Knee Pain in Farmers

 In this blog, I want to explain why knee pain is so common in farmers, what’s happening inside the knee, and most importantly what can be done to manage and prevent it.

Why Are Farmers So Prone to Knee Pain?

Farming is recognised worldwide as a high-risk occupation for musculoskeletal disorders, including knee pain and knee osteoarthritis. Research from Europe and Asia consistently shows that farmers experience higher rates of joint pain than non-farmers, even if they seek medical help less often.

Farming involves:

Prolonged standing and walking, often on uneven or muddy ground

Repeated squatting and kneeling (milking, lambing, fencing, machinery maintenance)

Lifting and carrying heavy loads, sometimes in awkward positions

Twisting movements while carrying weight

Long working days with little opportunity for rest or recovery

Over time, these stresses place repeated load through the knee joint.

What’s Actually Causing the Knee Pain?

Most long-term knee pain in farmers is not due to one single injury. Instead, it develops gradually.

Common causes I see include:

1. Knee Osteoarthritis

This is the most frequent diagnosis in older farmers. Years of weight-bearing work can contribute to:

Cartilage injury 

Joint stiffness

Swelling and aching pain, especially after activity

Studies consistently show that prolonged weight-bearing postures, such as standing and walking for long periods, significantly increase knee pain risk.

2. Overuse and Tendon Strain

Repeated squatting, kneeling, and lifting can irritate:

Patellar tendon

Quadriceps tendon

Surrounding soft tissues

This often causes pain at the front of the knee or around the kneecap.

3. Reduced Muscle Support

Strong thigh and hip muscles protect the knee. With age, pain, or reduced exercise, these muscles weaken meaning the knee joint takes more strain during daily farm tasks.

Why Farmers Often Delay Treatment

One of the biggest challenges I see in rural practice is delayed help-seeking.

Farmers often:

Self-manage pain for years

Continue working through discomfort

Seek help only when pain becomes severe

International research shows farmers have high pain levels but low healthcare use, often due to:

Time pressures

Distance to services

A culture of independence

Concern about taking time off work

Unfortunately, delaying treatment often allows pain and stiffness to worsen.

What Can Be Done? A Physiotherapist’s Practical Advice

The good news is that knee pain can be managed effectively, even if you continue farming.

1. Movement Is Medicine (Not Rest Alone)

Many people think painful knees should be rested. In reality, the right controlled pain free movement protects the knee.

I encourage physio supervised physical activities:

Regular walking at a comfortable pace

Gentle cycling or static bike use

Avoiding long periods of complete inactivity

Staying active helps keep cartilage healthy and reduces stiffness.

2. Strengthen the Muscles That Support the Knee

Strong muscles reduce joint load. Key areas include:

Quadriceps (front of thigh)

Hamstrings (back of thigh)

Gluteal muscles (hips and buttocks)

Simple exercises 

These can be done at home or in the farmyard with minimal equipment.

3. Modify How You Work (Not Stop Working)

Small changes can make a big difference:

Use kneeling pads or raised stools where possible

Alternate tasks to avoid prolonged squatting or standing

Break long jobs into shorter periods

Use mechanical aids for lifting when available

This is about reducing cumulative load, not avoiding work altogether.

4. Manage Pain Early

Pain relief can support movement and exercise:

Heat or cold packs

Simple analgesia (as advised by a GP or pharmacist)

Ignoring pain often leads to altered movement patterns, which increases strain elsewhere.

5. Seek Physiotherapy Early

Physiotherapy is not just for severe cases. Early input can:

Identify movement habits that overload the knee

Provide tailored strengthening programmes

Reduce the risk of long-term disability

In rural areas like the Scottish Borders, community and outpatient physiotherapy services are available and increasingly focused on keeping people working safely.

A Final Message to Farmers

Knee pain is not a personal failure, and it is not “just part of getting older.” It is often the result of years of physically demanding, essential work.

With the right education, exercise, and early management:

Pain can be reduced

Function can be maintained

Quality of life can improve

As a physiotherapist, my goal is not to stop you farming but to help you farm for longer, with less pain and more confidence.

If your knees are limiting your work or daily life, don’t wait until it becomes unbearable. Early support can make all the difference.

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