Knee osteoarthritis is a chronic degenerative disorder characterized by the progressive breakdown of articular cartilage, resulting in pain, stiffness, and reduced functional ability. It is one of the most common musculoskeletal conditions affecting the elderly population, particularly individuals above sixty years of age. The condition significantly affects daily activities such as walking, climbing stairs, and squatting. Various factors such as aging, obesity, genetics, trauma, and biomechanical alterations contribute to the development and progression of knee osteoarthritis. Globally, knee osteoarthritis is a major contributor to disability and reduced quality of life. In rural South India, the prevalence is reported to be relatively high, highlighting the need for effective rehabilitation strategies.

The aim of this study is to determine the effect of calf muscle stretching and resistance training on pain and functional outcomes in individuals with knee osteoarthritis. The calf muscles, especially the gastrocnemius, cross the knee joint and play an important role in maintaining knee stability and biomechanics. Weakness or tightness of these muscles may negatively influence knee joint function and contribute to increased pain and functional limitation. Despite their importance, limited research has focused on the role of calf muscle stretching and strengthening in the management of knee osteoarthritis.

This study adopts a quasi experimental design with a pre and post assessment approach. A total of sixty participants aged forty to sixty five years with clinically diagnosed knee osteoarthritis will be selected using purposive sampling from SRM Medical College Hospital and Research Centre. Participants will be divided into experimental and control groups. The experimental group will receive conventional physiotherapy exercises along with calf muscle stretching and strengthening, while the control group will receive only conventional physiotherapy exercises. The intervention will be conducted for six weeks.

Outcome measures include the Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale for pain, and ankle dorsiflexion flexibility measured using a goniometer. The findings of this study may help improve rehabilitation protocols and provide evidence based guidance for physiotherapists in managing knee osteoarthritis.