One of the biggest shifts in my career as a physio was changing how I interpret knee pain flare-ups.
I used to see every flare-up through the classic wear-and-tear lens.
Pain after running? Must be damage.
Pain still there 24 hours later? Something must be seriously wrong.
But learning more about load management and capacity — especially through the work of Tim Gabbett and A. D. Craig — completely changed my thinking.
Now I see most flare-ups less as “damage” and more as feedback.
Usually it’s a sign the load temporarily exceeded the body’s current capacity.
That doesn’t mean ignore it. It means listen to it properly.
And instead of catastrophising (which I’m definitely prone to 😅), we look at what the knee does over the next 24 hours.
✅ Did it settle reasonably well? ✅ Was the morning stiffness manageable? ✅ Did it return close to baseline by the next day?
That gives us useful information.
Because the goal isn’t to protect the knee from all stress forever. The goal is to gradually build a body that can tolerate and recover from stress better.
The body is incredibly adaptive. That’s the hopeful part.
This way of thinking has become a huge part of what I’m building with Project Knee 2026 🏃♂️ — helping people with persistent knee pain stop fearing every flare-up and start rebuilding real confidence, capacity and resilience again.