If your knee-jerk reaction to developing knee arthritis is to think you should stop exercising, you’re not alone. Arthritis develops when the smooth, spongy cartilage that cushions your joints breaks down over time. Many people with knee arthritis worry that exercise will cause further changes to the joint that can contribute to — or worsen — the pain, stiffness, reduced mobility, and muscle weakness they may already be experiencing. 

But hang on a sec. “Overwhelmingly, exercise is going to be your friend and be the thing that helps you continue to move and have a good quality of life,” says Caitlin Shaw, PT, DPT, a physical therapist with Hinge Health. 

In fact, research suggests exercise can be effective as over-the-counter pain medication in managing symptoms of knee arthritis and improving knee function. 

Once you establish a regular exercise routine – including the PT-recommended exercises in this article – you’ll likely find it easier to get back to all the other activities you used to enjoy.

Here’s what you need to know about exercising with knee arthritis.

How Does Exercise Help Relieve Knee Arthritis Pain?

Exercise eases knee arthritis in a many ways, including:

• Strengthening muscles that support and protect your knee joint. Your quads, hamstrings, and hips act like shock absorbers for your knees.“Strengthening your muscles provides a support system around your joint that absorbs shock and stabilizes the joint during weight-bearing activities like standing and walking,” says Dr. Shaw. A stable, supported joint has less friction and natural changes that occur over time. 

• Stretching to improve muscle flexibility and reduce stiffness, so your knee can achieve improved range of motion. 

• Boosting joint health with a steady supply of nourishing blood and oxygen. “It pumps all of those great nutrients into your joints and cartilage to keep them as healthy as possible,” says Dr. Shaw. 

• Helping you maintain a healthy weight, which reduces pressure on your knee joints. Research shows that just losing one pound of weight results in a reduction of four pounds of pressure from the knees, according to a trial of overweight and obese adults with knee osteoarthritis. So dropping just a few pounds can make a big difference in how your weight-bearing joints feel, easing pain during activities like walking and using the stairs.

• Improving mood and reducing anxiety through the release of feel-good chemicals like endorphins. There’s a strong connection between depression and pain; chronic pain can cause depression, and depression can worsen physical pain.

• Enhancing sleep quality. “Many people with arthritis have trouble sleeping and exercise directly impacts your ability to get more restful sleep, which can reduce your sensitivity to pain,” says Dr. Shaw. 

Before You Start Exercising: Preparation Tips

Before starting an exercise routine, consider these tips to help protect your joints:

• Take time to warm up. “Warming up increases blood flow, which allows you to have more range of motion while doing your activities,” says Dr. Shaw. “This helps prevent injury and allows you to do the exercises better, so you may see improved results.” 

• Pace yourself and listen to your body’s signals. If you haven’t exercised in a while, start slowly and adjust the intensity of your activities in response to your body’s cues. If you do push yourself too hard, though — learn from it, and adjust how you pace yourself next time.

“There is a wide spectrum of exercises that can contribute to joint health, and physical therapy is super important to determine which exercises best fit you and to tailor a program to safely stay within your envelope of movement,” says Dr. Shaw. These gentle stretches and strengthening moves are a great starting point for someone with knee arthritis and can safely be performed by most people three to five times a week.

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.

Aerobic Exercises

Aerobic (aka cardio) exercise really gets the heart pumping and the benefits are wide-ranging: It improves heart and lung health, helps control weight, and boosts energy. 

The increase in circulation benefits your joints as well, which are exposed to a steady supply of nourishing oxygen and nutrients that can help keep them healthy, explains Dr. Shaw. For instance, aerobic exercise increases the circulation of synovial fluid, the thick liquid located in your joints that helps to lubricate it. This helps reduce pain that can occur with movement. Cardio also reinforces cartilage: It has no blood supply of its own and instead gets its nutrients from the same synovial fluid that lubricates your joints

The goal of aerobic exercise is to raise your heart rate, but you want to do what feels right for your body. Some ideas include:

• Walking. If you’re just starting to walk, be aware that a single session isn’t more beneficial than a few shorter ones. For instance, the benefits of three 10-minute walks or one 30-minute walk are similar. You don’t have to push yourself to the max to get fit either. Exercise at a pace at which breathing is harder than usual while still being able to talk. 

• Swimming. If you have knee arthritis and prefer water to land, swimming – which decreases the amount of stress placed on your knees – is a great option. According to one study, due to the buoyancy of the water, aquatic exercise (swimming, water walking, or pool exercises) has fewer side effects and better therapeutic effects – including reduced joint pain and stiffness and improved muscle strength and function – than land-based exercise. 

• Biking. Putting your pedal to the metal can help any type of arthritis, but particularly knee arthritis. 

PT Tip: Stay Hydrated

“Hydration helps lubricate your joints, which may result in less friction and knee pain,” says Dr. Shaw. That’s why people with joint conditions like knee arthritis often find that their condition worsens when they’re dehydrated. 

There’s no hard-and-fast rule for how much water you need to drink each day. A general recommendation is to aim to drink half your body weight in ounces of water each day. (That means a 150-pound person should sip 75 ounces daily.) You may need more or less depending on weather, your activity, medications, or medical conditions. Foods like fruits and veggies, and healthy beverages such as herbal tea, seltzer, and milk, also help you stay hydrated.

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.

References

1. Miller, R. (2018, December 19). Knee Exercises for Arthritis. Arthritis Health. https://www.arthritis-health.com/treatment/exercise/knee-exercises-arthritis

2. Zeng, C.-Y., Zhang, Z.-R., Tang, Z.-M., & Hua, F.-Z. (2021). Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Frontiers in Physiology, 12. doi:10.3389/fphys.2021.794062

3. Messier, S. P., Gutekunst, D. J., Davis, C., & DeVita, P. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism, 52(7), 2026–2032. doi:10.1002/art.21139

4. Lund, H., Weile, U., Christensen, R., Rostock, B., Downey, A., Bartels, E., Danneskiold-Samsøe, B., & Bliddal, H. (2008). A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. Journal of Rehabilitation Medicine, 40(2), 137–144. doi:10.2340/16501977-0134

5. The Best Exercises for Osteoarthritis (OA) of the Knee. (2021, October 15). Cleveland Clinic. https://health.clevelandclinic.org/osteoarthritis-knee-exercises-stretches/

6. Foran, J. R. H. (2021, December). Managing Arthritis Pain With Exercise. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/treatment/managing-arthritis-pain-with-exercise.