Does exercise make knee osteoarthritis better or worse?

Physiotherapy, Bradley Jawl

By Bradley Jawl and Julia Biedermann


There are a lot mixed messages about how to deal with knee osteoarthritis (OA). We’re often told to exercise and engage in physical activity, but does exercise really make it better or worse? What exercises are best? What exercises should I avoid?

An exciting review article just came out and it summarizes all the high quality research ever done on exercise for knee OA.

So what were the findings? Well first off, we can definitively say that exercise is 100% good for knee OA. That part is easy. Second, regarding what exercises are best, it turns out that endurance exercises and strength exercises help the most; but coordination, stretching, and balance play an important secondary role too. I know what you’re thinking: “Thanks for narrowing that down”.

So let’s get a little more specific. Endurance exercise refers to things like walking, cycling, swimming, cardio machines at the gym, and jogging. Strength exercises can include squats, lunges, bridges, and calf-raises. Balance training can be as simple as standing on one leg; coordination exercises can include single leg squats and/or agility drills; and stretching tight tissues might look like a hamstring, quadriceps, calf, or hip stretch.

Clearly, there are a lot of options. Every individual is different. Ideally the exercises should be tailored to your weak-spots. Specifically said, you should start by strengthening muscles that are weak, stretching muscles that are tight, performing endurance exercises that you find particularly challenging and so on.

The other guiding light is pain. Try to avoid exercises that are overly painful. It is okay for there to be some discomfort, but start slow and try to find exercises that are hard on the muscles but easy on the pain. If you’re in a great deal of pain after exercising that’s a strong indication to pick different exercises or to adjust your exercises to the point where they don’t cause you so much irritation (notice I didn’t say “stop”).

If you find yourself struggling or needing a little guidance, hands-on manual therapy is another extremely effective intervention for knee OA, especially in the earlier stages. For this and for assistance with picking an ideal exercise program, a well trained Physiotherapist, Chiropractor, or Kinesiologist can be a great help.