Claims for the arrival of a new paradigm in river management argue that substantial progress has been made away from top-down, reach-scale engineering towards catchment-scale planning, community participation, ecosystem science and adaptive management. Implementing these new principles is widely seen as essential in reversing damage to river systems and in promoting sustainable management. However, the appraisal of a shift in river management is far from straightforward across the range of biophysical and social contexts involved. Literature from the philosophy and sociology of science suggests that such transitions are usually patchy and uneven. In particular, a paradigm shift requires recognition and integration of three levels of knowledge: technical, scientific and what Aristotle referred to as ‘phronesis’– contextualised and place-based wisdom built on experience and incorporation of cultural values. The application of these forms of knowledge to river management is considered by reference to recent reviews and case studies from Europe, North America and Australasia. The conclusion is that integration is still proving elusive. Claims for a wholesale paradigm shift in river management must therefore be treated with considerable caution.