Knee pain after sitting (or driving)? Why it happens and what can help!
- Emma Glynn
- 6 days ago
- 5 min read
By Emma Glynn - Hip & Knee Physio
General information only; not personal medical advice.
That first “oof” step after a long sit has a name: start-up pain. It can be common after 45 and usually a load-tolerance issue, not a sign your knee is “worn out.” When you sit, your knee is bent, pressure shifts, and tissues can get a little irritable. Then you stand and ask for force quickly - hello, grumble.
Good news: with small changes to dose (how much, how hard, how fast) and a few strength exercises, most people settle this within weeks.
What’s actually going on
When the knee stays bent for long periods:
The knee cap joint (patellofemoral) can get sensitive, especially if the quads are under-conditioned.
The fat pad under the knee cap can be a bit irritated and grumpy in deeper bend.
Osteoarthritis (if present) often hates long stillness but likes sensible movement.
A long drive adds hip and lower-back stiffness that changes how your knee loads when you stand.
None of this screams “damage.” It says, “match the load to what I can handle today.”
Quick self-checks (green vs. red flags)
Green lights:
Ache or stiffness ≤4/10 that eases within 10–15 minutes of moving.
No swelling, no giving-way, and the next day feels same or better.
Book a review sooner if:
Night pain that won’t settle, or pain waking you most nights.
Locking/catching, repeated giving-way, or hot/red swelling.
Worsening pain week-to-week despite sensible tweaks.
The 7-day “after sitting” starter plan
The aim is not heroics, it’s calm, controlled progress that your knee tolerates now.
Day 1–2: Calm it down (but don’t stop moving)
Before standing, do a 60-second warm-up (see routine below).
Keep the first 10–20 steps slow, like “tiptoe past a sleeping baby” energy.
For driving >30–45 minutes: plan one brief stop to shake out.
Day 3–4: Control before capacity
Keep the routine, add 2–3 strength exercises (examples below).
If you use stairs early in the day, use the handrail and go slower down than up.
Day 5–7: Add a little, not a lot
Increase walking or stairs ~10–15% for the week (not per day).
Still prioritise smoothness over speed; discomfort should settle within 24–48 hours.
Your 60-second “stand-up” routine
Do this before you stand from the desk, couch, or driver’s seat:
Ankle pumps × 10 per side
Seated knee extensions (gentle) × 10 each
Sit-to-stand (tempo) × 5 — 3 seconds down, 1 up, hands light on the chair
If this flares symptoms, shorten reps or the range. Comfortably challenging is the target, not martyrdom.
Two strength exercises most days
These build tolerance so the joint stops complaining after sits. Start small, move well.
Sit-to-stand
From a chair, feet hip-width, knees over second toe.
3 seconds down, 1 up.
2–3 sets of 6–8 reps, breathing stays easy.
Wall sit (comfortable depth)
Slide down a little so thighs are not parallel yet.
Hold 15–30 seconds, 3–4 reps.
If it hurts, reduce depth/time; if it’s easy, add 5 seconds next session.
(Optional) Supported step-downs (low step)
Tap heel to floor lightly; keep the working knee tracking mid-foot.
2–3 × 6–8 each side.
Progression rule: If symptoms spike during or 24–48 h after, reduce the depth, reps, or sets. If it’s calm, add a little next time.
Friendlier sitting and driving (small tweaks that add up)
Desk:
Knees ~90°, not tucked under the chair.
Feet supported; don’t dangle.
Stand every 30–45 minutes for a slow lap.
Car:
Seat slightly more upright and a notch forward so you’re not in deep knee bend.
For longer drives, set a timer to pull over briefly and stretch your legs.
At home:
Swap low, soft couches for a firmer, slightly higher chair when symptoms are cranky.
Stairs and hills while you’re settling
Use the handrail without guilt. It’s not cheating; it’s control.
Down loads kneecap + quads more than up. Slow the descent, keep knees tracking over the second toe, and reduce total stairs for a week.
Hills are fine later. For now, favour flatter paths and add hills after symptoms calm.
Heat, ice, sleeves and other comfort tools
Heat can help stiffness; ice can soothe irritability. 10 minutes, thin towel, skin-safe.
A soft knee sleeve may feel good short-term on busier days, but it doesn’t replace strength.
Gadgets are optional. The main course is load + strength.
“Do I need a scan?”
Usually no to start. A good assessment → tailored loading/strength → review progress. Imaging is helpful when there are red flags, you’re not improving, or the result would change the plan.
What a first session looks like here
History & goals → movement assessment → starter plan you can do today (2–3 exercises matched to tolerance) → clear 2–4 week progression.
Ready for a plan you can start today?
First session includes assessment, load plan, and 2–3 safe starters.
Prefer to talk? Call (03) 9978 9833
FAQs
Is knee pain after sitting just ageing?
No. It’s common with age, but usually relates to tolerance vs. load and improves with the right plan.
Should I stop walking if it aches after a drive?
Usually no. Trim distance/pace for a week, add the warm-up and strength snacks, and rebuild.
How long until I notice change?
Varies, but many feel smoother first steps in 1–2 weeks with consistent tweaks. Strength builds over several weeks.
Will squats make it worse?
Not if you dose them. Start shallower, control the tempo, and progress range as symptoms allow.
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