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Knee Osteoarthritis: Physical Therapy in Brooklyn to Ease Pain and Stay Active

By Dr. Jack Engelberg, PT, DPT · · 4 min read

Stiff knees in the morning, aching after a walk along the boardwalk, and a slow climb up the stairs to your apartment are familiar signs of knee osteoarthritis (OA). Knee OA is one of the most common reasons adults see a physical therapist. While arthritis can't be reversed, exercise-based care is consistently recommended as a core treatment, and many people find they can stay active and reduce pain for years.

What Is Knee Osteoarthritis?

Osteoarthritis is a condition affecting the whole joint, including the smooth cartilage covering the ends of the bones, the bone underneath, the joint lining and the surrounding muscles and ligaments. Over time, cartilage can thin and the joint can change shape. The body responds with processes that sometimes cause pain, swelling and stiffness.

The idea of OA as "wear and tear" isn't quite accurate. Joints aren't like car tires. Movement and appropriate loading actually help keep cartilage healthy, and how much pain someone has does not always match what their X-ray looks like.

Common Symptoms

  • Pain with activities like walking, stairs, squatting or getting up from a chair
  • Morning stiffness that eases within about half an hour
  • Stiffness after sitting for a while
  • Swelling, especially after activity
  • Grinding or creaking sensations
  • Reduced ability to fully bend or straighten the knee
  • A feeling of weakness or the knee giving way

What Increases the Risk?

  • Age — OA becomes more common as we get older
  • Previous knee injury — such as an ACL tear or meniscus tear
  • Body weight — extra weight increases load on the knees
  • Muscle weakness, particularly of the quadriceps
  • Genetics and sex — women are affected more often
  • Occupations that involve frequent kneeling, squatting or heavy lifting

How Physical Therapy Helps Knee Arthritis

Major clinical guidelines recommend exercise and education as first-line treatments for knee OA, regardless of age or how the X-ray looks.

Evaluation

Your therapist will assess knee motion, strength, swelling, balance and how you walk, and talk with you about which activities matter most, whether that's walking to shul, playing with grandchildren, or getting back to tennis.

Treatment May Include

  • Quadriceps and hip strengthening — stronger muscles absorb load and support the joint
  • Range-of-motion work — restoring as much bending and straightening as possible
  • Manual therapy — joint mobilization and soft tissue work to ease pain and stiffness
  • Balance training — to improve confidence and reduce fall risk (see balance and fall prevention)
  • Aerobic exercise guidance — walking, cycling or water exercise at the right dose
  • Activity pacing — balancing activity and rest to avoid boom-and-bust flare-ups
  • Assistive devices and footwear advice — a cane used in the opposite hand can reduce knee load
  • Pre-surgical "prehab" — for those planning a knee replacement

What You Can Do at Home

  • Keep moving. Regular low-impact activity such as walking, cycling or swimming helps many people with OA.
  • Strengthen your quads. Simple exercises like sit-to-stands from a firm chair, straight leg raises and gentle wall slides are good starting points.
  • Warm up first. A few minutes of easy movement or a warm shower can reduce morning stiffness.
  • Use ice or heat for comfort after activity.
  • Manage weight if appropriate. Even modest weight loss can reduce knee load.
  • Use the 24-hour rule. If pain is noticeably worse the day after an activity, scale back a little next time rather than stopping entirely.

When to See a Physical Therapist

Book an evaluation if:

  • Knee pain limits your walking, stairs or daily activities
  • You're having frequent flare-ups or swelling
  • You feel unsteady or the knee gives way
  • You've been told you may need a knee replacement and want to explore options or prepare

See a physician promptly if your knee is hot, red and swollen, especially with fever; if you can't bear weight; or if your knee suddenly locks and won't straighten.

Frequently Asked Questions

Is it safe to exercise with knee arthritis?

Yes. Exercise is one of the most effective treatments. Some discomfort during exercise can be acceptable as long as it settles within a day.

Will I eventually need a knee replacement?

Not everyone with knee OA does. Many people manage well with exercise and other conservative care. If you do need surgery, being stronger beforehand tends to help recovery. Read about knee replacement rehab.

Do knee braces help?

Some people with OA find certain braces or sleeves helpful for comfort or confidence. Your therapist can advise whether one makes sense for you.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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