Most people with knee arthritis will benefit from aerobic exercise, particularly low-impact aerobic exercise. An aerobic exercise program can be tailored to an individual, including his or her level of arthritis pain and fitness level.

See Knee Osteoarthritis Treatment

The greatest benefits occur when aerobic exercise becomes routine. It does not seem to matter if the exercise is done at a gym, alone at home, or in a class.

See Exercising with Arthritis

Aerobic Exercise for Mild to Moderate Knee Arthritis

Those with mild to moderate knee symptoms may consider walking, biking, swimming, and using an elliptical machine or other exercise machines at the gym.

  • Walking. Walking is fully weight-bearing but still low-impact enough for many people. Walking can be done outdoors or on a treadmill. People with knee arthritis are discouraged from adjusting the treadmill to an incline, which can change body mechanics and put more stress on the knee.
  • Biking. Biking outdoors, stationary biking, or spinning classes provide an aerobic workout without jarring the knees. To reduce strain on the knees, adjust the pedals so that the knees do not come up to an angle of greater than 90 degrees.
  • Swimming. Swimming is an excellent form of low-impact aerobic conditioning that is easy on the knees and other weight-bearing joints. Swimmers are encouraged to use proper form to reduce the chance of muscle strain; for example, people who do not use proper breathing techniques when swimming the freestyle (crawl) stroke may experience neck pain.
  • Using the elliptical machine. This exercise is ideal for many with knee arthritis, because it is a weight-bearing activity (which strengthens bones) but is not high impact on the knees (like jogging).

See Ways to Get Exercise When You Have Arthritis

Others may prefer golf, yoga, Pilates, or other exercise programs that include aerobic benefits. The duration and intensity of a workout can be varied to suit the needs of the individual.

See Tai Chi and Yoga for Arthritis

As a general rule, people should engage in a routine that they enjoy, because they will be more likely to stick with it.


Water Therapy for Advanced Knee Arthritis

People who have advanced knee osteoarthritis or who have knee arthritis and other joint problems may prefer water therapy (pool therapy) to land exercise or swimming. Water therapy provides the same health benefits as other aerobic exercise without placing pressure on the knees.

See Water Therapy for Osteoarthritis

Exercising while in the water provides:

  • Buoyancy, with the support of the water reducing pressure on the knee joints
  • Resistance, requiring muscles to work harder to move (e.g. walking in waist-deep water is more difficult than walking on land).

This combination of buoyancy and resistance is excellent for people with knee arthritis who need to engage in aerobic activity. Many local YMCAs and health clubs have pools and offer water exercise classes designed for people looking for a low-impact workout.


Workout Guidelines and Goals

It is best to gradually increase the intensity of the aerobic workout, ideally in concert with recommendations from a physician or other qualified health professional.

The goal is to incorporate low impact aerobic exercise into one’s daily routine. The US Department of Health and Human Services recommends a minimum of 150 minutes of moderate intensity aerobic activity each week, or 30 minutes 5 days per week. Individuals who can easily meet this goal can then increase the level of intensity of their workout.

Ron Miller is a licensed physical therapist with more than 20 years of experience specializing in spine care. He helped develop the physical therapy department at the NeuroSpine Center of Wisconsin, where he focuses on manual therapy, spinal stabilization, and therapeutic exercises.