The Best (and Worst) Exercises for Knee Osteoarthritis

Exercise is one of the best therapies for knee osteoarthritis, but the wrong exercises can do more harm than good.

group exercise outdoors

Medically reviewed in March 2021

Did you know that regular exercise is one of the best things you can do to relieve the pain and stiffness of knee osteoarthritis? If you have difficulty with daily activities, such as getting out of a chair or walking, exercise can help. In fact, exercise is one of the core components of treatment for osteoarthritis, along with medications and other lifestyle changes.

Poor strength in the muscles around the knee joint is understood to be a risk factor for knee osteoarthritis and subsequent disability, particularly in women. So is being overweight or obese, which puts extra stress on the joints. Regular exercise can help you lose weight and strengthens those important muscles so that joints can more effectively absorb stress. Exercise also helps reduce your risk of injury from falls.

According to the U.S. Centers for Disease Control and Prevention (CDC), exercise can reduce pain and improve symptoms for people with osteoarthritis by as much as 40 percent.

Components of a good exercise routine

There are three basic parts of a well-rounded exercise program: aerobic activity, strength training and flexibility.

Aerobic activity—such as walking, biking, swimming or using an elliptical trainer—strengthens your heart, improves your lung capacity and builds stamina. Stretching exercises and resistance training—with free weights, machines or through activities such as yoga and Tai Chi—also help the knee joint function more smoothly, allowing it to move through a greater range of motion. These exercises also improve your flexibility.

How much exercise do you need?

The US Department of Health and Human Services (DHHS) recommends adults get at least 150 minutes of moderate intensity aerobic activity (or 75 minutes of vigorous activity) each week. Getting closer to 300 minutes of week of moderate exercise or 150 minutes of more strenuous activity is even better. The more exercise your get, the greater the health benefits. If these numbers seem intimidating, remember that any amount of exercise is better than none. Short bouts of physical activity—even just a two-minute walk—count toward your weekly goal. If going to the gym or using a treadmill aren’t for you, dancing, gardening, climbing stairs and other low-impact activities all count as exercise that will help lower your risk of chronic health issues, like heart disease and diabetes.

The DHHS also recommends adults do muscle-strengthening activities at least two days per week. Older people should also add balance training to their weekly aerobic and muscle-strengthening activities to help reduce their risk for falls and fall-related injuries.

Even if you’ve had a sedentary lifestyle, you may be able to do more exercise than you think. The minimum amount of exercise you need to improve your osteoarthritis and prevent disability is walking at least 6,000 steps a day. The good news: According to the American College of Rheumatology, most everyone with knee osteoarthritis can already do this.

What are the best exercises for people with knee osteoarthritis?

Low impact aerobic activities provide the benefits you need without putting too much pressure or stress on your joints. Walking is an ideal activity for people with knee osteoarthritis because you can do it anywhere without special equipment or a gym membership. Swimming or other water exercises are also safe for people with knee osteoarthritis.

Tai Chi and yoga both incorporate slow, gentle movements and help enhance range of motion and flexibility. In a randomized trial published in July 2016 comparing Tai Chi to physical therapy, both were equally good at relieving knee pain and improving patients’ quality of life.

Leg raises are an effective way to build the muscles that support the knee. Lie on your back with your elbows supporting your upper body, one leg straight on the floor, the other leg bent with your foot on the floor. Slowly raise your straight leg into the air, hold the lift for a few seconds, then slowly return to the floor. Repeat 10 times, then switch legs.

You can also try mini-squats. With feet shoulder-width apart and a chair just behind you, slowly lower yourself toward a squatting position, stopping halfway to the chair before slowly rising back up to stand. In this move, it’s key to avoid squatting too low and to make sure your knees stay behind your toes throughout the entire move. Start with a set of 10 squats, then add sets as you build strength.

It’s also a good move to regularly stretch your quads and your hamstrings. Keeping those big muscles in the front and back of your upper leg limber can improve flexibility in the knee.

What are the worst exercises?

While mini-squats can be beneficial, you should avoid any exercise that requires kneeling or deep squatting motions, including lunges and full squats. These moves add more stress to already-weak knee joints and can actually raise your risk for knee disorders.

Remember to talk to your doctor before beginning an exercise program, particularly if knee pain is an issue for you. Your physician can help you determine what you can do to start, and how you can safely increase your activity level. The Arthritis Foundation website also has information about osteoarthritis-friendly exercises you can try at home.

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