02/06/2026
Knee arthritis management
One of the most common joints I see with issues is the knee joint, and it’s common to see osteoarthritis in that joint, not just in the population you expect (older people) but sometimes in younger populations too.
Once you have it, you have to manage it, not only to manage your pain but also to manage the degeneration that joint suffers so it doesn’t degenerate too quickly.
I have knee osteoarthritis and I’m bone-on-bone in my left knee. I don’t want an op and there’s no cartilage left to be repaired.
I was a runner when my knee first flared up. No trauma, just 41 and overnight, it all changed. I felt too young, but I know of people younger being diagnosed with knee osteoarthritis.
I don’t even want a cortisone injection, why? I did my research and I suggest you do too if you’re offered one. There are pros and cons to them, and I decided it wasn’t for me at that stage.
How do I manage my knee? Being a sports therapist, I know the impact that weak hip muscles can have on my knee, but also how my foot and ankle mechanics equally affect it. Am I a good girl and do my rehab at home? Nope, I have ADHD and get VERY distracted so honestly it doesn’t happen but I do go to Pilates regularly!
I’ve been doing Pilates now for 21 months, and I aim for 3-times a week and it’s made a monumental difference to my knee pain, hip pain, range of movement and overall quality of life. Did it happen overnight? No. Do I still get the occasional flare up? Yes, but only very occasionally. Winter 2024 a few months after I started Pilates compared to winter 2025 was vastly different because of it.
Why do hip muscles matter?
Hip muscles, Glute Max and Glute Med control rotation of the femur (thigh bone).
If they aren’t strong enough that bone rotates and the knee cannot lock out properly (there’s this whole mechanism called the screw-home mechanism). The tibia (shin bone) therefore rotates in response to allow this mechanism to still work and suddenly the forces going through the knee are utterly changed, they’re not going through the centre of the knee now, it’s the inside and this causes degeneration if certain circumstances are at play; Joint hypermobility syndrome, thyroid issues, peri menopause and menopause to name but a few can all increase the degenerative effect.
What do I do when I get a flare up?
My hamstrings guard when my knee flares so stretching them off is important, and a soak in an Epsom salts bath relaxes the muscles around the knee and decreases pain.
Infrared lamp; this light is on the infra-red spectrum and penetrates deep in the joint without burning the skin. It up-regulates cellular activity and repair, increases blood flow and decreases pain by relaxing the muscles guarding the knee.
If my knee is too flared up, I don’t ‘add heat to the flames’. It’s also not ideal if you have metal implants or have nerve damage and cannot sense the temperature in that area.
You can buy a decent one online and I’m happy to recommend the one I use at home.
Ice; If there is a lot of heat from swelling in my knee joint, then ice is a good go-to to reduce pain and swelling. Heat and ice together can help aid the removal of swelling. We call this contrast therapy.
Castor oil packs; Castor oil contains 90% ricinoleic acid (a fatty acid) which is anti-inflammatory and analgesic. I soak a pack in castor oil, wrap it around my knee, and place a hot water bottle over the area to help it soak in. This has been used for thousands of years, its not new, but I like it as opposed to pain killers. Its very beneficial. It can also aid lymphatic drainage which opens the pathway for swelling and oedema to go where it should instead of hanging around in your knee joint.
What sort of things flare my knee up?
Sitting for long periods and driving long distances. The noises my knees make after sitting for long periods are interesting to say the least. Keeping moving is good. Movement is medicine, motion is lotion as they say.
High impact activities are not helpful to my knee. I made the decision to stop running and I still miss it every day, it really helped my mental health and I struggled to find something after that that made me feel the same way. Pilates gave me the mental health benefits, hip stability and a lovely community to be part of so I feel like I won the lottery.
Poor sleep can increase my chances of a flare up, so can stress in my day-to-day life. This causes systemic inflammation which affects my nervous system and increases my pain.
Changes in weather; If the weather is cold and wet and we have a low-pressure weather system then the joint expands causing discomfort. During the summer we mostly have high-pressure systems so the joint has low pressure which feels more comfortable.
I’ve spent years in pain and the number one tip I will give to anyone is to work on your hip strength. It makes ALL the difference, but I learnt that the hard way so you don’t have to.
