Physiotherapy for knee pain, ACL and meniscus injuries.

• Kneecap (patellofemoral) pain. Pain around or behind the kneecap with stairs, running or long sitting. Often linked to load and to hip and thigh strength, and usually responds well to rehab.
• Tendon pain (patellar tendinopathy). Pain at the front of the knee that builds with jumping and heavy loading. It responds to a graded loading program rather than rest alone.
• Meniscus tears. The cartilage cushion in the knee can tear from a twist or wear. Many settle with rehab, and only some need surgery.
• ACL and ligament injuries. A twist or awkward landing can sprain or tear a ligament. A full ACL tear needs a clear surgery-versus-rehab decision, and strong rehab either way.
• Knee osteoarthritis. Age-related joint change that can be painful and stiff. Exercise and strength work are a first-line option and can delay or avoid the need for surgery.
• After a crash or work injury. A collision or a workplace incident can injure the knee, and ICBC or WorkSafeBC cover the physiotherapy that follows.

• Keep it moving gently. Move the knee through a comfortable range often rather than keeping it still. Gentle movement helps a swollen knee settle and keeps it from stiffening.
• Manage the load, do not stop everything. Reduce the activities that spike the pain, but keep doing what the knee tolerates. Total rest tends to leave the knee weaker.
• Settle swelling. For a freshly swollen knee, relative rest, elevation and short periods of cold can help you stay comfortable while it calms down.
• Support painful stairs. Lead with the stronger leg going up and the sore leg going down, and use a rail. Small changes reduce the load on an irritated knee.
• Start easy strength early. Gentle thigh and hip work, at a level that does not flare the knee, is usually helpful early. What is right for you depends on the assessment.

This is general information, not a treatment plan or a diagnosis. Get prompt assessment if the knee locks and will not straighten, gives way repeatedly, swells rapidly after an injury, or cannot take your weight. The right exercises for you depend on what your assessment finds.

• ACL tears. Some people manage well with rehab if the knee is stable for their activities. Others returning to cutting and pivoting sport choose reconstruction. Rehab is needed before and after surgery either way.
• Meniscus tears. Many settle with rehab and never need surgery. An operation is considered for specific patterns, such as a knee that locks. Strength work helps regardless.
• Knee osteoarthritis. Exercise and strength are a first-line option and can reduce pain and delay or avoid joint replacement for many people.
• Prehab before surgery. If surgery is planned, going in with a calmer, stronger knee tends to make the recovery smoother. This is where prehab fits.

The decision to operate belongs to a surgeon. Our job is to build the rehab around whichever path you and your surgeon choose, and to tell you plainly when your knee should be reviewed by a doctor.

• Extended health insurance. Most plans cover physiotherapy. We direct-bill most insurers up to your plan limit, and you pay any balance on the day.
• ICBC (after a car crash). A knee injured in a collision is treated within ICBC's pre-approved physiotherapy, with no referral needed. Bring your claim number and we bill ICBC directly.
• WorkSafeBC. If your knee injury is work-related and the claim is accepted, physiotherapy is covered at no direct cost to you.
• MSP. MSP helps only with a limited number of physiotherapy visits for people on its supplementary benefits (lower-income households).