Saturday, 25th April 2026

The Problem of The Painful Knee

Many apologies to all readers of our blog for the delay in sending out this episode – which should have gone out on March 7th. The delay has been caused by technological problems related to the change of name of Cardiac Rehab to Cardiac Health – apparently too difficult a change for IT to be able to cope. Even now, though you have received this edition, it is still not possible to circulate those whose email address includes “@btinternet”.

Knee pain

This is another response to a request. A common effect of the passing of the years is knee pain and I am asked from to time how to keep fit when hampered by this symptom – and also what exercise might reduce pain or at least slow the rate of progression.

Most knee pain in later life is caused by osteoarthritis (OA – wear and tear) of the joint. OA knee is a leading cause of pain and disability driven by the increasing age of the population and by increasing rates of obesity. It is extremely common, affecting about 20% of the population and about half of those aged more than 75. And the prevalence is rising!

For decades, the standard advice for knee pain was to rest. However, modern sports medicine and rheumatology have reversed this stance: for people with knee arthritis, motion is lotion. While it may seem counterintuitive, keeping active is crucial for managing pain and improving mobility. Exercise helps strengthen the muscles supporting the knee, reducing the load on the joint, and keeps the cartilage lubricated.

Here is a guide to the best exercises for managing knee arthritis pain and maintaining physical fitness, focusing on low-impact, sustainable movements.

The Role of Exercise in Arthritis Management

Knee osteoarthritis develops when cartilage wears down, causing friction and inflammation. The goal of exercise is not just to “get fit” but to:

Strengthen support muscles: Strong quadriceps and hamstrings stabilize the knee, reducing pressure on the joint.
Reduce Stiffness: Daily movement lubricates the joint, improving range of motion.
Manage Weight: Lowering body weight reduces the direct pressure on the knees.

Pain relief

These exercises focus on strengthening and mobility to reduce pain and improve stability.

1. Strengthening Exercises (2-3 times a week)

Straight Leg Raises: Sit in a straight-back chair and straighten your leg. Hold this position to the count of ten. Lower the leg – then repeat the straight leg raise to a total of ten times. This exercise should be repeated four times daily.
Sit-to-Stands (Chair Squats): Use a sturdy chair. Sit towards the edge, feet flat, and rise to standing without using your hands. Repeat to a total of five times increasing over time to ten times – again four times daily.
Step-ups: Using a low step, step up with the affected leg, followed by the other. Step down slowly. Again, repeat to a total of five times increasing over time to ten times – four times daily.

2. Mobility and Stretching (Daily)

Hamstring Stretch: Sit on the edge of a chair, straighten one leg with the heel on the floor, and gently lean forward from the hips.
Quadriceps Stretch: Stand, holding a chair for balance. Loop a towel around the ankle of the affected leg and pull the heel toward your buttock.
Lying Knee Bends: Lie on your back and slowly slide your foot towards your buttock to bend the knee comfortably.

Exercises to Maintain Physical Fitness

To maintain cardiovascular health and manage weight without aggravating the knee, focus on low-impact activities.

Swimming and Water Aerobics: The buoyancy of water supports body weight, taking the pressure off the joints while allowing for full movement.
Cycling (Stationary or Outdoor): Cycling is a smooth, circular motion that strengthens muscles without the impact of running. A recumbent bike is excellent because it supports your back and reduces strain on the knees.
Walking: A brisk walk is one of the best exercises if the knee pain allows, provided it is done on even terrain. A soft grassy surface is better tolerated than roads or pavements.
The gymnasium: If knee pain interferes with these approaches, try sticking to arm exercises – the local gymnasium is the best place to go to for guidance and supervision.

Additional points

Warm Up: Start with 5-10 minutes of light movement (e.g., gentle walking or pedalling) to prepare the joints.
Listen to Your Body: It is normal to feel some mild discomfort during exercise, but it should not be severe pain. If pain lasts more than two hours after exercise, you may be pushing too hard.
Progression: For any programme of exercises, start with just a few repetitions and build up gradually.

An image of The Problem of The Painful Knee

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2 responses to “The Problem of The Painful Knee”

Sonia Davey says:

26th April 2026 at 2:48 pm

Thanks for the tips.

I’ve had dodgy knees for years – one is even worse since damaging a cartilage nearly 2 years ago.

For months I limited my walks to “even terrain” (as you suggest in your blog) – thinking I should avoid straining it – but eventually discovered that was the worst thing I could do, because I was pounding the same surfaces over and over. I now try to limit walking on roads, pavements and hard, flat footpaths – and go for soft, slightly uneven (sometimes very uneven) terrain instead.

A physiotherapist also advised doing hip exercises to prevent my knees having to overcompensate.

And I found that yoga helped.

I thought I’d pass on my experience in case it can be used to help others.

- Hugh Bethell says:
  
  26th April 2026 at 2:50 pm
  
  Many thanks Sonia – it is very helpful to hear people’s lived experience. Best wishes Hugh