Exercise6 min read
Exercise in knee osteoarthritis: what and how much
Wariness of exercise is common in knee osteoarthritis, with many patients believing movement will wear the joint further. The evidence shows the opposite: regular exercise reduces pain and supports joint health.
Strengthening
Quadriceps strengthening is central. Straight-leg raises and seated knee extensions are usually tolerated even when pain is prominent.
Hip strengthening is often skipped but directly reduces load on the knee. Side-lying leg raises and bridges are the core exercises.
Load is increased progressively. Two or three sessions a week with sets of eight to twelve repetitions is a suitable start for most patients.
Aerobic work and range of motion
Walking, a stationary bike and pool work support joint nutrition. 150 minutes of moderate activity a week is the general target.
On a stationary bike, raise the saddle and keep resistance low. With those settings it is usually well tolerated even when pain is prominent.
Full knee flexion and extension must be preserved. Loss of range disturbs gait and loads other joints too.
Managing the pain threshold
Pain not exceeding five out of ten during exercise is acceptable. Expecting pain-free work here needlessly limits the programme.
The decisive criterion is the next day. If pain returns to normal by the next morning the load is appropriate; if it remains elevated, reduce it.
During flare-ups the programme is eased rather than abandoned. Load and repetitions are reduced while range-of-motion work continues.
Key points
- Regular exercise does not wear the joint; it reduces pain.
- Hip strengthening is often skipped but reduces knee load.
- On a bike, raise the saddle and lower the resistance.
- Pain up to five out of ten during exercise is acceptable.
- During a flare the programme is eased, not abandoned.
Frequently asked questions
Can I squat?
Yes, within the pain-free range. Shallow controlled squats are preferred over deep ones, with range widened as strength develops.
Can I run?
There is no evidence that regular running worsens knee osteoarthritis. If pain is tolerable and distance is increased gradually, running can continue.
Should I avoid stairs?
Complete avoidance is unnecessary and lowers capacity. During painful periods, use the handrail and take each step in two movements.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.