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Exercise for knee osteoarthritis

Musculoskeletal
        1. Exercise for knee osteoarthritis

First published: 6 Dec 2020

The RACGP gratefully acknowledge the following contributor:

  • Zoe Michaleff

Related GP HANDI entry Exercise for knee osteoarthritis


 

Your doctor has recommended exercise as a treatment for your knee osteoarthritis.

Key points

  • Exercise is one of the best treatments for knee osteoarthritis. It can reduce pain, improve your ability to do everyday activities and increase your quality of life.
  • If you have not been exercising, start slowly within your easy range and build up
  • Use the ‘2-hour pain rule’: if you have pain that is more than normal or unusual and that lasts longer than 2 hours after exercising, you have done too much. Consider slowing down, doing less or taking more breaks the next time you exercise.

Exercise is one of the best treatments for knee osteoarthritis

  • Osteoarthritis can cause pain and tenderness in your knee joint. This may cause everyday movements, such as walking or going up stairs, to become harder. As a result, you may move less over time, which can cause your muscles to become weaker and your joints less flexible.
  • Exercise is one of the best treatments for knee osteoarthritis. Exercise can reduce pain, improve your ability to do everyday activities, and increase your quality of life.
  • A mix of strength, overall fitness (aerobic) and flexibility exercises may be best.

The following table is a guide only – check with your GP what is suitable for you.

 

Strength

Overall fitness

Flexibility

Goal of training

To make your muscles stronger

To make you fitter

To increase your joint range of movement and flexibility of muscles around the hip and knee joint

Example

Exercises that use resistance, e.g. bodyweight, free weights, elastic resistance or weight machines. These exercises can be functional, such as stepping up and stepping down or moving from sitting to standing

Walking, cycling or water-based exercise e.g. swimming or pool aerobics

Stretches the target muscles in the back of your leg i.e. calf muscle and hamstring

How often

At least 3 times per week

20–60 minutes 2–5 times per week

At least 3 times per week

How hard (intensity)

6-12 exercises, repeat each exercise 8 – 15 times (repetitions), do this 2-3 times (sets) with 1-2 minutes of rest between sets

Moderate to high intensity, i.e. raises your heart rate; puffing but still able to talk

Hold each stretch for 15–30 seconds and repeat 2–4 times

How does exercise help with knee osteoarthritis?

  • Exercise can help make your leg muscles stronger so they can better support your knee joint. This can lead to less pain and improvements in how well your knee works.
  • Regular exercise can also improve your fitness and your ability to do everyday activities. As you get fitter, you can do more with less effort, which may improve your quality of life.

How do I get started?

  • If you are new to exercise, a physiotherapist or exercise physiologist can help to:
    • get you started and create an exercise plan
    • teach you when and how to increase the difficulty of the exercise for health benefits
    • motivate you to stick to your exercise program
    • give tips on exercise techniques and not ‘overdoing it’
  • There are many types of exercises you can do. Choose exercises that you enjoy so that you keep on doing them.
  • To get the most benefit, the exercises should be made more difficult over time (e.g. do harder exercises, move faster, repeat the movement more times or exercise for longer).
  • Having a goal can help with starting and sticking with exercise. Your goal needs to be important enough to get you exercising even when you don’t feel like it.

What to look out for

  • It can be hard to know how your body will respond to a new activity. Start slowly and progress exercises gradually. For example, if your goal is to walk for 30 minutes and you can comfortably walk for 20 minutes, start by walking only 15 minutes and do this 3 to 5 times in the first week. Every week or so, increase the amount of exercise by 10% until you achieve your goal.

    Example: If you walk for 10 minutes, increasing by 10% would mean adding a minute so you would walk for 11 minutes. If you walk for 20 minutes, increasing by 10% would mean adding 2 minutes, so you would walk for 22 minutes.

    Over time aim to exercise at least 30 minutes most days. You can break it down into shorter blocks, e.g. a 10-minute walk in the morning, afternoon and evening.
  • Use the ‘2-hour pain rule’: if you have pain that is more than normal or unusual and that lasts longer than 2 hours after exercising, you have done too much. Consider slowing down, doing less or taking more breaks the next time you exercise.
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