KNEE PAIN PHYSIOTHERAPY · HOBART
Knee PAIN
PHYSIO
HOBART
Most knee pain isn't actually a knee problem. The knee sits between two joints — the hip above and the ankle below — and when either stops doing its job, the knee cops the extra load.
Find what's actually driving it, fix that, and build the strength to handle it. That's what stops it coming back.
No referral needed • All major health funds
Quick Facts: Knee Pain
Most Common Presentation
Pain that builds with load: stairs, running, squatting. Eases with rest, then comes back the moment you get going again.
Typical Recovery Arc
Most people with acute knee pain feel meaningful improvement within 4 to 8 weeks with the right loading approach.
What We Look For
Hip control, ankle mechanics, movement pattern under load. Not just where it hurts.
Referral
No referral needed. Book directly online or call 0483 947 716.
WHATS ACTUALLY GOING ON
YOUR KNEE
PROBABLY ISN’T
THE PROBLEM.
The knee is a hinge joint. It's built to bend and straighten, it doesn't have much capacity to manage rotational or lateral forces on its own. When those forces arrive, they come from above or below.
Weak glutes mean the hip drops on the standing leg. The knee collapses inward. The kneecap tracks poorly. The outside of the knee gets compressed. Every step, every rep, every stair, the same load pattern repeated until something reacts.
That's why treating the knee in isolation so often doesn't work. The pain is in the knee. The problem usually isn't.
The pattern we see most
Runners and active people who've ramped load faster than their hips could handle. Desk workers whose glutes have switched off and whose knees track inward under load. Post-op patients who were discharged when the swelling settled but never got the quad and glute strength to actually protect the joint. The knee is the symptom. The hip — or the ankle — is where the answer usually is.
Very Common
Patellofemoral Pain
Aching under or around the kneecap. Worse on stairs, after sitting a long time, when squatting. Often called "runner's knee" but you don't have to run to get it. The kneecap tracks poorly because the hip isn't controlling the femur. Sort the hip control, sort the tracking.
Common
ITB Syndrome
Sharp pain on the outside of the knee, typically in runners or cyclists, often appearing at a predictable point in a run. The ITB doesn't stretch. What changes is the compression at the lateral femoral condyle, driven by hip mechanics and load volume. Graded loading and hip control is what changes it.
Common
Patellar Tendinopathy
Pain at the front of the knee, just below the kneecap. Stiff first thing in the morning or after sitting. Worse when jumping, running, or after a heavy leg session. Tendons don't respond to rest. They respond to load. The answer is structured, progressive loading the tendon hasn't had a chance to adapt to yet.
Common
Meniscal & OA Pain
Meniscal irritation can feel like a specific catch or click on one side of the joint. Knee OA tends to be more diffuse, worse after inactivity and easing slightly with movement. Both respond well to strength work. The joint needs load, not avoidance. The goal is building capacity around the knee so it shares that load properly.
WHATS ACTUALLY
DRIVING your
Knee pain.
The knee sits in the middle of a chain. The hip controls what happens above it. The ankle and foot determine the alignment below it. When either end isn't working properly, the knee absorbs the excess force across every step and every rep since the problem started.
Knee pain is rarely one thing. It's usually a combination of load, muscle imbalance, movement pattern, and the cumulative effect of how you've been moving — and protecting — since the pain began.
WHY IT HAPPENS
01
Weak Glutes & Hip Control
The most common driver. When the glutes aren't controlling the hip during single-leg loading, the femur rotates inward, the kneecap tracks laterally, and the joint takes forces it isn't built to handle.
02
Load Spike
Doing more than your tissues were ready for: a new running program, returning after time off, a long hike after months at a desk. The knee reacts before the rest of the system does. The issue wasn't the load. It was the gap between the load and your capacity.
03
Ankle & Foot Mechanics
Limited ankle dorsiflexion, overpronation, footwear that changes your natural pattern. All of these alter knee alignment from below. You can't assess the knee properly without looking at what the foot is doing.
04
Movement Avoidance
Once the knee has been sore, most people stop fully bending it. Quad and glute capacity drops. The movement you avoided becomes the one that flares worst when you return to it. Avoidance reinforces the problem.
05
Incomplete Rehabilitation
Treatment stopped when the pain settled. The movement pattern that drove the load was never fixed. So when load returns, so does the pain. This is why most knee pain is a recurrence, not a first episode.
06
Quad Dominance
Over-relying on the quads while the glutes and hamstrings are underloaded. Common in people who squat and lunge but never hinge. The patellofemoral joint takes excessive compression, and the posterior chain never builds the capacity to share it.
SYMPTOMS
SOUND FAMILIAR?
Pain on stairs — especially going down — that makes you grip the railing or slow right down
Stiff and achy after sitting — takes a minute to get going when you stand up
Pain that builds through a run or walk and eases when you stop — then returns next time
Sharp catch or clicking on one side of the knee — worse when twisting or squatting deep
You don't trust the knee anymore — you modify every movement to protect it without realising
Swelling that appears after activity and settles overnight — then comes back with the next load
Knee pain stopping you from running, hiking, skiing, or training — and you've been managing it for months
It's come back again — and this time you want to find out what's actually driving it
— HOW WE TREAT IT
THE By design
approach
to Knee pain.
The knee tells us a lot before we even load it. How you sit down. How you stand up. Whether your hip drops on the single-leg squat. Where the kneecap is tracking. The assessment isn't just about the knee, it's about everything the knee depends on.
We don't have a knee pain protocol. We find your specific pattern, and that determines everything else, the exercises, the load progression, the timeline. What's right for your knee, not a generic list.
Step 01
Find the Pattern
Single-leg squat, step-down, lunge, hip hinge. We look at the hip, the knee, and the ankle together, not in isolation. The coordination gap is usually obvious within the first few movements. That's where we start.
Step 02
One or Two Things First
Not a list of eight exercises. The one or two things that will change the pattern most efficiently. Usually glute activation in a specific range, or a cue that changes your knee position on landing. We send it with video. You can't get it wrong.
Step 03
Explain What's Happening
We walk you through it on the iPad. Link the scan or imaging to what the assessment found. Show you exactly why the knee has been loading the way it has. Most people leave session one understanding their knee for the first time.
Step 04
Hands-On When It Helps
Soft tissue work, joint mobilisation, dry needling where appropriate. Not as a standalone treatment, but to reduce sensitivity enough that you can start loading properly. For tendon presentations we're careful: the tissue needs progressive load, not just manual therapy.
Step 05
Progressive Loading
Once the pattern is right, we build the capacity. Step-ups, Bulgarian split squats, RDLs, hip thrusts. Loading the glutes, quads, and hamstrings together. Building a knee that can handle what you're actually asking of it, not just what the physio table loads it with.
Step 06
Return to What You Love
Running, hiking, skiing, training. Whatever the knee has been keeping you from. We don't just get you to pain-free. We get you back to the activity, under real load, with the capacity to stay there. That's when it actually sticks.
Phase 01
Calm the Knee
Load management and basic glute activation. The sharp pain settles. Movement becomes less guarded.
Phase 02
Sort the Pattern
Single-leg control. Hip hinge. Step-down mechanics. The knee starts tracking properly under load.
Phase 03
Build the Capacity
Into the gym. Progressive loading. The knee handles weight it couldn't before. Confidence comes back.
Phase 04
Keep It That Way
Back to running, hiking, training. Sessions spread out. You know what to do if it reacts. Usually it doesn't.
WHY BY DESIGN
WHAT MAKES US
DIFFERENT
01
We Look Beyond the Knee
Treating only where it hurts is why knee pain keeps coming back. We assess the whole chain: hip, knee, ankle. We find where the load is actually coming from. That's where the real work happens.
02
Strength Is the Treatment
Pain relief is the start. Building the glute, quad, and hamstring capacity to protect the joint under real-life load is what stops it returning. We don't discharge you when you feel better. We discharge you when the knee is strong.
03
We Explain the Why
You leave every session understanding more about your knee than when you arrived. When you understand why it's been hurting and what's changing, the rehab makes sense and you actually follow through.
04
Graded Return to Load
The movement that's been making it flare: we get you back to it, under increasing load, without you guarding against it. A few weeks in, you're doing the stair, the squat, the run. That's when the confidence returns. That's when it sticks.
05
Experienced Physios Only
Every physio on our team is highly experienced and held to a high standard. No juniors. No compromise on clinical quality. The same level of assessment and care regardless of who you see.
06
400+ Five-Star Reviews
Hobart's highest-rated physiotherapy clinic. The results speak for themselves.
COMMON QUESTIONS
ABOUT Knee PAIN.
My scan shows cartilage damage or a meniscal tear. Do I need surgery?
Not necessarily, and often not at all. Imaging findings in the knee are frequently present without symptoms, and many people with significant scan findings do well with structured physiotherapy. What matters is what your scan shows in the context of how you're actually moving and loading. A meniscal finding on a scan doesn't automatically mean surgical pain. We'll walk you through what yours means for your specific situation. For most presentations, well-structured physiotherapy is the right first step.
Should I stop running or training while my knee settles?
Probably not completely, but you may need to modify how much and how you're loading it. Complete rest tends to reduce capacity further, which makes the knee more reactive when you return. The goal is finding the load level your knee can handle right now and building from there. For most presentations that means modifying rather than stopping. We'll give you a clear framework at your first session.
I've had knee physio before and it came back. What's different here?
The most common reason knee pain recurs is that treatment addressed the symptom: pain reduction, some quad strengthening, without addressing the movement pattern that caused it. If your hip is still dropping every time you go down a stair, the load on the kneecap doesn't change. We look for the actual pattern driving your pain, address that, and build the capacity to maintain it. That's the difference.
How long will it take?
Most people with acute or subacute knee pain see meaningful improvement within four to eight weeks with consistent work. Longer-standing presentations like chronic tendinopathy, post-surgical rehab, and knee OA take more time and a more structured loading progression. We give you a realistic timeline at the initial assessment based on your specific presentation, not a generic estimate.
Do I need a referral?
No. You can book directly without a GP referral. If you have a chronic disease management plan (CDM/EPC) through your GP, we accept those. Medicare covers part of the cost for up to five sessions per year.
READY TO
SORT YOUR
Knee
FOR GOOD?
No referral needed • All major health funds • North Hobart
Or call 0483 947 716 • hello@bydesignphysio.com
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