If you’ve been active your whole life, it can be devastating to find yourself sidelined by pain related to knee arthritis. You may find that it’s harder to do activities that you’ve always loved, like running, hiking, biking, or even simply taking your grandkids to the park.

Arthritis isn’t the only cause of persistent knee pain, and a lot of people can achieve pain-free living in spite of an arthritis diagnosis. While it can be difficult to live with, conservative measures, including activity modifications and gentle movement, can go a long way in managing arthritis symptoms. 

There are a lot of different ways to stay active with arthritis. Here’s one that won’t worsen arthritis and will even make you feel better: It’s as simple as lacing up your sneakers and heading out for a walk. Whether it’s a power walk or a slow stroll, just moving will do you and your knees the world of good. 

“Motion is lotion for knee osteoarthritis,” says Heather Broach, PT, DPT, a physical therapist with Hinge Health. “While it may hurt initially, the more you walk, the stronger your legs will get — and the more control you’ll get over your knee osteoarthritis.” In fact, once you establish a walking routine, you’ll find it easier to get back to all the other activities you used to enjoy. Here’s what you should know about walking with knee arthritis.

3 Reasons to Start Walking for Knee Arthritis

“The question I get asked all the time is, ‘Is walking good for arthritis in the knee?’” says Dr. Broach. The answer: a resounding yes! In fact, people with knee osteoarthritis who walk for exercise are significantly less likely to go on to develop worse pain, according to a 2022 study published in Arthritis & Rheumatology. Here are a few reasons why: 

• Walking strengthens leg muscles. “It helps strengthen your quads, hamstrings and glutes, all of which provide support to your knee joints,” explains Dr. Broach. The stronger they are, the less pressure will be placed on your knee joint.

• Walking lubricates your joints. As you walk, the activity increases the circulation of synovial fluid, the thick liquid located between your joints that helps to lubricate it. This helps reduce pain that can occur with movement. 

• Walking protects cartilage. Research shows that exercise helps protect cartilage, the springy joint tissue that acts as a shock absorber for your knees. 

Tips for Walking When Dealing with Knee Pain

Your first instinct when you hear you have knee arthritis may be cut back on movement. It’s common to assume that if something hurts when you move it, you’re probably causing more damage. But we now know that arthritis can actually become worse with too much rest. The body responds really well to challenges. If you think about a muscle, it stays much healthier as you use it. The same is true with a joint.

Despite movement being the best medicine for knee arthritis, you may experience a temporary or occasional uptick in pain with more movement. While it can be challenging to nudge into pain, the following tips may help: 

Shorten your stride. “When patients with knee arthritis start to walk, I encourage them to begin with short strides which tend to irritate joints less,” says Dr. Broach. Over time, you’ll be able to work back to your normal stride length.

Find a surface that works for you. If the typical surface you walk on is really aggravating to your knees, you could consider looking for a new route (e.g. flatter route, or a route with more benches to take breaks) or a different surface to walk on. Indoor treadmills and outdoor tracks work well for many people, while others might find walking on the grass or the sidewalk to be their preference.

Ease into it. Before you begin your walk, Dr. Broach recommends doing a few warm-up moves, such as forward and backward leg swings or pelvic loops, to help loosen your limbs up and get blood flowing. It also helps to pause about 10 or 15 minutes into your workout to stretch. Here are a few stretches to try, recommended by Hinge Health physical therapists: 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Since your adductor muscles attach your pelvis to your knees, when they are tight, it throws your whole lower body off-kilter as it tries to compensate. “You want this area to be flexible enough so that you have a full range of motion while you walk to reduce pressure on your knees,” explains Dr. Broach. 

Go by time — not distance. “If you set a distance-based goal, you may end up taking on more than your knees are ready for,” says Dr. Broach. She recommends that you start with 10 to 15 minutes of walking at a pace that both you and your knees feel comfortable with. Then, increase your goal by a small amount every week — even five minutes can be highly effective. Once you feel confident, you can consider implementing a distance-based goal. 

Wear the right shoes. You don’t need a sneaker that has all the bells and whistles, like gel cushioning and special insoles. A simple walking shoe that is comfy is fine. “People should choose a shoe that feels like home — it shouldn’t feel like you need to break it in,” says Dr. Broach. A 2016 study published in the Annals of Internal Medicine found no difference in knee pain among people with knee osteoarthritis who used walking shoes specially designed to reduce knee pain versus regular garden variety walking shoes. 

Remember, it doesn’t matter where you walk or how far you go. “Sometimes, if people have very severe, painful knee arthritis, the best option is to start walking in a lap pool, which puts very little pressure on your knee joints,” says Dr. Broach. If that’s you, however, she recommends that you do see your doctor. They can give you a full examination and may recommend physical therapy so that you can begin to exercise on land, too.

Treating Arthritis in the Knee

One question Dr. Broach gets asked a lot: What else can I do to help arthritis in the knee? Along with walking, there are other things you can do to help manage arthritis in the knee so that you can stay active. Here’s how to treat arthritis in the knee: 

• Topical creams. Topical over-the-counter creams that contain a non-steroidal anti-inflammatory like diclofenac (e.g., Voltaren) have been shown to help relieve knee osteoarthritis pain to help people continue their walking routine. Topical NSAIDs may be safer than oral options. 

• Moist heat. “Knees with arthritis love warmth,” says Dr. Broach. She recommends keeping a heating pad or hot water bottle near you as much as possible. “It only takes 10 minutes of applying heat to help make you feel better,” she notes. In fact, research shows that people with knee arthritis who applied heat for 20 every other day for four weeks along with their regular care reported less pain than those who didn’t use heat. 

• Fuel your body with good food. People with knee osteoarthritis who eat a diet rich in fruits, veggies, whole grains, fish, and legumes report less pain and are less likely to experience worsening symptoms than people with poorer diets, according to a 2018 study published in the American Journal of Clinical Nutrition.

The Importance of Exercise Therapy for Knee Arthritis

There’s no doubt that walking is one of the best activities you can do to help with the symptoms of knee arthritis. But it’s also important to also incorporate resistance training exercises that strengthen knee muscles and increase mobility, such as squats, lunges, hamstring curls, or leg extensions. 

“The sooner you can address the symptoms and start strengthening the structures in and around the knee, the better,” says Dr. Broach. One reason why physical therapy is so helpful, she notes, is that your therapist can work with you to tweak exercises that you may be avoiding because of discomfort and make them less painful. “If a patient says a side lunge hurts, for example, I can give them a simple cue, like squeeze their butt muscle as they do the exercise,” she says. “This changes the whole exercise, so they still get the benefit of the movement but may be able to do it without pain.”

Other good options to include along with your walking workouts are either yoga or tai chi. A 2016 study published in the Annals of Internal Medicine found that people with knee osteoarthritis who practiced tai chi twice weekly for twelve weeks reported reduced pain and improved quality of life. Other research has found that a form of gentle yoga known as Iyengar yoga can help reduce pain and stiffness in people with knee osteoarthritis. “These activities not only stretch and strengthen knee muscles, they also help lower stress, which can worsen pain,” points out Dr. Broach.

Frequently Asked Questions

What’s a good exercise to help make it easier to walk with knee arthritis?

Squats! This can sound scary to someone with knee arthritis, but it’s actually a very functional and safe exercise, according to Dr. Broach. Squatting helps build strength in the structures in and around your knee, helping to increase the range of motion and create more joint stability. Over time, this helps reduce pain while walking. You can start with a mini squat — stopping about halfway down, instead of going into the full depth of a normal squat — if that feels better. Then progress to a full squat as you become more confident.  

While squats can be helpful, they are not for everyone. So if you have more advanced arthritis or you feel that squats are making your pain worse, you should stop the exercise and check with your healthcare provider. 

Indoor vs. outdoor walking: which is better for arthritis?

It’s not so much whether you are walking indoors or outdoors as much as the surface, says Dr. Broach. In general, if your symptoms are really severe, a pool is best, since water takes the most pressure off of joints. But after that, an indoor or outdoor track is a good bet, since it’s a soft, flat surface, says Dr. Broach. A treadmill is also a great way to build a walking routine since you can focus on walking time instead of walking distance. You can also take breaks as needed and adjust the incline to progress the challenge as you get stronger and more comfortable. If you find yourself walking on a surface that contributes to frequent pain flares, you can always scale back on the duration or intensity of your walks for a short time and gradually increase to give your body time to adapt.  

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Sheth, N. P. & Foran, J. R.H. (2023, February). Arthritis of the Knee. Ortho Info — American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-knee/

2. Lo, G. H., Vinod, S., Richard, M. J., Harkey, M. S., McAlindon, T. E., Kriska, A. M., Rockette‐Wagner, B., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kwoh, C. K., Nevitt, M. C., & Driban, J. B. (2022). Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals With Knee Osteoarthritis: Data From the Osteoarthritis Initiative Cohort. Arthritis & Rheumatology, 74(10), 1660-1667. doi:10.1002/art.42241

3. Bricca, A. (2018). Exercise does not “wear down my knee”: systematic reviews and meta-analyses. British Journal of Sports Medicine, 52(24), 1591–1592. doi:10.1136/bjsports-2018-099705

4. Hinman, R. S., Wrigley, T. V., Metcalf, B. R., Campbell, P. K., Paterson, K. L., Hunter, D. J., Kasza, J., Forbes, A., & Bennell, K. L. (2016). Unloading Shoes for Self-management of Knee Osteoarthritis. Annals of Internal Medicine, 165(6), 381. doi:10.7326/m16-0453

5. Messier, S. P., Resnik, A. E., Beavers, D. P., Mihalko, S. L., Miller, G. D., Nicklas, B. J., deVita, P., Hunter, D. J., Lyles, M. F., Eckstein, F., Guermazi, A., & Loeser, R. F. (2018). Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better? Arthritis Care & Research, 70(11), 1569–1575. doi:10.1002/acr.23608

6. Role of Body Weight in Osteoarthritis. (n.d.). Johns Hopkins Arthritis Center. https://www.hopkinsarthritis.org/patient-corner/disease-management/role-of-body-weight-in-osteoarthritis/#:~:text=Overweight%20women%20have%20nearly%204,or%20obesity%20and%20knee%20OA.

7. Yildirim, N., Filiz Ulusoy, M., & Bodur, H. (2010). The effect of heat application on pain, stiffness, physical function and quality of life in patients with knee osteoarthritis. Journal of Clinical Nursing, 19(7-8), 1113–1120. doi:10.1111/j.1365-2702.2009.03070.x

8. Xu, C., Marchand, N. E., Driban, J. B., McAlindon, T., Eaton, C. B., & Lu, B. (2020). Dietary Patterns and Progression of Knee Osteoarthritis: Data from the Osteoarthritis Initiative. The American Journal of Clinical Nutrition, 111(3), 667–676. doi:10.1093/ajcn/nqz333

9. Deveza, L. A. & Bennell, K. (2022, April 5). Management of Knee Osteoarthritis. UptoDate. https://www.uptodate.com/contents/management-of-knee-osteoarthritis 

10. Wang, C., Schmid, C. H., Iversen, M. D., Harvey, W. F., Fielding, R. A., Driban, J. B., Price, L. L., Wong, J. B., Reid, K. F., Rones, R., & McAlindon, T. (2016). Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial. Annals of Internal Medicine, 165(2), 77–86. doi:10.7326/M15-2143

11. Kolasinski, S. L., Garfinkel, M., Tsai, A. G., Matz, W., Van Dyke, A., & Schumacher, H. R. (2005). Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. Journal of Alternative and Complementary Medicine, 11(4), 689–693. doi:10.1089/acm.2005.11.689