People living with knee arthritis pain may feel like exercise is the last thing they want to do or even should do. However, most people with knee osteoarthritis can benefit from regular exercise. In fact, research suggests regular exercise can be as effective as acetaminophen or NSAIDs in reducing knee arthritis pain.1

Squats are an example of an exercise for knee strengthening.

If done regularly, almost any knee exercise programs will result in improvements in knee pain and function.1 This article discusses the benefits of knee exercise and provides specific stretching, strength training, and aerobic exercises to get people started.

Learn more about Knee Osteoarthritis Treatment

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Benefits of Knee Exercises

Strong muscles support the knee joint and help maintain healthy joint space between the bones. Without exercise, the muscles become weak and joint space is reduced, increasing joint friction and worsening knee arthritis.

Exercise can provide multiple benefits to people who have or are at risk of knee arthritis, including:

Pain reduction. Exercise strengthens muscles, and stronger muscles can better support joints. By strengthening the quadriceps, hamstrings, and other muscles surrounding the knee, the knee becomes more stable and bones experience less impact during weight bearing, which in turn reduces pain. Exercise also releases endorphins, the body’s natural painkillers.

Studies show that people who participate in land-based exercise and/or strength training routines rate their knee pain 10 to 15% lower than people who do not exercise.2 This reduction can make the difference between needing pain medication or not.

Increased range of motion and function.Pain can discourage a person from being active, which can lead to joint stiffness and muscle weakness, which can lead to even more pain. Regular exercise will help keep the knee joint and surrounding muscles remain limber, thereby increasing knee function.

With exercise, knee function can improve by approximately 10%2—this means people who exercise can see tangible improvements, such as bending the knee further, getting out of a chair more easily, and walking longer distances.

Healthier cartilage. The joint cartilage needs motion and a certain amount of weight-bearing stress to stay healthy. Synovial fluid is stored in cartilage like water in a sponge. When the joint is used, the cartilage is squeezed and synovial fluid is released from the cartilage, delivering nutrients and lubrication to the rest of the joint.

See What Is Cartilage?

Synovial fluid is also thought to encourage a healing environment for the joint, thereby reducing inflammation and supporting healthy joint function.

Weight loss. Exercise combined with a nutritious, plant-based diet can help shed pounds, thereby putting less pressure on the knee joint. The effect of weight loss has an amplified benefit: losing 10 pounds translates into 30 fewer pounds of pressure exerted on the knee with each step.3-4

See How Effective is Weight Loss for Treating Knee Arthritis Pain?

Preparing for Knee Exercises

Health care providers advise a warm up before exercise and a cool down after exercise.

Warm up: Exercise should typically be preceded by a 10-minute warm-up activity. A warm-up increases blood flow and literally warms up the body, making muscles more flexible. A good warm-up is a walk or other slow-paced aerobic activity. For those with more severe arthritis, a warm compress and gentle range-of-motion activities might be sufficient.

Post workout: Immediately after a workout, the knees may feel swollen and achy, but steps can be taken to reduce swelling and relieve discomfort. Some people elevate the knees or ice the knees with a cold compress (a bag of frozen peas will do). Over-the counter NSAID medication, such as ibuprofen or naproxen, may be used occasionally—just keep in mind that regular long-term use can lead to stomach problems, particularly in older adults.

Read more: How to Care for a Swollen Knee

If pain is felt during knee exercises, stop and seek advice from a healthcare professional or an appropriately qualified athletic trainer before continuing.

References:

  1. Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research pubished through January 2009. Osteoarthritis Cartilage. 2010;18(4):476-499. As cited in Cohen, Donna, Crochrane for Clinicians, Putting Evidence into Practice: Exercise for Osteoarthritis of the Knee. Am Fam Physician. 2015 Nov 1;92(9):774-775.
  2. Fransen M, Mcconnell S, Harmer AR, Van der esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:CD004376.
  3. D’Lima DD, Fregly BJ, Patil S, Steklov N, Colwell CW. Knee joint forces: prediction, measurement, and significance. Proceedings of the Institution of Mechanical Engineers Part H, Journal of Engineering in Medicine. 2012;226(2):95-102.
  4. Messier SP, Gutekunst DJ, Davis C, Devita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026-32
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