The WORST Exercise for Knee Arthritis (and What To Do Instead)

The WORST Exercise For Knee Arthritis

Often, videos with titles like "The worst exercises for _____" create unnecessary fear of movement, or "kinesiophobia".

Fear or avoidance of movement has been shown in research to be harmful to recovery for a variety of different conditions.

Furthermore, videos that discourage certain exercises may reinforce myths about knee arthritis such as:

• Rest is best
• Exercising can make your knee arthritis worse
• You should avoid certain exercises such as squats or running

You may have even heard some of those things from your doctor.

That type of advice is based on the way that acute injuries are managed.

However, it's not appropriate for more chronic conditions like knee arthritis.

Why No Exercise Is BAD For Knee Arthritis

If you sprain your ankle or tear a ligament in your knee, it makes sense to rest it for a few days to allow the tissues to heal.

But with more chronic conditions like arthritis, where the tissues are unlikely to "heal" per se, it's more about managing the symptoms and preventing progression.

In the case of knee arthritis, if you rest waiting for it to "heal", you might be waiting a really long time.

Then when you do eventually eventually try to get back to activity, you have more pain and more difficulty getting back to those activities.

No Pain, No Gain For Knee Arthritis? (Well, sort of)

That's not to say you should push through unnecessary amounts of pain when you're exercising.

But exercise doesn't have to be completely pain-free either.

The 0 to 10 pain rating scale is subjective, so there's no absolute number to say is a safe amount of pain to have when you're exercising.

But a general rule of thumb is that you shouldn't feel worse after exercising than you did before.

If your pain levels increase slightly during exercise, that's okay to a point.

After all, pain is really just your brain's way of telling you that there's a risk of potential danger, not necessarily actual tissue damage.

However, if your knee feels worse for hours or longer after exercising, you probably exercised too long or too intensely.

Is It Safe To Run With Knee Arthritis?

There's no research that I know of that shows that running causes progression of knee arthritis.

In fact, there's research to the contrary. A 2023 systematic review in Orthopedic Journal of Sports Medicine revealed that among runners and non-runners in their 50s and 60s, runners were less likely to have knee pain and were less likely to progress onto a total knee replacement.

However, running with proper technique does take a lot more strength than does walking.

So if you have never run, it you may not want to start running if you have knee arthritis.

However, if you're a runner and you'd like to continue running, it's probably safe to do so in appropriate amounts.

However if you're not a runner...

Walking Is One Of The BEST Exercises For Knee Arthritis

Walking is also protective of knee arthritis.

A study published in Arthritis & Rheumatism in 2022 revealed that among walkers and non-walkers in their 50s, people who walked for exercise were less likely to have pain or joint space loss than people who did not walk for exercise.

What If My Knee Feels Worse After Walking?

You may wonder:

"What if my knee feels worse after I walk? I thought I should avoid exercises that worsen my pain."

And that's true.

However, it's rarely a question of IF you should walk but rather HOW MUCH you should walk.

The acronym FITT comes into play here.

• Frequency
• Intensity
• Time
• Technique

Frequency and Duration of Exercise For Knee Arthritis

The American Heart Association,  American College of Sports Medicine, and the U.S Department of Health and Human Services, all recommend 30 minutes of aerobic activity on 5 or more days per week.

However, that's not to say that it has to be 30 minutes of continuous exercise.

If you can't walk for 30 minutes without your knee pain increasing, you can split that up into three 10-minute walks per day.

Or if even 10 minutes is a struggle for you right now, start with three 5-minute walks and progress from there.

Walking Technique Affects Knee Arthritis Pain

Additionally, your walking technique also plays a role in whether or not you'll experience knee pain when you're walking.

Muscle stiffness affects your walking pattern

Many people develop knee pain when walking due to stiffness of their hip flexors or calves.

If your hip flexors and calves are tight when you go to take a step, it causes your foot to flatten, or overpronate.

That can cause twisting inside the knee joint, which doesn't feel good if you have knee arthritis.

Therefore, stretching your hip flexors and calves is a good idea to be able to walk longer with knee arthritis.

Additionally, making conscientious changes to gait pattern can relieve knee arthritis pain.

This is a complex topics that often requires one-on-one treatment to learn properly.

However, some general tips include:

• shortening your stride
• keeping your arch domed when you're walking
• using orthotics or arch supports

Learn more specific tips for walking with knee arthritis in these posts:

How To Improve Walking Gait Instantly Without Exercises

Try This Unique Exercise For Walking Balance, Flexibility, & Strength

Best Walking Balance Exercise For Seniors

 

Adjusting Intensity of Walking With Knee Arthritis

You can also adjust the intensity of your walking by adjusting your walking speed or picking routes that are less hilly.

However, one of the main intensity factors for knee arthritis is the amount of load that you have coming down on your knee.

Losing weight is a really helpful thing to do if you have knee arthritis. According to research, 1 pound of weight loss decreases knee joint forces by about 4 lbs.

Admittedly though, it is harder to lose weight if you can't exercise as much as you would like.

Using a cane, a walker, or walking in the water can also decrease how much load you have bearing down on your knee.

Many people are afraid to do that because they're afraid that using a cane or a walker will make them look old or become weaker or become dependent on it.

But the reverse is actually true.

If using a cane or a walker allows you to walk for longer periods of time, then over time, you get stronger and less dependent.

On the other hand, avoiding exercise because it hurts too much - that's what makes you weaker and more dependent.

...which is why doing no exercise is the worst exercise for knee arthritis.

Other Exercises For Knee Arthritis

If you can't walk for as long as you'd like,  you can also supplement that with other forms of exercise, such as exercise biking or doing water aerobics.

What Are The Best Strengthening Exercises For Knee Arthritis?

What strengthening exercises are best if you have knee arthritis?

Strengthening exercises for knee arthritis should be functional, meaning they should allow you to do the things that you need and want to be able to do in everyday life.

Many people mistakenly think that squats are bad for people with knee arthritis.

However, if you ever get up out of a chair or stoop down to pick something up out of a cabinet, then you do a version of a squat.

And I'll bet that you do it on a daily basis.

Therefore, squats are one of the best, most functional exercises for knee arthritis.

It's not usually a question of IF you should do squats, but again, how Frequently, how Intensely, how many Times, and with what Technique you're doing squats. (FITT)

Frequency of Strength Training With Knee Arthritis

If you're just doing body weight exercises, you do such things daily such as getting up out of chairs.

So you can do body weight squats every single day. If you're getting up out of a chair, try standing up a few times rather than just once.

That's a way to work some strengthening exercises into your day.

If you're using added weight 2-3 strength training sessions per week is enough.

Intensity of Strengthening Exercises

As far as intensity, you can easily adjust intensity on squats by using more weight.

But what if just body weight squats are challenging?

Well, you can adjust the intensity of a body weight squat by how deep you go.

The deeper the squat, the more muscle force that is required.

Deeper squats also increase the joint compression force on your knees.

If you're just starting out or if you have more severe knee arthritis, doing shallow mini squats is a good way to start.

How Many Repetitions (Times)?

You can also adjust your intensity with squats by how many times or repetitions you do.

People frequently ask, "How many repetitions should I do?"

There's no magic number, and it's going to be different for everyone depending on where you're starting, how deep you go, how much weight you're using.

However a good rule of thumb is to start with a weight and number of repetitions that challenges you.

Do as many repetitions as you can with good technique without increasing your pain. Then progress from there.

It's the overload principle - push your body to levels it's not used to going, and it will get stronger.

Squatting Technique For Knee Arthritis

Squatting also substantially affects if you'll  have pain when squatting or how much pain you'll have when squatting.

I've already done a very thorough video on how to squat without knee pain (even if you have arthritis).

You can check that out in this post.

Balance Exercises For Knee Arthritis

Furthermore, balance exercises are really important if you have knee arthritis.

Walking is basically a series of balancing on one leg and then balancing on the other leg over and over and over again.

Therefore in order to increase your walking ability with less pain if you have knee arthritis, doing balance exercises is a good idea.

Just balancing on one leg is a great place to start.

Once you've mastered that then you can add in other advanced balance exercises like doing kicks to the side, the front, the back, or doing mini squats on one leg.

But first master being able to balance on one leg stationary and then progress from there.

Conclusion

There are so many different types of exercise out there, that it can be overwhelming.

Oftentimes people get stuck in analysis paralysis meaning they hold off on doing anything because they want to make sure they're doing the right exercises and not doing the wrong exercises.

But again, the worst exercise for knee arthritis is doing no exercise at all.

So find some type of exercise that you'll enjoy and that you can commit to doing on a regular basis.

Then get started TODAY.

If you need one-on-one help to find the best exercises for your knee arthritis and you're in the St. Louis area, we'd be happy to help you here at More 4 Life.

Just tap the button below to request an appointment with one of our specialist physical therapists.

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