WhatsAppBook

Physiotherapy · Knee arthritis

Knee arthritis physio in Phuket

Arthritis is a reason to train smarter, not to stop moving. Our physios test what your knee can do and build your strength step by step, then our coaches keep you training.

For sore knees on stairs and walks, people told they need a new knee, and active people who want more.

Book a free physio assessment

Opens WhatsApp with a message ready to send.

Questions first? Ask us on WhatsApp

Rated 5.0 from 57 Google reviews

What the research says

Pain-free knees can look worn too

Knee arthritis is a change in the whole joint, not just worn cartilage. What an X-ray shows is only loosely linked to how much your knee hurts.1 So a scan is a poor guide to what your knee can do.

  • 43%

    of pain-free, uninjured adults had cartilage changes on MRI, in studies with an average age of 40 and over.2

  • 0of 5

    In one US study of 1,753 people with knee arthritis, none of five pain patterns got substantially worse over 6 years.3

  • 27%

    Average knee pain fell from 4.7 to 3.4 out of 10 after a 6 to 8 week exercise and education program. Registry data, no control group.4

Your scan does not set your limits. What your knee can do is what we measure and train.

How we work

Start with what guidelines recommend

Education, exercise and weight loss if you need it are the first treatments recommended by international and national guidelines.5,6,7 Injections and surgery are options you can add, not the starting point.

  • Understand your knee

    Arthritis changes the whole joint, and scan findings match pain poorly.1,2 Knowing what is going on makes it easier to keep moving. Major guidelines include education in every plan.5,7

  • Build your thigh strength

    Programs focused on the quadriceps, the muscles at the front of your thigh, reduced pain more than general leg exercise in a review of 48 trials.8

  • Add aerobic exercise you enjoy

    Walking, cycling and swimming all count. On average, exercise helps a modest amount, and people with more pain at the start tend to gain more.9,10

  • Read your knee, then progress

    Load rises step by step as your knee copes. Your physio tests you, teaches you to read your knee and signs off each stage. Then our S&C coaches keep you training.

Your recovery

Four phases, each with a test

Timeframes are typical. Your test results decide when you move on, and your physio signs off each stage.

  1. 01

    Typically 0 to 2 weeks

    Understand and start

    Your physio confirms the diagnosis and checks for anything that needs a doctor. If you are 45 or over with activity-related pain and morning stiffness of 30 minutes or less, a scan is not needed to diagnose it.7

    Move on whenYour baseline tests are recorded, you can use the traffic light, and you are exercising 2 to 3 times a week and walking most days.

  2. 02

    Typically 2 to 8 weeks

    Build strength

    The heart of the program: strength training two to three times a week, focused on the quadriceps, with the load rising as you get stronger.8 Sit to stand, step-ups, split squats, knee extensions, hips and calves.

    The handover gateChair stands up by at least 2, 10 controlled step-ups each leg, two weeks without extra swelling and a 30-minute walk. Your physio signs it off.

  3. 03

    Typically 8 to 12 weeks

    Build function

    An S&C coach helps you turn strength into everyday life: stairs, slopes, getting up from the floor, carries, golf or a long beach walk. Your physio retests you at 12 weeks.

    The 12-week retestChair stand, walking test and knee score improved, stairs step over step, up from the floor without help, and back to an activity you had stopped.

  4. 04

    From 12 weeks

    Stay strong for life

    Your coach keeps you training two to three times a week, with aerobic activity most days and a flare plan. Your physio reviews you at 6 and 12 months.

    On track whenYou train at least twice a week most weeks, flares settle within days, and you are doing the activities you set as goals.

Your X-ray grade does not decide whether exercise can help: in a review of 48 trials, benefits were similar whatever the X-ray showed.8 The average benefit was smaller at 12 months than at 12 weeks,10 so staying with it matters.

Between sessions

Some discomfort is normal

Pain may increase at first when you start exercising, and regular exercise still helps.7 We use a simple 0 to 10 rule tested in people with severe knee or hip arthritis.11

Check three things: pain during and just after exercise, how the knee feels the next morning, and any new swelling or stiffness.

  • Green: progress

    Pain stays below 5 out of 10 and is back to your usual level by the next day. Keep going and progress as planned.

  • Amber: hold

    Pain reaches 5, or the knee feels a bit stiffer next morning but settles that day. Repeat the same load before you progress.

  • Red: step back

    Pain goes above 5, is still worse than usual the next day, or there is new swelling. Reduce the load and tell your physio.

Get medical help today if

  • A hot, red, swollen knee, or a fever
  • A hot or swollen knee after a joint injection
  • Sudden severe pain and swelling without an injury
  • A fall or twist, then swelling or you cannot take weight
  • Calf swelling, pain or warmth in one leg
  • Chest pain or sudden breathlessness: call 1669

See a doctor within days for morning stiffness lasting hours, several swollen joints, constant night pain, unexplained weight loss, cancer history with new pain, rapid worsening, or a locking knee.

Thinking about a knee replacement?

Decide with clear numbers

A knee replacement can be a good option. A structured 12-week program can help you decide, and if you choose surgery it becomes your preparation.

One Danish trial took 100 people eligible for a knee replacement. Half had surgery plus a 12-week program; half did the program alone.12 Two years later, two in three in the program-only group had not had surgery. Surgery gave about twice the improvement, with more complications.13 Training before surgery may also help: reviews show less pain ahead of a knee replacement and after it.14,15

2 in 3

in the program-only group had not had surgery at two years13

2x

the improvement with surgery plus the program13

Patient reviews

What our patients say

Rated 5.0 from 57 Google reviews

  • “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”

    Michelle LawlorGoogle review

  • “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”

    Catlin McCrackenGoogle review

  • “Meaw has been incredible. She helped me recover from long term neck and lower back pain and gave me personalized exercises that I now do daily. These have made a huge difference in my strength, mobility, and overall well-being. I’m so grateful for her expertise and highly recommend her to anyone looking for real, lasting results!”

    Jeff CraigGoogle review

  • “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”

    Unfiltered OpinionsGoogle review

  • “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”

    Jamie AllworkGoogle review

  • “I have been seeing Karim for long term issues with my neck and the results have been fantastic. I have attended several physios in the past and none compare to Karim. His skills and knowledge helped to pinpoint the exact cause of the issues and the treatment plan has made massive improvements.”

    joyce billingtonGoogle review

  • “I came to Optimize with chronic back pain and absolutely no ability to train. I was first matched with Khun Meaw, a highly skilled rehabilitation trainer who helped me eliminate my back pain completely. … After that, I continued training with Kate for a full year.”

    nesterzhzhotGoogle review

Read all 57 reviews on Google

Questions

Knee arthritis questions

Does arthritis mean my knee is worn out?

Scans often show changes in knees that do not hurt, and scan findings match pain poorly. Guidelines put exercise first: your knee is something to use, not something to protect.1,2,5

Will running wear out my knees?

Recreational runners were no more likely than non-runners to have hip or knee arthritis in a large review.16 In one study of over-50s with knee arthritis, running was not linked to worsening. These are links, not proof.17

If it hurts, am I doing damage?

Pain may increase at first when you start exercising, and regular exercise still helps.7 In one supervised program, pain up to 5 out of 10 was acceptable if it settled by the next day.11

Is my X-ray too bad for exercise?

In a review of 48 trials, exercise helped whatever the X-ray showed.8 People with more pain at the start tend to gain the most.10 Your tests, not your scan, set your plan.

Do I have to lift very heavy?

No. In one large trial, high-intensity training eased pain no more than low-intensity training at 18 months.18 Steady, progressive loading is enough.

Does physio work better than an injection?

In one trial of 156 people, physiotherapy led to less pain and better function at one year than a steroid injection.19

Physio team

Your physio team

Meaw leads our clinical standards and checks every handover to your coach.

How physiotherapy works here
  • Meaw, Head Physiotherapist at Optimise

    Meaw

    Head Physiotherapist

  • Karim, Physiotherapist at Optimise

    Karim

    Physiotherapist

Also on the team Sukanya, Physiotherapist

Next step

Find out what your knee can do

Message us on WhatsApp to book your free physio assessment. You leave with a clear picture of your knee and a plan built around your goals.

Book a free physio assessment

Opens WhatsApp with a message ready to send.

Questions first? WhatsApp +66 65 914 1604

Low back painSciaticaShoulder painRunner’s kneeACL rehabAnkle sprainNeck painTendon painHamstring strainMeniscus tearsHeel painHip arthritisFrozen shoulderRotator cuff tearsKnee and hip replacement
Sources (19)
  1. Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116.
  2. Culvenor AG, Øiestad BE, Hart HF, et al. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med. 2019;53(20):1268-1278.
  3. Collins JE, Katz JN, Dervan EE, et al. Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage. 2014;22(5):622-630.
  4. GLA:D Denmark. GLA:D Denmark Annual Report 2023-2024. Odense: University of Southern Denmark; 2025.
  5. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.
  6. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220-233.
  7. National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. London: NICE; 2022.
  8. Juhl C, et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: a systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol. 2014;66(3):622-636.
  9. Lawford BJ, Hall M, Hinman RS, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2024;12(12):CD004376.
  10. Holden MA, Hattle M, Runhaar J, et al. Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. Lancet Rheumatol. 2023;5(7):e386-e400.
  11. Ageberg E, Link A, Roos EM. Feasibility of neuromuscular training in patients with severe hip or knee OA: the individualized goal-based NEMEX-TJR training program. BMC Musculoskelet Disord. 2010;11:126.
  12. Skou ST, Roos EM, Laursen MB, et al. A randomized, controlled trial of total knee replacement. N Engl J Med. 2015;373(17):1597-1606.
  13. Skou ST, Roos EM, Laursen MB, et al. Total knee replacement and non-surgical treatment of knee osteoarthritis: 2-year outcome from two parallel randomized controlled trials. Osteoarthritis Cartilage. 2018;26(9):1170-1180.
  14. De Klerk TC, Dounavi DM, Hamilton DF, et al. Effects of home-based prehabilitation on pre- and postoperative outcomes following total hip and knee arthroplasty. Bone Jt Open. 2023;4(5):315-328.
  15. Zhang W, et al. Prehabilitation is effective in relieving pain after knee arthroplasty, but has little effect on length of stay and knee function: a meta-analysis of randomized controlled trials. Front Med (Lausanne). 2025;12:1457407.
  16. Alentorn-Geli E, Samuelsson K, Musahl V, et al. The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47(6):373-390.
  17. Lo GH, Musa SM, Driban JB, et al. Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol. 2018;37(9):2497-2504.
  18. Messier SP, et al. Effect of high-intensity strength training on knee pain and knee joint compressive forces among adults with knee osteoarthritis: the START randomized clinical trial. JAMA. 2021;325(7):646-657.
  19. Deyle GD, Allen CS, Allison SC, et al. Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. N Engl J Med. 2020;382(15):1420-1429.

This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.