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Why Walking Is Good for Knee Arthritis, According to Physical Therapists

Explore the benefits of walking as a treatment for knee arthritis and get access to physical therapist-approved exercises to alleviate knee pain.

Published Date: Feb 2, 2024
Two-black-women-walking-for-exercise-in-the-morning-is-walking-good-for-arthritis-in-the-knee

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 arthritis can pose challenges, there are many ways to manage your symptoms and reduce pain flares. One prime example: walking. 

“Motion is lotion for knee osteoarthritis,” says Heather Broach, PT, DPT, a physical therapist at Hinge Health. “While it may hurt a bit initially, the more you walk, the stronger your legs will get — and the more control you’ll have 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 more about the benefits of walking for knee arthritis. 

Our Hinge Health Experts

Dr. Heather Broach, PT, DPT
Physical Therapist
Dr. Broach is a Hinge Health physical therapist who enjoys treating shoulder, low back, knee, and ankle issues.
Jonathan Lee, MD, MBA
Orthopedic Surgeon and Medical Reviewer
Dr. Lee is a board-certified orthopedic surgeon and an Associate Medical Director at Hinge Health.
Dylan Peterson, PT, DPT
Physical Therapist and Clinical Reviewer
Dr. Peterson is a Hinge Health physical therapist who focuses on developing clinical exercise therapy programs and member education.

Benefits of 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! Walking is always a great treatment option for knee arthritis, but it can be especially good if you’re having a pain flare. Walking is gentle enough for times when your joints are feeling sensitive, and simultaneously a terrific way to strengthen the structures in and around your knees to make them more resilient to pain. 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 knees,” 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. 

Reasons for Knee Pain While Walking 

You might be wondering if the benefits of walking for knee arthritis hold true if walking causes you pain or discomfort. Again, the answer is a resounding yes. 

Sometimes, activity contributes to knee pain because of things like increased friction in the knee joint, less shock absorption due to less cartilage, joint inflammation, or muscle weaknesses or imbalances. These are all factors that can contribute to making your knees more sensitive to pain. But here’s the thing to remember: What helps you manage pain long term is not always the same as what helps you hurt less right now, explains Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. 

“For example, if your knee is really bothering you, a massage may help calm down that pain response, but it’s not going to make your knee healthier, stronger, or more resilient. Walking, on the other hand, makes knees healthier, stronger, and more resilient next week, even if it causes a short-term increase in pain right now,” says Dr. Peterson. 

Recovery often needs to focus on both short-term and long-term solutions to balance how you can calm pain down right now while still building healthier, stronger knees for the future. But pain with activity is not always a great guide on whether it is helping you in the long run.

Tips for Walking When Dealing with Knee Pain

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. a 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. See below for stretches recommended by Hinge Health physical therapists. 

  • Go by time — not distance. When you have arthritis, it’s important to try and find your movement sweet spot. “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 starting 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.

Stretches to Help Knee Pain When Walking

Since your adductor muscles attach your pelvis to your knees, tight adductors can throw 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. 

Above are a few gentle stretches recommended by Hinge Health physical therapists. They can be done before, after, or during a walk to help prevent and alleviate knee pain. 

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.

Treating Arthritis in the Knee

Along with walking, there are other simple treatments that can help you manage arthritis in the knee so you can stay active, such as: 

  • 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. 

  • 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 may only take 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 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. 

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Heather Broach, PT, DPT
If I could take all of my patients with knee arthritis back in time, I’d have them start physical therapy the moment they first felt that little twinge of pain in their knee.

“The sooner you can address the symptoms and start strengthening the structures in and around the knee, the better.” One reason why exercise 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 telling them to 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 consider 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 12 weeks reported reduced pain and improved quality of life. “These activities not only stretch and strengthen knee muscles, they also help lower stress, which can worsen pain,” points out Dr. Broach.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

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.

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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