Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave knowing what is wrong, why it happened, and exactly what we are going to do about it.
What We Treat
Knee Pain Treatment in London
Most knee pain is mechanical, and reaching for rest usually backfires. We find what is driving yours, then rebuild the strength that protects the joint so you get back to the stairs, the gym and running.
Overview
Understanding knee pain
What is knee pain?
Knee pain is pain in or around the knee joint, and in most cases it is mechanical: a problem of load and strength rather than lasting damage. It can sit at the front around the kneecap (patellofemoral pain), in the patellar tendon just below it, down the outer knee along the iliotibial band, or in a joint with early osteoarthritis. Most of it settles with the right loading, not with rest, a scan or surgery.
Knee pain that flares on the stairs or after a run feels alarming, but it is rarely the start of an inevitable decline, and the instinct to stop and rest usually backfires: the joint loses the strength that protected it, and the pain returns the moment you load it again. We see this constantly in runners training in the Royal Parks and Regent's Park near our Marylebone clinic, and in gym-goers pushing their squats and mileage: the answer is usually smarter loading, not a month on the sofa.
Knee pain rarely has one universal cause. At assessment we work out which structure and which load are driving yours, because the plan is different for each:
- Patellofemoral (kneecap) pain: often a spike in running, jumping or gym load meeting strength and control deficits in the quadriceps, gluteal and hip muscles.
- Patellar tendinopathy: repetitive jumping, hopping or rapid changes of direction without adequate recovery.
- Iliotibial band irritation: pain down the outer knee, often linked to a sudden increase in running mileage or a change of surface or footwear.
- Early osteoarthritis: age-related joint changes that respond well to exercise rather than rest.
- After injury or surgery: a knee sprain, ligament or meniscal problem, or an operation, where strength and load tolerance still need rebuilding.
Do I need a scan or surgery?
Usually neither, at least not first. NICE recommends therapeutic exercise for osteoarthritis ahead of imaging or surgery, and the BJSM supports progressive loading for tendinopathy. We rule out the rare red flags, find the structure and the load behind your pain, then build a strength plan around how you train, work and move.
We treat professionals, athletes and active people through physiotherapy and sports rehab across our Soho, Liverpool Street and Marylebone clinics, rebuilding the joint with strength training and, for a stubborn patellar tendinopathy that has not settled with loading, considering shockwave therapy as an adjunct. Self-referral; no GP letter needed.
Physiotherapy for knee pain can help to:
Pinpoint the structure behind the pain
Kneecap, tendon, outer thigh or an early-arthritic joint: they present differently and they load differently. The assessment identifies which one is driving your pain, because a plan built for the wrong structure wastes weeks. You leave with a working diagnosis you understand.
Get you back on the stairs comfortably
Pain behind the kneecap on stairs, squatting or after long sitting responds to graded loading of the quadriceps, gluteal and hip muscles. We rebuild the strength those structures lost, so the kneecap stops absorbing load it was never prepared for.
Settle a grumbling tendon
A patellar tendon that warms up during sport then punishes you the next morning is asking for progressive load. We build it back with a structured programme, and reserve shockwave for the stubborn cases that have not settled with first-line loading.
Keep an arthritic knee moving
Early osteoarthritis responds to exercise rather than rest: NICE recommends therapeutic strengthening ahead of imaging or surgery. Strong muscles protect and offload the joint. We pace the programme to your starting point, so you build capacity without flaring the knee.
Return you to running on evidence
Rest alone leaves the knee weaker, and the pain returns the week you load it again. We rebuild strength and control step by step, then judge your return to running and sport on measured milestones rather than on how the knee feels one good morning.
Protect the knee after injury or surgery
After a sprain, a meniscal problem or an operation, load tolerance has to be rebuilt deliberately. We work with your history, restore strength and confidence in stages, and address the hip and gluteal deficits that let the knee become overloaded in the first place.
Why it happens
What causes knee pain?
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A rapid spike in running, jumping or gym load that outpaces what the knee can currently tolerate, the usual driver of patellofemoral and tendon-related pain
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Strength and control deficits in the quadriceps, gluteal and hip muscles, so the kneecap and tendons absorb load they are not prepared for
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Patellar tendinopathy from repetitive jumping, hopping or rapid changes of direction without adequate recovery
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Iliotibial band-related irritation, often linked to a sudden increase in running mileage or a change in surface or footwear
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Early osteoarthritis: age-related joint changes that respond well to exercise rather than rest
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Recovery after a knee sprain, ligament or meniscal injury, or knee surgery, where strength and load tolerance need rebuilding
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Deconditioning after time off, illness or surgery, leaving the joint and surrounding muscles under-prepared
What happens at your first physio appointment?
The assessment covers a detailed history and a thorough examination of movement, strength and the affected area. We explain what we find and agree a working diagnosis and plan you understand before you leave.
You go home with a written summary and a home-exercise programme built around your diagnosis and goals, so progress continues between visits.
Move better. Train stronger. Live fully. Pain relief that lasts is not enough on its own: we find the cause, then rebuild the strength behind the pain so it stays gone. No guesswork, no generic rehab.
- Three central London clinics: Soho, Liverpool Street and Marylebone, plus home visits across London and online sessions.
- Led by physiotherapist Sam Harvey: 15 years of clinical practice and an elite-sport background across football, rugby and GAA.
- Physiotherapy, strength and nutrition under one roof: three clinicians, three disciplines, joined-up care.
Fees and booking
Ready to optimise you? You can self-refer and book directly: no GP letter needed, and every new patient can start with a free 15-minute consultation call. The same fees apply across our Soho, Liverpool Street and Marylebone clinics.
- Physiotherapy: a full 60 minutes for £145, whether it is your first visit or a follow-up
- 30-minute follow-ups at £90, with video appointments from £70
- Strength training and Reformer Pilates £120, sports massage from £75
- VALD performance and strength testing with a written report, £195
- 5% off a block of five sessions, 10% off a block of ten
- An itemised receipt with every session, for claiming back where your policy covers physiotherapy
How physiotherapy works
from assessment to return to sport
Everything starts with finding the cause. Whether the goal is a marathon start line or a week at your desk without pain, we treat what is driving the problem, then build the strength that keeps it fixed.
Treatment
Hands-on manual therapy combined with a progressive, tailored exercise programme. Sports massage, dry needling, shockwave or Reformer Pilates are added where they help your specific problem.
Rebuild
Coached, progressive strength work restores the load tolerance your body lost, paced to where you start. This is the stage that decides whether the fix lasts.
Perform
Each follow-up reassesses you against your baseline, with VALD testing where useful, so your return to work, sport or training rests on measured readiness. Discharge happens by mutual agreement when you can manage independently.
What our physiotherapists treat
- Physiotherapy and sports rehabilitation
- Coached strength and conditioning
- Reformer Pilates
- Sports massage and soft-tissue therapy
- Dry needling and shockwave therapy
- VALD performance and strength testing
- Post-operative rehabilitation
- Running and gait analysis
- Sports nutrition and dietetics
Treatment approach
How do we treat knee pain?
Physiotherapy & Sports Rehabilitation
£145Assessment first identifies which structure is driving your knee pain: patellofemoral, ITB, tendon or early osteoarthritis, then delivers an individualised, progressive loading and rehabilitation programme, the first-line, best-evidenced treatment across all of these presentations.
See treatment detail →Shockwave Therapy
Price on enquiryFor patellar tendinopathy that has not settled with first-line loading, shockwave therapy may be considered as an adjunct alongside continued rehabilitation, in line with NICE interventional procedures guidance; evidence is mixed and it is never a substitute for progressive loading.
See treatment detail →FAQ
Frequently asked
questions
What is the best treatment for knee pain?
For most knee pain: patellofemoral, ITB-related, tendon-related or early osteoarthritis, exercise-based loading is first-line. NICE recommends therapeutic exercise for osteoarthritis, and the BJSM consensus supports progressive loading for tendinopathy. A graded strength programme tailored to your knee rebuilds capacity. Rest alone rarely works and can leave the joint weaker.
Should I rest my knee or keep moving?
Usually keep moving within sensible limits. Complete rest tends to leave the knee weaker, so pain returns when you resume activity. The evidence supports relative rest: temporarily easing the most aggravating loads while progressively rebuilding tolerance through structured exercise. Your physiotherapist guides exactly how much load is right for your stage of recovery.
Do I need a scan for my knee pain?
Usually not. NICE advises against routine imaging for osteoarthritis, and scans often show age-related changes common in pain-free people that rarely alter treatment. We reserve imaging for clear red flags, a locked or giving-way knee suggesting a structural injury, or symptoms that fail to improve and point to a specific cause needing investigation.
Does shockwave therapy work for knee pain?
It can help some recalcitrant patellar tendinopathy that has not responded to first-line loading, used as an adjunct alongside continued rehabilitation per NICE interventional procedures guidance. The evidence is mixed and it is not a guaranteed cure or a substitute for progressive loading. We will tell you honestly whether it suits your specific knee.
When should I seek urgent help for my knee?
Seek urgent care after significant trauma, or if your knee is hot, swollen and you feel unwell with a fever, which can signal infection. A knee that locks, gives way or cannot bear weight needs prompt assessment for a structural injury. For these, physiotherapy is not the first step; see your GP or attend A&E.
Can I keep running with knee pain?
Often yes, in a modified form. For most runners the answer is not stopping but adjusting: easing mileage or pace for a spell while you rebuild strength, then progressing load on a plan. Sharp, worsening or giving-way pain is the exception and needs assessing first. We help you keep as much running as your knee can handle.
Related What We Treat
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in London.
Physio and Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
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