Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Always consult a qualified health professional before commencing a new exercise program. © 2026 Better Physiotherapy Bundoora.
The fear that exercise will damage an arthritic knee is one of the most persistent — and harmful — myths in knee OA management. Exercise is not only safe but essential. The right program can reduce pain by 40–50% and improve function significantly — outcomes that outperform most medications.
The Best Exercises for Knee OA
1. Quadriceps strengthening: The quadriceps are the primary shock absorbers and stabilisers of the knee joint. Weakness directly increases pain and functional limitation in knee OA. Effective exercises include: leg press (starting with low resistance), straight leg raises, sit-to-stand from a chair, step-ups (starting with a low step), and supported wall sits.
2. Hip abductor strengthening: Gluteus medius weakness causes the knee to drop inward (valgus) during weight-bearing, dramatically increasing medial knee load. Side-lying hip abduction, clamshells, and lateral band walks are effective and low-load.
3. Aerobic exercise: Walking, cycling (stationary or outdoor), swimming, and water aerobics provide cardiovascular benefits, aid weight management, and have independent pain-reducing effects through central pain modulation.
4. Flexibility: Maintaining quadriceps and hamstring flexibility reduces knee loading during movement. Gentle stretching is appropriate.
Exercises to Approach Carefully
- Deep squats (below 90°) in moderate-to-severe OA — reduce depth to comfortable range
- Prolonged kneeling — can aggravate the prepatellar bursa and compress the joint
- High-impact activities (running, jumping) — may be acceptable in mild OA with good muscle support
Pain Monitoring During Exercise
Use the "traffic light" rule: green (0–4/10 pain, fine to continue), yellow (5/10, monitor carefully), red (above 5/10 or pain lasting more than 24 hours after exercise — reduce load). Never exercise into sharply increasing pain.
Knee OA Exercise Prescription at Better Physiotherapy Bundoora
We design individualised knee OA exercise programs and deliver the GLA:D program. Medicare EPC available. Call (03) 9467 6900 or book online.
Frequently Asked Questions
Is walking good or bad for knee OA?
Good. Walking is one of the most recommended activities for knee OA. It maintains joint nutrition, manages weight, improves cardiovascular health, and has low impact on the knee joint at normal walking pace. Start at a comfortable distance (even 10 minutes) and gradually increase. A supportive shoe with good cushioning helps. If walking is very painful, pool walking is a gentle starting alternative.
Will strengthening my quadriceps help knee OA pain?
Yes. Quadriceps weakness is consistently found in people with knee OA and strongly associated with pain severity and functional decline. Strengthening the quadriceps (and hip abductors) directly reduces knee joint load during walking and stairs. Leg press, sit-to-stand exercises, and step exercises are effective and safe starting points.
Is cycling good for knee OA?
Excellent. Cycling is arguably the best exercise for knee OA — it loads the quadriceps through a functional range without the impact of walking. It improves aerobic fitness and manages weight, both important for OA. Both stationary and outdoor cycling are appropriate. The key is setting the seat height correctly — slightly higher than normal to reduce knee flexion load.
How do I know if exercise is making my knee OA worse?
A pain monitoring framework: exercise pain up to 5/10 that returns to pre-exercise baseline within 24 hours is acceptable. Pain above 5/10 during exercise, or pain that takes more than 24 hours to settle, suggests the load needs to be reduced. Significant increase in swelling after exercise is also a sign to reduce load. A physiotherapist will guide your exercise progression within these parameters.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora