Physiotherapy Q&A: My knee aches after walks, but I don’t want surgery. Do I need to see a doctor?

I am a 55 year old active walker and recently I have been getting catching pain in my right knee. It never locks or gives way but is often achy at the end of a long day of walking now. I don’t really want surgery as I still consider myself quite young but my partner is insisting I see a doctor for this. What do you think this might be and could I be doing more damage by not getting it looked at?

From the symptoms you describe it is possible you are experiencing some early wear and tear (arthritic) changes in your knee. This is fairly common and nothing to be concerned about. It is thought that 18% of the population in England aged 45 and over are affected by knee osteoarthritis.  Arthritis, or more specifically osteoarthritis, is the medical term for degeneration of the boney cartilage lining the ends of your bones at a joint. Although often associated with aging it does not mean you are getting old or have to curtail activities such as walking! In fact, quite the opposite; exercise is very beneficial.

Healthy cartilage provides a smooth surface between the tibia (your shin bone) and the femur (your thigh bone). This allows the knee to bend and straighten easily and also provides a stable weight bearing surface. In a knee that is affected by arthritis, the cartilage tends to wear out unevenly, becoming rough and thin and the ‘catching pain’ you describe can be an awareness of the decreased smoothness of the joint surface. This can also be compounded by other changes happening in your joint, including the thickening of the bones at the joint surface and thickening of the joint capsule.

Research suggests that the symptoms of arthritic joints can be well managed with a combination of conservative measures such as exercise, over the counter medication such as paracetemol and ibuprofen, activity modification and weight management to name a few. This essentially means there are plenty of options for you to explore before considering surgery.

With regards to exercising, low impact activities such as walking, cycling and swimming are best as they reduce the amount of stress going through the joint compared to high impact activities such as running, jumping or racket sports. You may also benefit from some specific strengthening and stretching exercises for the muscles around your knee and hip.