Knee Pain
Expert knee assessment, treatment and rehabilitation at Physio Tullamore, Co. Offaly
Book a Knee Pain Assessment in TullamoreExpert knee assessment, treatment and rehabilitation at Physio Tullamore, Co. Offaly
Book a Knee Pain Assessment in TullamoreAt Physio Tullamore, we provide comprehensive assessment, treatment and rehabilitation for all forms of knee pain. The knee is a complex joint, subject to both traumatic injury — such as meniscal and ligament tears sustained in sport — and gradual wear-and-tear, including osteoarthritis and tendinopathy. Because knee pain can arise from the joint itself, the tendons and ligaments around it, or from biomechanical issues at the hip and foot, accurate diagnosis is essential.
Our approach to knee pain combines hands-on treatment, exercise rehabilitation and, where appropriate, adjunct therapies such as shockwave therapy, injection therapy and clinical pilates. We do not simply treat the painful area — we aim to identify the factors contributing to your knee pain and develop a tailored plan to help you return to the activities that matter to you, whether that is walking, running, sport or work.
Knee osteoarthritis is a degenerative condition characterised by progressive wear of the articular cartilage that covers the ends of the bones within the knee joint. As the cartilage thins and the joint space narrows, patients typically experience pain, stiffness, swelling and a gradual reduction in function. Osteoarthritis is most common in older adults, but it can occur earlier in life following a previous knee injury such as a meniscus tear or ligament rupture. Symptoms often fluctuate, with periods of flare-up alternating with more settled phases.
Our treatment approach for knee osteoarthritis is designed to reduce pain, improve joint mobility and restore function. Hands-on
treatment includes joint mobilisations to improve range of movement and reduce stiffness. Exercise
therapy
is central to management, focusing on strengthening the muscles that support and offload the knee — particularly the quadriceps,
hamstrings and gluteals. Shockwave therapy may be used as an
adjunct for pain relief and to support tissue healing in selected cases. Where conservative management is insufficient, Injection
therapy
may be considered as part of a comprehensive plan.
The meniscus is a crescent-shaped cartilage that cushions and stabilises the knee joint. Meniscal injuries can be traumatic — often caused by a twisting force on a weight-bearing knee — or degenerative, developing gradually as the cartilage wears with age and repeated loading. A torn meniscus can cause pain, swelling, clicking or locking of the knee, and a sensation of giving way.
Ligament injuries involve damage to one of the four major ligaments of the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) or lateral collateral ligament (LCL). These injuries are common in sport, often resulting from sudden twisting, pivoting or direct contact mechanisms. ACL injuries in particular can have a significant impact on knee stability and may require a structured rehabilitation programme or, in some cases, surgical reconstruction.
Our treatment approach begins with a thorough assessment to determine the nature and severity of the injury. Hands-on treatment, exercise rehabilitation and a graded return-to-activity progression form the foundation of management. For athletes, we use performance testing to objectively assess readiness for return to sport. In some cases — particularly significant ligament injuries or complex meniscal tears — referral for a surgical opinion may be appropriate.
Patellofemoral pain, sometimes described as patella tracking dysfunction, refers to pain around or behind the kneecap. It is often related to how the patella tracks within the femoral groove as the knee bends and straightens. While it may feel as though the kneecap itself is the problem, the underlying cause frequently lies elsewhere in the lower limb.
The work of Powers and colleagues has significantly advanced our understanding of patellofemoral biomechanics. Powers demonstrated that patellofemoral joint kinematics are strongly influenced by femoral rotation and hip control, not simply by the patella itself. In essence, the patella is a passenger — its tracking is determined by the control of the femur beneath it. When the femur rotates inward or the knee collapses into valgus, the patella is pulled laterally within its groove, increasing contact stress and pain. This highlights the importance of addressing hip control, femoral rotation and overall lower-limb biomechanics rather than focusing exclusively on the knee.
Our treatment approach for patella tracking issues combines hands-on treatment, taping to support patellar alignment, and exercise therapy focused on hip and core control. Motor control retraining is a key component, helping patients learn to control femoral rotation and valgus during functional movements. Clinical Pilates forms part of this motor control approach, providing a structured environment for improving movement quality, core stability and lower-limb alignment.
Iliotibial band syndrome is a common cause of pain on the outside of the knee, particularly in runners and cyclists. The iliotibial band is a thick band of fascia that runs down the outside of the thigh and attaches just below the knee. As the knee bends and straightens, the ITB passes back and forth over the lateral femoral condyle — the bony prominence on the outer side of the knee. When compressive forces are excessive, irritation and pain develop at this point.
ITB syndrome is frequently related to training load errors — such as a rapid increase in running mileage or intensity — as well as biomechanical factors including hip control, foot posture and running technique. The condition shares important principles with compressive tendinopathy: the repeated compression of the ITB against the lateral femoral epicondyle is thought to be the primary mechanism of pain, rather than simple friction.
Treatment focuses on load modification to settle symptoms, hands-on treatment to address tightness and soft
tissue restrictions, biomechanical correction of contributing factors such as hip control and foot posture, and progressive strengthening to
improve the capacity of the tissues around the knee and hip.
Osgood Schlatter disease is a common cause of knee pain in young athletes during periods of rapid growth, typically between the ages of 9 and 16. It is most frequently seen in young people involved in running, jumping and change-of-direction sports such as football, basketball, athletics and gymnastics. The pain is felt at the tibial tuberosity — the bony bump just below the knee — and is often tender to touch, worsened by activity and relieved by rest.
The condition is essentially a tendon-related problem. The patella tendon attaches to the tibial tuberosity, and during a growth spurt the bone grows faster than the tendon can adapt. The repeated pull of the quadriceps through the patella tendon on the immature growth plate (apophysis) produces a traction injury — hence the term traction apophysitis. The resulting inflammation and microtrauma at the attachment point are the source of pain.
Treatment is centred on load modification and education. During flare-ups, relative rest from aggravating
activities allows symptoms to settle. Progressive loading of the quadriceps and patella tendon is then introduced to build tissue capacity
and reduce sensitivity. Importantly, Osgood Schlatter is a self-limiting condition — it resolves once the growth plate fuses — and our role
is to help young athletes manage symptoms while remaining as active as possible. Shockwave
therapy
may be considered as an adjunct treatment option in selected persistent cases.
Patella tendinopathy, often referred to as jumper's knee, is a tendinopathy of the patella tendon — the strong tendon that connects the kneecap to the tibia. It is common in sports involving repetitive jumping and loading, such as basketball, volleyball, athletics and dancing. Patients typically experience pain at the lower pole of the patella, which worsens with loading activities such as jumping, squatting and stairs.
Patella tendinopathy follows the tendinopathy continuum, progressing through reactive, dysrepair and degenerative stages depending on the duration and nature of the load applied to the tendon. Management requires a clear understanding of tendon mechanics: the patella tendon is subject to very high loads during jumping and change of direction, and capacity must be rebuilt progressively.
Treatment centres on progressive tendon loading, careful load management and addressing biomechanical
factors that may be contributing to excessive tendon stress — including quadriceps flexibility, hip control and jumping/landing
technique. Shockwave therapy may be used as an adjunct to
support pain relief and tissue healing alongside a structured rehabilitation programme.
We take an integrated approach to knee pain, matching each presentation with the most appropriate combination
of treatments. Below is a summary of how we link common knee conditions with their treatment pathways.
Joint mobilisations to improve range and reduce stiffness, exercise therapy to strengthen supporting muscles, Shockwave therapy as an adjunct, and Injection therapy where appropriate.
Hands-on treatment, exercise rehabilitation, and a graded return-to-sport progression. Performance testing is used to assess readiness for return to sport. Surgical referral may be arranged where appropriate.
Taping to support patellar alignment, exercise therapy focusing on hip and core control, motor control retraining, and Clinical Pilates as part of the motor control approach.
Load modification to settle symptoms, biomechanical correction of contributing factors such as hip control and foot posture, and progressive strengthening to improve tissue capacity.
Load modification and relative rest during flare-ups, progressive loading to build tendon capacity, and education on the self-limiting nature of the condition. Shockwave therapy may be considered as an adjunct.
Progressive tendon loading, load management, biomechanical correction, and Shockwave therapy as an adjunct to support healing and pain relief.
If you are experiencing knee pain — whether from osteoarthritis, a meniscus or ligament injury, patella tracking issues, ITB syndrome, Osgood Schlatter disease or patella tendinopathy — our experienced physiotherapists can help. We provide comprehensive knee assessment, treatment and rehabilitation from our clinic in Tullamore, Co. Offaly, serving patients and athletes from Tullamore, Offaly and across the Midlands.
Book an Appointment Online