© 2019 OA Knee Pain. All Rights Reserved.

Osteoarthritis in the knees is a debilitating condition. Not only can it be extremely painful, but it reduces mobility and makes exercise seem much more difficult. When you're diagnosed with this condition any form of workout can seem like a distant, unrealistic proposition, but exercise is actually one of the best ways to slow the condition’s progression. It can seem daunting to begin with, but rest assured that there are plenty of physiotherapy exercises for knee osteoarthritis which are completely safe, pain free and will help with the condition.

You’ll find that exercise forms a positive cycle. The more knee OA exercises that you perform, the fitter and stronger you’ll become which, in turn, helps you do more exercise. It won’t cure the condition but it will certainly slow its progression.

Exercising with osteoarthritis in the knees is completely safe and, while there are some osteoarthritis exercises to avoid, there are many more that offer real, tangible benefits. Always remember to exercise at your own pace, gently, and without trying to push through pain barriers. Remember that the process is supposed to be gradual and the benefits long term. It’s also important to understand that exercise alone isn’t a cure-all solution and factors like diet and general lifestyle should also be considered.

With all that in mind, let’s take a look at some of the best knee OA exercises in a little more detail.

The five essential exercise areas

There are five specific areas to address, and working on these regularly (but gently!) can have a profound effect on your quality of life.

These areas are:

  • Flexibility and stretching
  • Aerobic exercises
  • Aqua aerobics
  • Walking
  • Muscle strengthening

Regularly focussing in on these areas can help maintain and improve movement while also decreasing the pain and swelling associated with osteoarthritis.

Flexibility and stretching

These are sometimes known as range of motion exercises. They're fairly simple to perform and can be scaled up and down depending on your level and progress. Knee flexibility is usually associated with the stretching and bending of the knee itself, but these exercises also work on its connection to the hip and ankle. This plays a crucial role in knee health and it’s why these are some of the best physiotherapy exercises for knee osteoarthritis, so we recommend giving them a try today.

The crux of these exercises is the movement of the feet and hips in smooth circular motions. We recommend that you perform them every day to reap the full rewards, but there’s no need to over push if this is your first foray into exercising with osteoarthritis. Safe, gradual progression is the aim of the game.

Frontside thigh stretch

This exercise is designed to boost your flexibility and range of motion and it involves stretching out your thigh. You can do this exercise standing up (as shown in the video) or lying down, as outlined below. If you want to scale the workout up a little, you can include a resistance band.

  • Original position: On the side, with your lower leg at a 90° angle to your hip and knee joint. The upper leg is stretched.
  • Flex your lower leg to the back and pull with your hand or an arm elongation (e.g. towel) until you feel a nice stretch on the frontside of your thigh.
  • Keep this position for approximately five minutes, then relax.
  • Repeat 5-10 times.

Backside thigh

Original position: Dorsal, hip angle is 90°. To support the position of the thigh use your hands or an arm extension like a towel or a gymnastics band.

  • Extend the flexed leg until you feel a distinct but not painful stretch on the backside of your thigh.
  • Keep this position for approximately five seconds and retreat slowly to the original position.
  • Repeat 5-10 times.

Knee strengthening exercises for osteoarthritis like these are easy on the body, shouldn’t be painful to perform and over time will increase flexibility. It’s important to take these exercises at your own pace. You’ll be able to feel a stretching sensation on your thigh with both exercises, so it’s up to the individual to determine how much stretch is enough without causing discomfort.

Exercise Playlists

If you’re searching for a slightly lengthier programme of exercise with some added variety, we recommend that you check out this playlist from Össur Academy. It’s somewhat more advanced than the knee OA exercises offered here, so it’s great if you’re looking to scale things up. Many of the stretching and muscle strengthening exercises on the playlist use a variety of apparatus including chairs and exercise balls, so they're great if you want to mix things up a little.

Check out this playlist from Össur Academy which offers a range of stretching and muscle strengthening exercises using a variety of apparatus.

Aerobic exercises

As well as its many well publicised health benefits, aerobic exercise is absolutely essential for those suffering from arthritis. It’s widely considered the best exercise for osteoarthritis because it helps to slowly increase conditioning. This means less fatigue and more stamina, allowing you to partake in more exercise. That, of course, reduces the likelihood of weight gain, which can have a detrimental effect on already swollen and painful knees.

Better still, aerobic exercise releases endorphins and a host of other mood boosting hormones. Not only will these make you feel better during the day, but they’ll help you sleep better at night. As we all know, a well rested body is a healthy body, especially if you’re suffering from osteoarthritis.

Aqua aerobics

Any form of aerobic exercise will be hugely beneficial, but aqua aerobics is one of the best physiotherapy exercises for knee osteoarthritis. This is because the water supports some of your body weight, which means that there’s far less strain on your joints. It’s difficult to overstate how much of a difference this makes, and how important it is to those suffering from painful joints. As the pressure on those joints is reduced, you’ll find that you can suddenly move in ways which were previously too painful. This opens up a whole range of new exercise opportunities and allows you to straighten out your joints without pain. Aqua aerobics is a full body workout which also benefits the hips and lower back.

These classes are extremely simple and safe. An instructor will stand at the side of the pool and lead the class, usually with a musical accompaniment. You’ll be submerged up to your chest in water, and all you have to do is copy the instructor’s movements! It’s a fantastically simple way to exercise pain free using water for added support.

Walking

Walking is another exercise that’s fantastic for overall health and conditioning. Something as simple as walking a short distance every day improves circulation, decreases your risk of heart disease, lowers blood pressure and strengthens the heart and respiratory system. Unfortunately, walking can be a challenge with osteoarthritis knee pain, which has a detrimental effect on the motion and flexibility of the affected joint.

The key is to start off slow and small. Walking is a great exercise because it’s so easy to scale. The more you walk, the more endurance you build up, and it becomes easier to lengthen your next exercise. Before you know it, you’ll be able to cover much longer distances.

Walking is certainly the best exercise for osteoarthritis, but there is a caveat. If you’re walking with osteoarthritis of the knee (or any other medical condition), we recommend walking with somebody else, or at the very least letting someone know you’re going, and what time you plan to get back. If you have weak limbs as a result of your condition, you may wish to consider the use of a medical support or an appropriate brace until your stability returns.

There are plenty of ways to get into walking. Walk 4 Life will point you in the direction of local walks, or you might consider joining a walking group or even taking on a challenge!

Muscle strengthening exercises

Osteoarthritis presents a unique problem. Stronger muscles are the key to supporting painful joints (the stronger the muscle around the joint, the less pressure on the joint itself), but it’s difficult to strengthen muscles around a painful joint. This paradox can make osteoarthritis seem daunting and limiting but there are plenty of safe, pain free ways to increase muscle strength and relieve pressure on the joint itself.

Bridging

Bridging is a closed chain weight-bearing exercise which works to increase the muscular strength of the hip extenders and promotes overall stability.

It is often prescribed for patients with back pain, and increases the activities of core stabilisation muscles such as the internal oblique, external oblique and erector spinae muscles.

  • Original position: Dorsal position with legs bent at 90°. Ankles and knee joints are hip-width apart.
  • Arms are positioned next to the body.
  • Build-up tension by increasing pressure under your feet.
  • Increase tension until your behind is lifted up.
  • Lift your pelvis 10-20 times so that your upper body builds a straight line with your thighs.

Take care to keep the distance between your ankles/knee joints at hip width.

We might consider this a 'foundational' exercise. By increasing overall stability you’ll find that pressure on your knees becomes less, and you’re more capable of taking on other forms of exercise.

Skier seat

This is another exercise designed to enhance core stability and counteract any instability in the knee joint. It’s recommended for those suffering from osteoarthritis or who are ACL (Anterior Cruciate Ligament).

  • Original position: Stand with your back to the wall (we recommend choosing a smooth surface so you can slide up and down more easily) Slide down with your back to the wall until your thighs only have a light downward slope.
  • Your feet should be at some distance to the wall so you can place them directly under your bent knees.
  • Hold this position for a maximum of 20 seconds and repeat 5 times.

Don't slide further down than putting your thighs parallel to the floor.

Leg raise

A straight leg raise is used as part of your rehabilitation from knee, hip and thigh injuries. It’s a great way to rebuild confidence in your body and increase motion, and it helps develop the quads and abdominal muscles too.

  • Original position: Dorsal, with the gymnastic band wrapped around the toes and attached with the hand to the floor on the same side.
  • The leg is raised up straight with a slight orientation to the inside and released carefully back to the original position.
  • Repeat 10-20 times per side.

What next?

Sign up to the OA Knee Pain newsletter