ball at home

– Movement retraining

– Rigid taping or KT taping of the affected area for symptomatic relief