Knee Arthritis: Exercises That Help, and Ones to Avoid

If you have knee osteoarthritis, you may have been told your knee is "worn out" and you should rest it. The evidence says the opposite. Exercise is a first-line treatment for knee arthritis in major international guidelines, and for many people it meaningfully reduces pain and improves daily function.

Why exercise helps an arthritic knee

• Stronger thigh muscles absorb load that would otherwise go through the joint.
• Movement nourishes cartilage, which gets its nutrition from joint fluid moved in and out by loading.
• Better balance and control reduce awkward, painful movements.
• Weight control reduces force through the knee on every step.

Exercises that usually help

Start with 2 sets of 10 and build up gradually.

1. Straight leg raise: lying on your back, one knee bent, lift the straight leg to the height of the other knee. Lower slowly.
2. Sit-to-stand: stand up from a chair without using your hands, then sit down slowly. Use a higher chair if needed.
3. Inner range quads: lying with a rolled towel under the knee, straighten the knee fully by pressing the back of it into the towel and lifting the heel. Hold 5 seconds.
4. Step-ups: onto a low step, holding a rail. Increase the step height over weeks.
5. Bridges: lying on your back, knees bent, lift your hips. Strengthens the hips and buttocks, which also support the knee.
6. Calf raises: holding on to a counter, rise onto your toes and lower slowly.

Add regular walking, cycling or swimming for general fitness.

What to modify (not necessarily avoid)

• Deep squatting and sitting cross-legged on the floor can be painful for an arthritic knee. You don't need to avoid bending, but you may need to limit how deep and how long.
• Kneeling on hard floors: use a cushion.
• Running and jumping aren't banned for everyone, but build up slowly if your knee tolerates them.
• Long, steep stairs: use the rail and take them one at a time on bad days.

How much pain is OK?

A useful rule: mild pain during exercise is acceptable, around 3 to 4 out of 10. It should settle back to your usual level within 24 hours. If pain is worse the next day, reduce the amount, not stop altogether.

How long until it works?

Expect to exercise regularly for at least 6 to 8 weeks before judging the results. Strength takes time to build, and the benefits continue only while you keep exercising.

When to see us

If your knee is locking, giving way, very swollen, or you can't walk without significant pain, get it assessed. We can design a programme matched to your knee and your daily life.