Knee osteoarthritis does not mean you have to stop moving. If your knee feels stiff after sitting, aches on the stairs or makes walking less comfortable, the right exercise plan can help you build strength and stay active. It may feel daunting to start when the joint already hurts, so the key is to begin at a manageable level and progress gradually.
What is knee osteoarthritis?
Osteoarthritis is a common joint condition that can cause pain, stiffness and changes in how a knee moves. Symptoms can vary from day to day. An X-ray alone does not tell the whole story of how much pain someone feels or what they can do. Persistent symptoms deserve an assessment to confirm the likely cause and discuss the best plan.
What are the best exercises for knee osteoarthritis?
NICE recommends therapeutic exercise tailored to the person, including local muscle strengthening and general aerobic fitness. A useful programme often combines the following:
1. Strength exercises
Strengthening the muscles around the knee and hip can make everyday activities easier. Depending on your starting point, a physiotherapist might use sit-to-stands from a sturdy chair, supported mini squats, step-ups or leg extensions. Begin with a range and effort you can manage, then build gradually.
2. Gentle movement
Bending and straightening the knee regularly can help you maintain comfortable movement. Simple seated knee bends or knee extensions can be a starting point, especially on a stiff day. The goal is steady, tolerable movement rather than forcing the joint through pain.
3. Aerobic activity you can repeat
Walking, cycling or swimming are options for improving general fitness. Choose something you enjoy and can do consistently. Short, regular bouts may be more manageable than one long session, particularly when returning to activity.
Should exercise hurt?
Some initial discomfort can happen when you begin exercising. That does not automatically mean you are damaging the joint. However, a programme should be adjusted if pain rises sharply, swelling increases or symptoms remain markedly worse afterwards. Reduce the effort, range or duration and seek individual advice if you are unsure. Progress based on how your knee responds over time, not on a fixed timetable.
What else can help?
- Education and pacing: understand your symptoms and spread demanding tasks across the day.
- Weight management, if relevant: NICE recommends supporting people who are living with overweight or obesity to lose weight, as this can improve pain and function.
- Pain relief: a pharmacist or GP can help you consider suitable medicines alongside exercise, taking your health and other medicines into account.
Exercise and self-management remain central even when other treatments are being considered. If symptoms continue to affect your quality of life despite a suitable plan, a clinician can discuss further options.
When should you see a physiotherapist or GP?
Seek an assessment if knee pain or stiffness persists, you are struggling with daily activities, or you are unsure how to exercise safely. Get urgent medical advice if your knee is very hot and swollen, you have a fever, or you cannot bear weight after an injury.
Can online physiotherapy help?
In a video consultation, a YourPhysio physiotherapist can discuss your symptoms, observe movements such as standing up and stepping, build a realistic exercise plan and adapt it as your confidence and capacity improve. If you need an in-person examination or medical review, they can advise you accordingly.
Start with a conversation: book a free initial consultation to meet the physiotherapist, explain your knee symptoms and learn how our service works. This introductory conversation is free; any subsequent treatment sessions are paid and optional.
Sources: NICE osteoarthritis guidance; NHS treatment and support; Royal Orthopaedic Hospital knee exercises. General information, not an individual diagnosis. Photo: Yan Krukau / Pexels.