Excessive stress on the knee is a major contributor to the onset of pain and arthritis. Improper posture and movement patterns of the foot, knee, and hip all contribute to excessive stress. Our primary strategy for helping those with knee pain and arthritis involves reducing these excessive stresses through the development of more efficient lower extremity movement and posture. This can be achieved with a tailored program of manual therapy, goal specific exercise, and education. Although the degenerative changes cannot be reversed, progression of osteoarthritis can be delayed and symptoms can greatly improve.