What is the Best Exercise for Knee Osteoarthritis?

The best exercise for knee osteoarthritis (OA) is the one that strengthens your joints & keeps you active without hurting your joints. The fitness plan for patients with knee OA generally involves moderate intensity exercises from four categories- range of motion, aerobic, strengthening and stretching. The right combination varies from person to person, depending on the individual intensity of their pain, lifestyle and preexisting medical conditions. But yes, while OA is not curable, exercises can help big time, slowing the progression of this painful disorder. The pain and stiffness in your knees may condition your brain into thinking that rest is what you need.  

But that’s not true.  

In the case of knee Knee Osteoarthritis, inactivity contributes further to the stiffness and ache. The right level of exercise, on the other hand, provides the necessary strength to the affected joints and helps you move pain-free.  

Note: Every patient is unique. So, the list mentioned here is for informative purposes only. You should consult with a physical therapist who, upon evaluation, can recommend the best exercises for your knee osteoarthritis.  

How Do You Know You’ve Knee Osteoarthritis? 

Osteoarthritis is one of the most painful forms of arthritis. It is the deterioration of cartilage present at the end of joints. As the cartilage fades, the ends of bones rub against each other, resulting in pain, stiffness, inflammation and movement difficulties. The condition affects joints in the hips, spine, hands and knees.  

It can occur due to multiple reasons. Age is a very common factor. Excessive wear and tear of the joints is another. Other reasons can include an underlying medical condition or an injury to that specific joint resulting in OA.  

The most common symptoms of knee OA include: 

The knee hurts when you’re active, such as when walking, climbing stairs, or getting up from a chair. 

The pain often feels worse in the evening after you’ve been on your feet all day. 

The knee feels stiff and difficult to move when you first wake up. 

The knee feels stiff and difficult to move when you first wake up. 

The tissues around the knee joint may become irritated. 

You may find it difficult to move your knee as freely as you used to. For example, you might not be able to bend your leg as far back or straighten it out completely. 

The knee might feel “wobbly,” as if it could buckle or “give out” on you. This can happen when the muscles around the joint weaken. 

According to the Burden of Osteoarthritis in Canada (2021) report, more than 4 million Canadians have OA, with the knee as the “most common symptomatic joint site” reported, followed by the hand, back and hip.  

According to the organization ‘Bone and Joint Canada’, this number is expected to rise to 10 million within a generation.  

So yes, knee osteoarthritis may be an epidemic in the upcoming years. Do not panic if you experience the symptoms. Science, recovery and rehabilitation are doing their diligent research to combat this disorder. Meanwhile, take a deep breath and talk to your nearest physiotherapist, who can guide you through the best non-surgical way of managing Knee Osteoarthritis and leading a healthy lifestyle effectively.  

What are the Best Exercises for Osteoarthritis of the Knee? 

The following list of exercises is gathered from research papers and shared by top physiotherapists/physical therapists. It is, however, recommended not to choose the exercises on your own to manage your knee Osteoarthritis.  

Let your therapist evaluate the cause of your condition, your pain levels and then they can explain what is the best exercise for your knee pain/stiffness because every person is unique and so are their medical conditions.    

The best exercise for managing knee osteoarthritis can be a combination of different movements from four categories. Let’s go through the most effective exercises under each category to manage Knee Osteoarthritis.  

Range of Motion (ROM) Exercises for Knee Osteoarthritis

Range of motion exercises involve slow, gentle movements to extend the joint through its full, natural path of movement. ROM exercises do not build muscle or endurance. They, however, maintain flexibility and reduce stiffness in the knee joints.  

1. Heel Slides (Lying Down)

This is the classic “go-to” ROM exercise for knee Knee Osteoarthritis, as it is non-weight bearing and controlled. 

Position: Lie on your back on a bed or firm surface with legs straight. 

Action: Slowly slide the heel of your affected leg along the bed towards your buttocks, bending your knee as far as is comfortable. 

Hold: Pause for 3-5 seconds at the top of the bend. 

Return: Slowly slide the heel back down until the leg is completely straight and relaxed. 

Repetitions: 10-15 times. 

2. Seated Knee Extension (“Kicks”)

This exercise works on joint lubrication and helps maintain the ability to fully straighten the knee. 

Position: Sit securely on a sturdy chair with your back resting against the chair back and feet flat on the floor. 

Action: Slowly lift one foot up, straightening your knee until your leg is as straight as possible in front of you. 

Hold: Squeeze your thigh muscle gently and hold the straight position for 3-5 seconds. 

Return: Slowly lower the foot back to the floor. 

Repetitions: 10-15 times per leg. 

3. Seated Assisted Knee Flexion

This uses a chair to help you gently increase how much your knee can bend without putting full body weight on it. 

Position: Sit firmly on the edge of a sturdy chair. 

Action: Plant your foot firmly on the floor. Slowly slide your body forward on the chair while keeping your foot in the same spot. This will naturally increase the bend in your knee. 

Alternative: While seated, simply use your other foot to gently push your affected leg further back underneath the chair to increase the bend. 

Hold: Hold gently for 10-20 seconds when you feel a mild stretch. 

Repetitions: 3-5 times. 

4. Prone Knee Bends (Lying on Stomach)

This position uses gravity to help bend the knee and can also provide a gentle stretch to the thigh muscles (quadriceps), which often get tight with OA. 

Position: Lie flat on your stomach (you can use a pillow under your head for comfort). 

Action: Slowly bend your affected knee, bringing your heel toward your buttocks. 

Hold: Hold for 3-5 seconds at your comfortable limit. 

Return: Slowly lower the leg back to the straight position. 

Repetitions: 10 repetitions. 

5. Passive Knee Extension (Prop Hangs)

Many people with knee Knee Osteoarthritis lose the ability to fully straighten their leg. This “passive” exercise uses gravity to gently encourage full extension. 

Position: Lie on your back or sit up in bed. Place a rolled-up towel or a firm pillow only under your heel or ankle, so your calf and knee are unsupported in the air. 

Action: Relax your leg completely. Let gravity gently pull your knee straight toward the bed. 

Hold: Start with 1-2 minutes. It might feel uncomfortable (a stretching sensation behind the knee), but it should not be sharply painful. 

Goal: Gradually work up to 5-10 minutes to help regain a fully straight knee. 

Aerobic Exercises for Knee Osteoarthritis

“Aerobic” means “oxygen”. So, aerobic exercises are the ones that during which your body uses oxygen to break down glucose and fat for energy.  

1. Swimming and Water Aerobics

Water exercises are often considered the ideal choice for knee Knee Osteoarthritis. The buoyancy of the water supports your body weight, which takes nearly all pressure off your knee joints. The water also provides gentle resistance, helping to build muscle strength around the knee. 

Why it’s good: Non-weight-bearing, builds strength, and improves cardiovascular health. 

Activities to try: Lap swimming (using a gentle kick), water walking, or a dedicated water aerobics class. 

2. Cycling (Stationary or Outdoor)

Cycling is a fantastic low-impact exercise that strengthens the muscles that support your knee (like the quadriceps and hamstrings). The continuous, smooth, circular motion helps lubricate the joint and can improve its range of motion without the jarring impact of activities like running. 

Why it’s good: Low-impact, builds leg strength, and promotes joint mobility. 

Tip: Make sure your bike seat is adjusted correctly. Your knee should have a slight bend (about 10-15 degrees) at the bottom of the pedal stroke. 

3. Elliptical Trainer

An elliptical machine provides a cardiovascular workout that mimics the motion of running but without the high-impact stress. Your feet remain on the pedals at all times, creating a smooth, gliding motion that is much gentler on the knees, hips, and back. 

Why it’s good: Low-impact weight-bearing exercise provides a full-body workout (if using handles) and is easy on the joints. 

4. Walking

Walking is a simple, accessible, and effective low-impact aerobic exercise. It helps strengthen the muscles around your joints, maintains bone density, and improves circulation. It’s important to start slowly and gradually increase your distance and pace. 

Tip: Wear supportive, well-cushioned shoes and try to walk on flat, even surfaces (like a track or level path) to minimize stress on your knees. 

These exercises can help increase your cardiovascular fitness, strengthen the muscles that support your knees, improve range of motion, and reduce pain. The most important thing is to listen to your body and stop if you feel any sharp or increasing pain. 

Strengthening Exercises for Knee Osteoarthritis

Strengthening exercises are one of the best exercises for knee osteoarthritis. These are low-impact and build strength in the main muscles supporting your knee joint. You should feel the muscles working, but no sharp pain while performing these exercises.  

1. Quad Set (Isometric)

Why it helps: This is the most basic and safest way to activate your quadriceps (the muscles on the front of your thigh) without bending your knee. 

How to do it: 

Sit on the floor or a firm bed with your affected leg straight out in front of you. (You can bend your other leg). 

Place a small, rolled-up towel under your knee. 

Tighten your thigh muscles (quadriceps) and try to press the back of your knee down into the towel. 

Hold the contraction for 5-10 seconds. 

Relax. Repeat 10-15 times. 

2. Straight Leg Raise

Why it helps: This strengthens your quadriceps and hip flexors without putting any weight or impact through the knee joint. 

How to do it: 

Lie on your back on the floor or a firm bed. 

Bend your “good” knee and place your foot flat on the floor. 

Keep your affected leg straight. 

Tighten the thigh muscle (quadriceps) of your straight leg and slowly lift it up about 12 inches (or to the height of your other knee). Keep the leg straight and your thigh muscle tight. 

Hold for 3-5 seconds, then slowly lower it back down. 

Repeat 10-15 times for 2-3 sets. 

3. Glute Bridge

Why it helps: Strong glutes (buttocks) are essential for knee stability. They help control the movement of your thigh and prevent your knee from collapsing inward. 

How to do it: 

Lie on your back with both knees bent and your feet flat on the floor, hip-width apart. Keep your arms by your sides. 

Squeeze your glute muscles and lift your hips off the floor until your body forms a straight line from your shoulders to your knees. 

Hold this position for 3-5 seconds. 

Slowly lower your hips back down. 

Repeat 10-15 times for 2-3 sets. 

4. Wall Sit

Why it helps: This is an isometric exercise that builds strength and endurance in your quadriceps, glutes, and calves in a safe, supported way. 

How to do it: 

Stand with your back flat against a wall. 

Place your feet about shoulder-width apart, and about two feet away from the wall. 

Slide your back down the wall until your knees are bent at a 45 to 90-degree angle. Do not go deeper than 90 degrees, and if you have pain, stay higher (a “mini-sit”). 

Your knees should be directly above your ankles, not in front of them. 

Hold this position for 20-60 seconds, or as long as you can maintain good form. 

Slide back up the wall to stand. Rest and repeat 2-3 times. 

5. Clamshell

Why it helps: This exercise targets the hip abductors (outer thigh and glutes), which are crucial for pelvic stability and preventing your knee from buckling inward when you walk. 

How to do it: 

Lie on your side with your hips and knees bent, and your feet together. Your head should be resting on your arm or a pillow. 

Keep your feet touching each other. 

Lift your top knee up toward the ceiling as far as you can without letting your hips roll backward. (Keep your core tight). 

Hold for 3 seconds, then slowly lower your knee. 

Repeat 10-15 times for 2-3 sets on each side. 

 Stretching Exercises for Knee Osteoarthritis

These are gentle exercises designed to improve your flexibility and range of motion. Hold each stretch for 20-30 seconds and remember to breathe. Never stretch to the point of sharp pain. 

1. Seated Hamstring Stretch

Why it helps: Loosens the muscles on the back of your thigh (hamstrings). Tight hamstrings pull on the knee, which can increase pain and stiffness. 

How to do it: 

Sit on the edge of a sturdy chair. 

Straighten one leg out in front of you, with your heel on the floor and your toes pointing up. Keep your other foot flat on the floor with your knee bent. 

Keeping your back straight, slowly lean forward from your hips (not your waist) until you feel a gentle stretch in the back of your straight leg. 

Hold for 20-30 seconds. 

Slowly sit back up. Switch legs and repeat. 

2. Standing Calf Stretch

Why it helps: Your calf muscles connect to your heel, and tightness here can affect how you walk, putting extra stress on your knee. 

How to do it: 

Stand facing a wall, about arm’s length away. Place your hands on the wall for support. 

Step back with your affected leg, keeping the heel on the floor and the leg straight. 

Keep your other leg forward with the knee bent. 

Lean into the wall until you feel a stretch in the calf of your back leg. 

Hold for 20-30 seconds. Switch legs and repeat (even if only one knee is affected, this benefits both sides). 

3. Standing Quadriceps Stretch

Why it helps: Stretches the large muscles on the front of your thigh (quadriceps). Tight quads can increase pressure on your kneecap. 

How to do it: 

Stand next to a wall or a sturdy chair and hold on for balance. 

Bend your affected knee and bring your heel up toward your buttock. 

Gently grab your ankle or pant leg with your hand. If you can’t reach, you can loop a towel around your foot and hold the ends. 

Pull gently until you feel a stretch in the front of your thigh. Keep your knees close together. 

Hold for 20-30 seconds. Switch legs and repeat. 

4. Heel Slide (Knee Flexion)

Why it helps: This is a key range-of-motion exercise. It helps your knee bend more easily and lubricates the joint. 

How to do it: 

Lie on your back on the floor or a firm bed, with both legs straight. 

Slowly slide the heel of your affected leg toward your buttock, bending your knee as far as you comfortably can. 

Hold for 5 seconds. 

Slowly slide your heel back to the starting position. 

Repeat 10-15 times. 

5. Seated Knee Extension (Passive)

Why it helps: Many people with knee Knee Osteoarthritis lose the ability to fully straighten their knee. This gentle stretch helps regain and maintain that full extension, which is crucial for walking. 

How to do it: 

Sit in a chair and place another chair or a low stool in front of you. 

Place the heel of your affected leg on the other chair/stool, letting your leg be as straight as possible. Your knee should be unsupported. 

Relax your muscles and let gravity gently pull your knee into a straighter position. You should feel a mild stretch, likely behind the knee. 

Hold for 30 seconds to a minute (or as long as comfortable). You can repeat this several times a day. 

Why Knee Osteoarthritis Patients Should Exercise? 

When your knee hurts, not moving is likely to be your first instinct to avoid the pain. On the contrary, because you’re moving less, the muscles around your knee (your quads, hamstrings, and glutes) get weaker. 

Exercise is the single best way to manage this pain. 

Here’s why exercise is crucial for managing knee osteoarthritis 

Builds your natural muscle strength- The strengthening exercises build up your quadriceps, hamstrings and glutes.  

Nourishes the joint- The range of motion and aerobic exercises help push essential nutrients into the cartilage and flush out waste products.  

Helps manage weight– Aerobic exercises help burn calories and manage a healthy weight, which directly reduces the daily load on your joints.  

Reduces pain and stiffness– Stretching and ROM exercises reduce the ‘stiff’ feeling in the knees and make movement easier.  

Improves daily function- With stronger muscles, better flexibility and less pain, it is easier to do daily tasks which otherwise would have been difficult with knee Knee Osteoarthritis.  

Professionals recommend exercises not to fix the cartilage but to build a strong, supportive system around the joints to make its job easier. “How do I know which exercise is right for me?” Well, that’s a question your physical therapist or doctor can provide the best answer to.  

Final Thoughts,  

Getting diagnosed with knee osteoarthritis doesn’t mean you have to stop doing the things you like or limit your daily activities. It implies that you now know what the exact problem is and thus can take the right measures to manage the condition. Pain meds and surgeries help. But exercises are the most natural, safe methods to prevent osteoarthritis from worsening. Physiotherapy clinics like Physiotherapy First can develop a fully customized fitness plan based on the type of Knee Osteoarthritis you are experiencing, so you can restore your daily activities with peace of mind. It takes effort, but it is possible to manage knee osteoarthritis effectively.