Knee and hip osteoarthritis physio in Manchester
Ease the ache, get your strength back and keep doing the walks, stairs and sessions you enjoy.
Knee and hip osteoarthritis physio in Manchester city centre
Reviewed by Nick Chatziviltsos, PgDip, HCPC-registered physiotherapist (PH114351), November 2026
At a glance
Who gets it: Mostly people over 45, and younger people after an old knee injury or hard years of sport.
Main symptom: A stiff, aching knee or hip that's worse after rest or a busy day, and sometimes clicks or swells.
What helps most: Strength exercise. NICE recommends it for everyone with osteoarthritis, whatever their X-ray shows.
Sessions: Most people need 4 to 8 over 2 to 3 months.
Avoid: Resting it, and letting an X-ray report decide what you can do.
Get checked quickly: A hot, swollen joint with fever, or a joint that suddenly locks or gives way: see your GP the same day.
Osteoarthritis is the most common type of arthritis in the UK, and the knees and hips are where it shows up most. The good news is that the UK's national guidelines put exercise, not rest, at the centre of treatment.
An X-ray full of "wear" doesn't decide how your joint feels. Many people with marked changes on a scan have little pain, and pain often eases with the right strength work, even when the X-ray stays the same.
We help you answer three questions. What is making your knee or hip sore right now? What is it not strong enough for yet? And what will keep you walking, training and sleeping well for years? That's what this page, and your first session with us, is built around.
🛠️ How we treat knee and hip osteoarthritis
Every osteoarthritis plan at Athos Physio follows the same three steps. What changes is what we find at each one.
Step 1. Find the root cause of your knee or hip pain
Osteoarthritis is the label, but it isn't the whole story. Two people with the same X-ray can have very different pain. In your first 60-minute session we work out three things:
What's irritated: the joint lining after a flare, the kneecap joint, the muscles around the hip, or a nearby tendon or bursa
What's overloading it: a sudden jump in walking or stairs, a new class, weak thigh and hip muscles, extra body weight, or stiffness that changes how you move
What's keeping it sensitive: poor sleep, low mood, fear that exercise will "wear the joint out", or doing less and less until everything feels harder
We show you on a 3D anatomy model on a tablet what's happening inside the joint, so you can see why it aches and why your plan looks the way it does.
Step 2. Treat what's driving it
Calm the pain. Joint mobilisation for the knee or hip, soft tissue work on tight thigh, calf and hip muscles, and IASTM where the tissues feel guarded.
Find the movements that help. Cycling, swimming, a set of slow sit-to-stands or a short walk often ease an arthritic joint. We test what settles yours and build from there.
Reduce the overload, not your life. We adjust walking distance, stairs, kneeling and class choices for a few weeks, so you keep moving without flaring.
Treat the areas around it. A stiff ankle, weak glutes or a stiff lower back can push extra load through the knee or hip. We work on those too.
Step 3. Build a knee or hip that lasts
Osteoarthritis is long term, so the goal is a joint that copes with what you want to do. Step 3 builds that capacity:
Progressive strength work for your thighs, hips and calves, such as sit-to-stands, step-ups, split squats, bridges, side-lying hip abduction, leg press and Romanian deadlifts, loaded steadily over 8 to 12 weeks.
Rehab on the gym floor. Being inside F45 NQ means we can move from the treatment table to the bike, sled and free weights, and coach your technique.
Practise what matters to you. Stairs at work, getting up off the floor with your children, a long city walk, a round of golf or your F45 class.
A flare-up plan. What to do for the first few days if your joint swells or aches more, so you can manage it without booking in.
We finish when you're doing what you want with confidence, not just when the ache has eased.
Want to know what your knee or hip can really handle? Your first 60-minute session tests it properly and starts your plan the same day. Book your assessment →
🔍 What is osteoarthritis?
Osteoarthritis affects the whole joint. The smooth cartilage on the ends of the bones thins, the bone underneath thickens, and the joint lining can become irritated. Small bony growths can form at the edges.
It's often called "wear and tear", but that's misleading. Joints are living tissue that respond to load. The NHS notes it doesn't necessarily get worse over time, and symptoms can improve.
Doctors usually diagnose it from your symptoms alone. If you're 45 or over, your pain is linked to activity and any morning stiffness lasts 30 minutes or less, an X-ray usually isn't needed.
Types of knee and hip osteoarthritis we treat
Inner (medial) knee osteoarthritis: inside of the knee; ache walking, worse on uneven ground, sometimes a bow-legged look.
Kneecap (patellofemoral) osteoarthritis: front of the knee; pain on stairs, squatting, kneeling and after sitting.
Outer (lateral) knee osteoarthritis: outside of the knee; ache standing and walking, sometimes knock-kneed.
Hip osteoarthritis: groin, front of the hip or thigh, sometimes the knee; stiff putting on socks, pain getting out of the car, a limp on longer walks.
Osteoarthritis after an old injury: any of the above, often earlier in life; past meniscus or ACL injury, joint swells after sport. See meniscus tear.
Most people also fit somewhere between mild (aches after a busy day), moderate (daily pain that limits walking or sport) and severe (pain at rest or at night, and big limits on daily life). The stage changes how hard we start, not whether exercise helps.
⚠️ Osteoarthritis symptoms
Most knee and hip osteoarthritis shows a mix of these:
Pain that builds with use and eases with rest, often worse at the end of the day
Stiffness first thing or after sitting that usually eases within 30 minutes
Knee pain on stairs, hills, kneeling or getting up from a low chair
Hip pain in the groin or outer hip, and trouble with socks, shoes or getting into a car
Swelling, creaking or a grating feeling as the joint moves
The knee feeling weak or giving way, or a limp on longer walks
Is it osteoarthritis, an inflammatory arthritis or something else?
Knee and hip pain have several causes, and the plan for each is different. These clues help us tell them apart:
Morning stiffness lasting more than 30 minutes, in several joints, often the hands or feet, points to an inflammatory arthritis such as rheumatoid arthritis. That needs your GP. See rheumatoid arthritis.
Pain on the outside of the hip, worse lying on that side or climbing stairs, is often the gluteal tendons rather than the joint. See trochanteric bursitis.
Front-of-knee pain in a younger runner or gym-goer is more often runner's knee than arthritis.
Sudden locking or catching after a twist may be a meniscus tear.
Buttock or thigh pain with tingling below the knee may come from your lower back. See sciatica and lower back pain.
We test each of these at your first session rather than guessing from the symptoms alone.
🔍 What causes knee and hip osteoarthritis?
There's rarely one cause. Osteoarthritis develops when the joint's repair process can't keep up with the load on it. Age, genes, past injuries and body weight all play a part. Symptoms flare when load jumps ahead of what the joint is currently strong enough for.
Common triggers we see in Manchester
Long days sitting, then a busy weekend. The knee stiffens at a desk all week, then a long walk, hike or move of house sets off a flare.
Stepping up activity too fast. A new F45 or HIIT class, adding running or a charity walk with little build-up.
An old injury. A football knee injury, meniscus tear or ACL injury raises the chance of knee osteoarthritis later.
Weak thigh and hip muscles. Weak quads and glutes leave the joint absorbing more of each step.
Extra body weight. Each step loads the knee and hip, and fat tissue also adds to joint inflammation.
Doing less and less. Avoiding stairs and walks to protect the joint makes the muscles weaker and the pain more likely.
What doesn't usually cause it
Running in sensible amounts doesn't appear to wear out healthy knees. Neither does normal walking, cycling or gym training. Creaking on its own isn't harmful either. The bigger risks are long-term inactivity and muscle weakness, which is why we keep you moving.
🧪 How we assess knee and hip osteoarthritis
Your first session lasts 60 minutes, so there's time to assess properly and start treatment the same day. Here's what happens:
Your story (10 to 15 minutes). When it started, what makes it better or worse, past injuries, your work, activity and sleep, and what you want to get back to. We use a short questionnaire, such as the KOOS or HOOS, to measure where you're starting from.
Safety screen. We check for the warning signs listed on this page, and for signs of an inflammatory arthritis.
Movement and function tests. How you walk, squat, climb a step and rise from a chair. We time a 30-second chair stand and a short fast walk, so we can re-test progress later.
Joint tests. Knee bend and straightening, a swelling check, kneecap movement and joint-line tenderness. For the hip, rotation range plus the FADIR and FABER tests.
Strength tests. Quads, hamstrings, glutes and calves, often with a handheld dynamometer or a single-leg test, compared side to side.
Neighbouring areas. A quick check of your lower back and ankle, so we don't miss pain referring into the knee or hip.
Your diagnosis and plan. In plain English: what's sore, why now, what to keep doing, what to change this week, and how many sessions we expect.
You'll leave with treatment already started, the first two or three exercises of your custom rehab plan, and a clear plan for the next few weeks. If anything suggests you need an X-ray, blood tests or a surgical opinion, we'll tell you and write to your GP.
🛠️ Knee and hip osteoarthritis treatment at Athos Physio
We don't hand out a sheet of generic leg lifts. Every plan is built around your joint, your goals and how your pain responds. It moves through four phases, at the pace your knee or hip allows.
Settle (weeks 0 to 2). Calm a flare and get you moving with confidence. Joint mobilisation and soft tissue work; easing movements such as cycling or pool work; pacing walks and stairs; sleep and pain-relief advice.
Restore (weeks 2 to 6). Get back comfortable movement and walking. Range-of-movement work for the knee or hip; walking targets; sit-to-stands and step-ups at low load.
Strengthen (weeks 6 to 12). Build strength in the thighs, hips and calves. Progressive loading such as split squats, leg press, bridges, hip abduction and Romanian deadlifts, 2 to 3 times a week.
Return and maintain (week 12 onwards). Get you back to sport, classes or long walks, and keep you there. Activity-specific training, a long-term gym programme and a flare-up plan you can run yourself.
Hands-on treatment helps most early on. It eases pain and stiffness and makes exercise easier to start, but NICE only recommends it alongside exercise, not on its own.
Throughout, you'll get a home programme of 3 to 5 exercises, about 15 minutes a day. We review and progress it each session. Most people need 4 to 8 sessions over 2 to 3 months, often spaced further apart as you take over.
What actually works for knee and hip osteoarthritis?
The UK's National Institute for Health and Care Excellence (NICE) published its osteoarthritis guideline in 2022 (NG226). Our approach follows it.
Recommended: therapeutic exercise for everyone with osteoarthritis, tailored to you, ideally with some supervised sessions; exercise combined with education and support to change habits; weight loss if you carry extra weight. NICE notes any loss helps, and 10% is likely to help more than 5%; manual therapy for the knee or hip, but only alongside exercise; walking aids, such as a stick, if they help you stay active; diagnosis from your symptoms, without routine X-rays.
Not recommended: acupuncture or dry needling; electrotherapy such as TENS, ultrasound, interferential or laser; keyhole surgery to wash out or tidy up the joint (arthroscopic lavage or debridement); hyaluronic acid injections, glucosamine and strong opioids; insoles, braces and supports as routine treatment.
NICE says paracetamol isn't routinely needed, and topical anti-inflammatory gels are a first option for the knee. Steroid injections can help for 2 to 10 weeks, mainly to support exercise. Speak to your GP or pharmacist about medicines.
⏱️ How long does it take for osteoarthritis to feel better?
Osteoarthritis doesn't "heal" like a sprain, but pain and function often improve a great deal. These are typical ranges we see. Your timeline depends on how long you've had symptoms, your strength and how consistently you do the plan.
A flare of mild knee or hip osteoarthritis: feeling much better: 2 to 4 weeks; back to full activity: 6 to 8 weeks.
Moderate knee osteoarthritis: feeling much better: 6 to 12 weeks; back to full activity: 3 to 4 months.
Kneecap (patellofemoral) osteoarthritis: feeling much better: 6 to 10 weeks; back to full activity: 3 months.
Moderate hip osteoarthritis: feeling much better: 8 to 12 weeks; back to full activity: 3 to 6 months.
Severe osteoarthritis, possibly heading for surgery: feeling much better: steady gains over 2 to 3 months; back to full activity: depends on surgery plans.
"Back to full activity" means your normal walks, classes, golf or gym sessions, not just a better day-to-day. Strength takes 8 to 12 weeks to build. That last step is where most people stop too early, and it's what protects you from the next flare.
✅ Living well with osteoarthritis
If you work at a desk
Get up every 30 to 45 minutes. Stiffness builds when the knee or hip stays still. A walk to the kettle or the printer helps.
Raise your chair if hip pain is the issue. Hips level with or just above your knees make standing up easier.
Use the commute. Walking part of the way from Piccadilly or Victoria is good joint exercise, built up gradually.
If you train
Keep training. Swap high-impact moves like jumps and burpees for the bike, rower, sled pushes or step-ups. Your F45 coach can adapt the stations.
Use a 0 to 10 pain rule. Pain up to 3 or 4 out of 10 during exercise is usually fine, as long as it settles by the next morning.
Load the legs twice a week. Squats, split squats, leg press and hinges protect the joint. Start light and add weight slowly.
Avoid sudden jumps in volume. A new running plan or extra classes should build over weeks, not days.
Self-help for a flare
Keep moving little and often, and cut back the activity that set it off for a few days
Use heat for stiffness or a wrapped ice pack for a swollen, warm knee, 15 to 20 minutes at a time
Wear cushioned, supportive shoes for long walks around town
Sleep with a pillow between your knees for hip pain, or under your knee for knee pain
Do I need a knee or hip replacement?
Most people with knee or hip osteoarthritis never need surgery. A replacement is worth discussing when pain and stiffness seriously affect your quality of life, and a good rehab programme hasn't helped enough.
Try a full programme first if you can still walk reasonably, sleep most nights and do most of what you want. Give strength work 3 months before judging it.
Ask your GP about a surgical referral if pain stops you sleeping, walking short distances or working, despite exercise, weight loss where needed and pain relief.
NICE says the decision should rest on how much your life is affected, not on an X-ray score, and not on age or weight alone. If you do go ahead, building strength beforehand helps recovery. See hip replacement recovery and post-op rehab.
Related conditions
Rheumatoid arthritis: swollen, stiff joints on both sides, worst in the morning
Hip replacement recovery: rehab before and after a new hip
Trochanteric bursitis (GTPS): pain on the outside of the hip, worse lying on that side
Meniscus tear: knee pain with clicking, catching or swelling after a twist
❓ Knee and hip osteoarthritis FAQs
🚨 Physio, GP or A&E?
Most knee and hip osteoarthritis is safe to manage with a physio. A few symptoms need a doctor first. This list follows NHS and NICE guidance.
Book a physio (no GP referral needed): knee or hip pain that builds with activity, with stiffness that eases within 30 minutes; a flare after a busy week or new class that hasn't settled in 1 to 2 weeks; pain that's stopping you walking, training, working or sleeping.
See your GP: morning stiffness over 30 minutes, or swollen, painful joints in your hands, wrists or feet (see your GP to rule out an inflammatory arthritis); pain that's getting rapidly worse, unexplained weight loss, or night pain that doesn't ease with any position.
Call your GP urgently or 111: a sudden hot, red, swollen joint that's very painful to move, especially with a high temperature or shivers (get an urgent GP appointment or call 111 the same day); calf pain and swelling in one leg, with warm or darkened skin (get an urgent GP appointment or call 111).
Call 999 or go to A&E: leg swelling with chest pain or trouble breathing (call 999 or go to A&E); unable to put weight on the leg after a fall.
A hot, swollen joint with fever can be a sign of septic arthritis, a joint infection that needs urgent treatment. If you're ever unsure, ring us on 07475 433300 and we'll tell you honestly whether you should see us or someone else first.
Not sure whether physio or a surgical opinion is the right next step? Book a free 15-minute call and we'll tell you honestly. Book a free call →
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Yes. NICE recommends therapeutic exercise for everyone with osteoarthritis. A physio-led strength programme usually reduces pain and makes walking, stairs and sport easier.
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Yes. Strengthening the glutes and thighs, improving hip movement and pacing activity help most people with hip osteoarthritis walk further with less pain.
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Usually not. NICE advises diagnosing osteoarthritis from your symptoms if you're 45 or over, with activity-related pain and short morning stiffness. A scan is only needed if something doesn't fit.
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Yes, in amounts your knee tolerates. Build up gradually, use supportive shoes, and pair walking with strength exercises for the best results.
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Sit-to-stands, step-ups, split squats, leg press and bridges, plus low-impact cardio such as cycling or swimming. We'll set the right level for your knee.
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No. The right exercise strengthens the muscles that support the joint and usually reduces pain. Some discomfort during exercise is normal, as long as it settles by the next day.
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The joint changes can't be reversed, but symptoms often improve a great deal. Many people with clear X-ray changes have little pain once they're stronger.
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Most people need 4 to 8 sessions over 2 to 3 months, with a home programme in between. We'll give you an estimate at your first appointment.
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Yes. Building strength and fitness before surgery can make recovery smoother. We can also support your rehab afterwards in clinic or at home.
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Yes. We work with Bupa, WPA, Vitality and Aviva. Check with your insurer first, as some ask for a GP referral or an authorisation code.
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Your first 60-minute assessment and treatment is £95. Follow-up sessions are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. See our price list for all fees.
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Yes. Book a free 15-minute consultation and we'll tell you honestly whether physio is the right next step for your knee or hip.
📍 Book knee and hip osteoarthritis physio in Manchester city centre
Athos Physio is inside F45 NQ, 77 Piccadilly, Manchester M1 2BU, a two-minute walk from Piccadilly station and Piccadilly Gardens. We're open 7am to 8pm, Monday to Friday, so you can come in before or after work.
Your first appointment is a 60-minute assessment and treatment (£95). Follow-ups are £55 for 30 minutes, £95 for 60 minutes or £135 for 90 minutes. We work with Bupa, WPA, Vitality and Aviva, and you can see all our fees on the price list.
Can't get into town? We also offer home physio visits and online physiotherapy. Not sure physio is right for you? Book a free 15-minute call and we'll talk it through.
Call or WhatsApp 07475 433300, or book online.
Other services: Physiotherapy and active rehab · Sports massage · Pregnancy and postnatal physio · Home visits · Online physio
Written by Nick Chatziviltsos, physiotherapist and founder of Athos Physio, BSc (Hons) Physiotherapy, HCPC registered. Last reviewed: November 2026.
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Athos Physio is a full-service physiotherapy clinic
We offer injury rehabilitation, post-surgery functional strengthening, deep tissue massage and pain relief, and strength training expertise. We support you in becoming pain-free so that you can achieve a limitless life experience. If you want to speak with us before booking a session you reach out via WhatsApp, call us or email us.
We are based in Manchester city centre a couple of minutes walk from Piccadilly train station and Piccadilly Gardens Square