Why Exercise for Knee Arthritis is Key

By: Brian A. McCarty, MD

Arthritic knees hurt. No matter which type of arthritis affects your knees, you are likely experiencing significant pain, especially when climbing stairs and standing up from a seated position. You know the stiffness, swelling, buckling, and cracking sounds in your knees all too well. It might seem counterintuitive, but one of the best things you can do for your arthritic knees is to exercise. Proper exercise for knee arthritis is key to reducing pain, maintaining knee function, and improving your overall health.

The orthopedic doctors and physical therapists at Midwest Orthopedic Specialty Hospital can help construct an exercise program tailored to your specific needs and abilities. You can also design your exercise schedule by learning more about knee arthritis, why exercise is essential, and how to maintain joint health.

Arthritis and Knee Joints

There are over 100 types of arthritis, and all of them include joint pain and stiffness. Arthritis affects the bones and tissues in and around the joint. Osteoarthritis (OA) is the most widespread type of arthritis, affecting 1 in four Americans. Sometimes called “wear and tear” or “degenerative joint disease,” OA of the knee means the articular cartilage of the knee joint is damaged, which creates pain, stiffness, and swelling. Osteoarthritis of the knee is most common in people over 50.

Other types of arthritis that affect the knee include:

  • Post-traumatic knee arthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Juvenile idiopathic arthritis (JA)
  • Gout
  • Reactive arthritis

Exercise and Joint Health

Joint health is important, especially as we age. Healthy joints allow us to move, walk, run, play and make our daily lives easier. If our joints aren’t healthy, our whole body can be affected by pain and discomfort. Sometimes pain can subconsciously keep us stationary because our instincts tell us to stay still. However, when you have arthritis, you need to keep moving.

According to the John Hopkins Arthritis Center, “Physical activity is essential to optimizing both physical and mental health and can play a vital role in the management of arthritis. Regular physical activity can keep the muscles around affected joints strong, decrease bone loss, and may help control joint swelling and pain. Regular activity replenishes lubrication to the cartilage of the joint and reduces stiffness and pain.”

Think of exercise for knee arthritis the same way athletes think about training; you must continually condition your knees. If you don’t exercise and care for your knees, you won’t get the most out of them. It is crucial to maintain strength to protect your joints from further damage. You also need to stretch carefully and regularly to preserve your flexibility. A sedentary lifestyle will worsen your arthritis and make it more difficult for your knees to function. But unlike an athlete, your end game isn’t to push physical boundaries. Instead, your goal is to lessen the risk of further joint damage and maintain full knee function using simple, brief exercises peppered throughout the week.

Physical Benefits of Exercise

  • Reduces pain
  • Maintains function
  • Strengthens muscles for better joint support
  • Increases energy
  • Increases stamina
  • Maintains or improves flexibility
  • Increases efficiency of the cardiovascular system
  • Lowers blood pressure
  • Lowers blood sugar
  • Slows the loss of bone mass
  • Improves balance
  • Helps control weight

Psychological Benefits of Exercise

  • Increases mood
  • Improves quality of life
  • Releases endorphins
  • Reduces anxiety and depression
  • Improves self-esteem
  • Improves cognitive function

How to Safely Exercise with Knee Arthritis

Safety is the first concern when designing an exercise program, which is why consulting with a physical therapist is a good idea. Knee arthritis exercises to avoid include basketball, tennis, and distance running, because they include high impact on hard surfaces or repetitive jumping. If you need to continue these activities, consider doing them every couple of days to allow rest between games or long runs.

Even the best exercises for knee pain need to be started slowly so you can gauge your current level of physical ability. Always warm up first and listen to your body. You should not feel pain while exercising—not in your knees or elsewhere. Consider wearing a knee brace, which can relieve pain by helping to bear the load on your knee as an external structural support.

Exercises for Knee Arthritis

While there are many benefits to exercising an arthritic knee, the main goal is to maintain or improve the full range of motion so your knees remain functional. The exercises that best meet that goal focus on strength, function, aerobic activities, and neuromotor issues.

Strength Training for Knee Arthritis

When it comes to knee health, it’s all about three key muscle groups: quadriceps, hamstrings, and glutes. Muscle groups like your quads and glutes provide stability and do the hard work required for movements like walking and lunging. And the primary job of your hamstring muscles is to protect the ligaments inside your knees. Keeping these muscle groups strong and healthy helps your body absorb shock and, therefore, protects your knee joints. When planning for exercise to improve your knee arthritis, design a routine that works your quads, hamstrings, and glutes. You are creating a safer environment for your knees by conditioning these main muscle groups.

Resistance bands can also be effective for building strength without putting too much pressure on the joint. Knee extensions and standing leg raises when done in moderation, can be highly effective in helping arthritis pain and stiffness. If you have arthritis, try strengthening exercises two to three times a week.

Function Exercises for Knee Arthritis

Function (and flexibility) refers to the usefulness of your knee and the joint’s range of motion. Exercises that help your knee stay flexible include gentle stretching, yoga, and warming up before other activities. There are two main categories of stretches useful to people living with knee arthritis:

  • Static stretches are gentle flexions or extensions until you feel a “pull.” These are the most common stretches, usually done sitting or standing.
  • Dynamic stretches are done while moving or to stimulate movements that will be used after a warm-up session. Examples include high stepping (marching), hip circles like you are hula hooping, and leg swings.

Sample Strength and Flexibility Exercise Program

You can find a knee conditioning program for arthritis of the knees on the OrthoInfo website, created by the American Academy of Orthopaedic Surgeons. You can benefit from this program if you have arthritic knees, a knee injury, or after knee surgery. Be sure you check with your doctor before beginning an exercise regimen. The program includes instructions with diagrams for the following exercises, which focus on strength and flexibility:

  • Heel cord stretches
  • Standing quadriceps stretch
  • Supine hamstring stretch
  • Half squats
  • Hamstring curls
  • Calf raises
  • Leg extensions
  • Straight-leg raises
  • Straight-leg raises, prone position
  • Hip abduction
  • Leg presses

Aerobic Exercises for Knee Arthritis

Aerobic exercise, sometimes known as “cardio,” is any activity that increases your heart and breathing rate, so your body becomes more efficient in oxygenating your cells. For people with arthritis in their knees, examples of moderate aerobic exercise include walking, swimming, biking, or jogging. Only do activities you can tolerate and don’t cause additional pain.

Aim for moderate exercise three to five times a week and modify your activity levels based on the arthritis symptoms you are experiencing that day.

Aim for moderate exercise three to five times a week and modify your activity levels based on the arthritis symptoms you are experiencing that day.

Neuromotor Exercises for Knee Arthritis

Arthritis can come with unfortunate alterations to the neuromotor functions of the knee, meaning arthritis may be affecting your gait, posture, passive muscle tone, balance, and coordination. Activities that can help retrain your knee’s neuromotor abilities include side-stepping, Tai Chi, Pilates, dancing, walking backward, or walking heel to toe. Try to do 20 to 30 minutes of neuromotor exercises every couple of days.

Arthritis and Overall Wellness

Maintaining a healthy weight can be challenging. However, weight management is crucial, especially if you suffer from problematic knee joints. It’s estimated that every pound of weight lost takes four pounds of pressure off the knees.

The right diet can also help knee arthritis. A study by The American Journal of Clinical Nutrition suggests that adherence to the Mediterranean diet can relieve some knee arthritis symptoms. The Annals of Rheumatic Diseases has published the results of two studies, demonstrating that the dietary intake of fiber reduces body weight and inflammation, preventing or mitigating the effects of knee osteoarthritis.

Drinking water is exceptionally effective for combating knee arthritis. The Arthritis Foundation advises, “If there’s a magical elixir to drink, it’s water. Hydration is vital for flushing toxins out of your body, which can help fight inflammation.” Try to drink around eight glasses of water every day to help ease symptoms of arthritis and maintain your overall wellness.

When to See a Doctor for Knee Arthritis Pain

If you have knee arthritis, you expect pain and swelling. However, if you begin an exercise program and notice a negative change or experience any of the following symptoms, consult with your orthopedic specialist:

  • Intense or worsening pain
  • Redness and tenderness of the joint
  • Noticeably swelling
  • Warmth of the knee joint
  • Inability to use the joint or can’t bear weight
  • Joint deformity
  • Sudden or sharp pain

If you have any questions or want training and exercise guidance, please contact one of our knee specialists or the MOSH Physical Therapy Team. In addition, if you are injured, we now have ortho walk-in appointments in the MOSH Performance Center Clinic featuring top orthopedic specialists, hydration therapy, imaging, sports training, indoor turf training, and more. Call 414-817-6620 or schedule online today.

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