Why Surgery Isn’t Always the Answer for Knee Pain After 50

Contributed by Taruna Rijhwani, Health Watchers PT

As a movement specialist working with adults over 50, I’ve seen more and more patients walk into my clinic convinced they’re on an inevitable path to knee surgery. They’ve been told their MRIs show arthritis or “bone-on-bone” changes, and naturally, they assume replacement is the only option.

That’s not always true. In fact, fewer than 5% of the active adults I see with these MRI findings actually require surgery. The other 95% need a completely different approach, one that addresses mobility, strength, flexibility, and lifestyle. And more often than not, it works.

Understanding What’s Really Going On

Most of the adults I work with—typically in the 50+ or 65+ age groups—come in because their knees feel stiff, painful, and unreliable. Walking long distances, climbing stairs, getting off the floor, or hiking trails they once loved begins to feel difficult or even risky.

These concerns are real. But the problem isn’t always the joint itself. More often, it’s tightness in the soft tissues and joint capsule, which limits how well the knee can move and function. When mobility is restricted, the rest of the body compensates, creating more pain, instability, and even fear of falling.

That’s why the first step is restoring full range of motion in the knee joint—making sure it bends and extends properly during walking, stairs, and other weight-bearing activities. Once that motion returns, pain often decreases and function improves dramatically.

Using Regenerative Therapies

At our clinic, we also use a cutting-edge modality called shockwave therapy, sometimes referred to as regenerative or extracorporeal wave therapy. This treatment delivers targeted pulses that stimulate your body’s natural healing mechanisms, promoting repair of cartilage and surrounding soft tissues. Combined with mobility work, patients often notice measurable improvements in both pain and function within weeks.

Why Strength Alone Isn’t Enough

You’ve probably heard that strength training is key for joint health—and it is. But how you activate your muscles matters just as much as building strength.

I often see patients who walk daily, go to the gym, or take fitness classes yet still struggle with knee pain. The issue? They’re not engaging the right muscles at the right time. Weak core muscles, inactive glutes, and underutilized quads and hamstrings force the knee joint to absorb more stress than it should.

We retrain movement patterns so muscles fire in the correct sequence. Whether you’re climbing stairs or hiking trails, properly activating your core, glutes, quads, and hamstrings can dramatically reduce strain on the knees.

Treating the Whole Person

For many patients—especially women during or after menopause—knee health is about more than joints and muscles. Hormonal changes, bone density loss (osteopenia or osteoporosis), nutrition, and sleep all affect pain, healing, and mobility.

That’s why we take a whole-person approach. We assess protein intake, recovery habits, and overall wellness. Often, small adjustments in these areas accelerate healing and build resilience far more than any single treatment on its own.

Final Thoughts

Knee surgery can be life-changing for the right person, but it’s not the default solution for everyone. Before considering invasive procedures, I encourage anyone with knee pain to explore a comprehensive, non-surgical approach. By focusing on mobility, proper muscle activation, flexibility, alignment, and whole-body health, we help patients move better, feel better, and return to the activities they love—confidently and pain-free.

Want More Help?

If you’d like to learn more about knee joint issues and non-invasive ways to improve mobility, join us for our upcoming workshop: “Move Freely Again: Practical Strategies for Lasting Knee Support” at 10 a.m. Saturday, Nov. 1.

If you can’t attend, call or text us at 571-308-8252 to apply for a Complimentary Discovery Visit.