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Does exercise make my knee pain worse?

Updated: Oct 10, 2023

If you have knee osteoarthritis you may experience some or all of the following symptoms which may make exercising and movement more difficult. These include pain knee pain with weight-bearing, stiffness, instability, giving way, clicking, catching or crunching. You may also experience difficulties getting up from sitting, twisting, kneeling, squatting and going up and down stairs. All of these factors can sometimes make the thought of exercising more difficult.

Can exercise help my knee osteoarthritis?

YES! Evidence overwhelming indicates that exercise improves pain and quality of life for people with knee osteoarthritis. Recent studies have reported a 68% improvement in pain and disability in participants who underwent exercise as part of their treatment for knee osteoarthritis and 75 % of these participants delayed their knee joint replacement surgery for one year, and a further 68% for at least 2 years (Skou et al., 2018).

Why is it important to stay physically active if you have knee osteoarthritis?

Exercise has been shown to be the best treatment for people with knee osteoarthritis. Specific tailored exercises can relieve pain and improve joint health and function. Importantly this allows you to continue doing the things you love.

Being physically active also assists with weight loss, improves mood and mental state. It assists in the prevention of other conditions such as high blood sugar levels, high blood pressure and high cholesterol, cancer, heart disease and stroke, to name a few. It is the best thing you can do for your health.

Most importantly targeted exercise for your knee osteoarthritis can significantly improve pain and function. When your joints are loaded and unloaded though exercise, nutrients are pumped into and out of the cartilage which assists with cartilage growth and reformation increasing strength to these areas. Exercise also helps improve joint range of movement, making activities such as getting up from sitting and putting on shoes much easier.

What if exercise causes me pain should I stop exercising?

If you have knee osteoarthritis or when you initially start to exercise you may experience some muscle and joint related pain. Do not panic!! Pain is normal and often poorly related to damage. Excessive inactivity is usually worse for your knee osteoarthritis than activity itself. If your body is not used to exercising regularly, increases in pain can be common as your body needs to adjust to the new loads and stressors. The joint pain you experience during exercise should not exceed your acceptable limit of pain and should reduce in the 24 hours after exercise to the

same level as before exercise. If your pain does not settle, your level of exercise is likely too much and you need to reduce this slightly.

What evidence tells us about what exercise and how much exercise we should do

There is strong evidence to suggest that exercise for those with knee osteoarthritis can improve pain and function regardless of age, severity of arthritis and pain levels (Royal Australian College of General Practitioners, 2018). Growing evidence recommends exercise should be tailored to the individual's goals and should be performed a minimum of 2 times per week, with 3-4 sessions providing superior outcomes, for a minimum of 6 week period (Juhl et al., 2014). These exercises can include walking/running/cycling and weight/ strength training.

If you are unsure about how to start exercising or want further information on what type of exercises you should be doing our physiotherapists are highly trained in the management and prevention of knee osteoarthritis and can provide you with a tailored program based on your functional goals and needs.

GLA:D Australia. (2017, February 16). GLA:D AU.

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