From the Guidelines
Low-impact exercises such as swimming, water aerobics, cycling, elliptical training, walking, yoga, and Pilates are recommended for individuals with knee problems, as they are easy on the knees and can help improve joint stability and reduce pain. These exercises are beneficial because they strengthen muscles around the knee joint, improve joint stability, enhance circulation to aid healing, and help maintain a healthy weight, which reduces pressure on knee joints 1.
Key Exercises
- Swimming and water aerobics are particularly gentle on joints because water provides buoyancy that reduces weight-bearing stress
- Stationary cycling eliminates impact while strengthening leg muscles that support the knees
- The elliptical machine mimics running motion without the jarring impact
- Walking on soft surfaces like tracks or grass is gentler than running
- Yoga and Pilates focus on controlled movements that build strength and flexibility without stressing joints
Recommendations
- Start with 10-20 minutes, 2-3 times weekly, and gradually increase duration and frequency as fitness improves
- Proper form is essential—maintain good posture, avoid locking your knees, and wear supportive footwear when appropriate
- Tai chi is also strongly recommended for patients with knee and/or hip OA, as it combines meditation with slow, gentle, and graceful movements, deep diaphragmatic breathing, and relaxation 1
- Weight loss is strongly recommended for patients with knee and/or hip OA who are overweight or obese, as it can result in symptom or functional improvement 1
Additional Considerations
- Self-efficacy and self-management programs are strongly recommended for patients with knee, hip, and/or hand OA, as they use a multidisciplinary group–based format combining sessions on skill-building, education, and fitness and exercise goals and approaches 1
- Balance exercises are conditionally recommended for patients with knee and/or hip OA, as they can improve the ability to control and stabilize body position 1
From the Research
Low-Impact Exercises for Knee Health
Exercises that are low-impact and easy on the knees are essential for individuals with knee osteoarthritis or those who want to maintain healthy knees. Some of the low-impact exercises that are beneficial for knee health include:
- Swimming: a non-weight-bearing exercise that can help improve cardiovascular fitness and strengthen muscles without putting excessive stress on the knees 2
- Cycling: a low-impact exercise that can help improve cardiovascular fitness and strengthen leg muscles without putting excessive stress on the knees 2, 3
- Walking: a low-impact exercise that can help improve cardiovascular fitness and strengthen leg muscles without putting excessive stress on the knees 4
- Powerstriding: a low-impact exercise that can help improve cardiovascular fitness and strengthen leg muscles without putting excessive stress on the knees 2
Benefits of Low-Impact Exercises
Low-impact exercises have several benefits for knee health, including:
- Reduced stress on the knee joint: low-impact exercises can help reduce the stress and impact on the knee joint, which can help alleviate pain and discomfort 2, 3
- Improved cardiovascular fitness: low-impact exercises can help improve cardiovascular fitness and overall health 2, 3
- Strengthened muscles: low-impact exercises can help strengthen the muscles around the knee, which can help improve stability and support 2, 3
- Improved function: low-impact exercises can help improve functional ability and reduce disability in individuals with knee osteoarthritis 3
Exercise Recommendations
The optimal exercise modality and dose for knee health are not currently known, but research suggests that any regular exercise can be beneficial 5. Moderate-intensity exercise performed three times weekly for 20-60 minutes appears to be optimal for knee symptom control 5. It is essential to consult with a healthcare professional or clinician to determine the best exercise program for individual needs and abilities.