The 3 Best Exercises for Knee Osteoarthritis
August 22, 2025
Knee osteoarthritis (OA) affects millions worldwide, leading to pain, stiffness, and reduced quality of life. But here's the good news: exercise is one of the most effective non-pharmacological treatments for managing knee OA. In fact, recent research confirms that regular movement not only eases pain but also improves strength and daily function. So, which exercises offer the best results?
Let’s break down the top 3 exercises you should be doing to manage knee osteoarthritis.
1. Aerobic Exercise
Aerobic exercise helps improve cardiovascular health, maintain a healthy weight, and reduce systemic inflammation, all of which can help manage OA symptoms.
Recommendations:
- 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week is recommended**.
- Benefits include reduced joint pain and stiffness and improved endurance.
Best options for knee OA:
- Brisk walking
- Swimming
- Cycling (stationary or outdoors)
**Note: This is a general recommendation. While research hasn’t determined the exact amount of aerobic exercise required specifically for osteoarthritis, any amount can offer benefits. However, to support overall health and well-being, which can positively impact OA, the recommended guidelines remain a helpful target.
2. Resistance Training
Strengthening the muscles around the knee, especially the quadriceps and glutes can reduce joint pain.
Recommendations:
- Resistance training programs lasting 5 weeks or more produce moderate improvements in pain, strength, and function.
- Interventions under 4 weeks are generally ineffective.
- Surprisingly, total exercise volume or adherence levels are not strongly associated with better outcomes. This means doing some training consistently over time matters more than hitting perfection.
Strength exercises for knee OA:
- Sit-to-stands or chair squats
- Step-ups
- Leg extensions
3. Functional Exercises
Functional exercises are movements that closely mimic the activities you perform in daily life or during recreational tasks. Functional exercises can improve your ability to carry out everyday movements like walking, standing, climbing stairs, or getting out of a chair, key areas affected by knee osteoarthritis.
What the research says:
- Moderate benefits for physical function in daily activities (ADL) and sport-specific function after 3–6 months of exercise
- Resistance training improves functional outcomes, especially when programs are at least 5 weeks long.
These findings highlight the importance of exercises that mimic real-life movements and support daily independence.
Functional exercises can include:
- Breaking down an activity you find difficult into smaller movements
- Doing the movement you find painful but with supports, different ranges of motion or for less repetitions
- Walking drills and controlled lunges
Focusing on these movements can improve strength and functional capacity, helping you move better and more confidently in daily life.
What the Science Says Overall
A recent meta-analysis of over 280 studies showed:
- Moderate benefits for pain and physical function from 3 to 6-month resistance training programs.
- Longer interventions (up to 12 months) had additional functional gains.
- No clear link between total exercise dose or adherence and outcome, so the key is to just get started and stay consistent.
🏁 Final Thoughts
Managing knee osteoarthritis doesn’t require extreme workouts, it requires smart, consistent, and purposeful movement. Focus on aerobic activity, resistance training, and functional exercises to see the biggest improvements in pain and daily function. Symptoms from knee osteoarthritis will present differently in each individual person which is why it is important to have a personalised, tailored exercise program.
If you're not sure where to begin, speak with an exercise physiologist to build a safe, effective plan tailored to you.
Need help getting started? Reach out to our team for personalised support in managing osteoarthritis through movement.
Why Exercise Is Essential in Preventing and Managing Type 2 Diabetes
The 3 Best Exercises for Osteoporosis Backed by Science
Rethinking Pain in Exercise: A Journey Beyond Discomfort
We often take for granted the simple acts of daily life—walking to the shops, climbing stairs, or even maintaining our balance as we move about.
Yet for many Australians, these seemingly effortless activities can be significant challenges.
In our latest blog, our team shares their insights and the impact of their role in helping people achieve the best version of themselves.
Ever wondered what a day in the life of an Exercise Physiologist looks like?
We sat down with the team to get their insights and stories around what their average day looks like.
In our latest article, Janine Elias, our Speech Pathologist here at Activate Allied Health shares her journey into a career in Speech Pathology, along with the challenges, rewards and key insights you need to know.
In our latest article, our team shares the most rewarding aspects of their role as an Exercise Physiologist, while providing a candid insight into their challenges too.
Of course, the personal fulfilment and rewards from the job outweigh the challenges, but it’s great to share these insights, especially for people considering a career in Exercise Physiology.
In our latest article, our team of expert EPs have shared their insights on the skills, qualities and mindset needed to thrive in this role.
The Essence of Movement: Rethinking Exercise Engagement In the realm of exercise science, we're perpetually confronted with evolving methodologies, cutting-edge research, and the perennial quest to optimise. human performance and health. Yet, amidst this scientific context, a foundational truth often gets obscured – the paramount importance of movement, in any form, as the cornerstone of physical well-being. As a seasoned Exercise Physiologist and a proponent of challenging industry norms, I propose a perspective that might seem controversial to some: "the best you can hope for with clients is that they do some form of movement, however little." This assertion is not a capitulation to mediocrity but a call to redefine our engagement with exercise and its role in health promotion. Consider this - A client, let's call them Alex, comes to you with a history of starting and stopping various fitness regimes, each time ending in frustration and a sense of failure. Alex's story is not unique but rather emblematic of a widespread issue – the daunting nature of conventional fitness ideals. This example foregrounds a vital conversation about the barriers to regular physical activity and the need for a paradigm shift in how we define and approach movement. Unpacking the Proposition At its core, this stance encourages us to reconsider what we deem "successful" in the context of physical activity. Traditional metrics of success – be it lifting heavier, running faster, or achieving a sculpted physique – while valid, do not encapsulate the broad spectrum of benefits derived from simply moving more. Movement, in its most unadorned form, encompasses a range of activities beyond structured exercise, offering accessible pathways to health for a broader audience. Insights from Exercise Physiology Research consistently highlights the myriad benefits of regular physical activity, including but not limited to cardiovascular health, mental well-being, and reduced risk of chronic diseases. The Exercise & Sports Science Australia (ESSA) and similar accrediting bodies underscore the importance of physical activity at any level, advocating for movement as a non-negotiable pillar of health. Studies have shown that even minimal increases in physical activity can lead to significant health benefits. This evidence supports the notion that fostering any form of movement can be a critical step in enhancing one's quality of life. Addressing Assumptions and Biases The fitness industry, at times, can be overly prescriptive, pushing narratives that valorize extreme fitness regimes and marginalize those unable to meet these standards. This bias not only alienates a significant portion of the population but also perpetuates a false dichotomy between being a dedicated athlete and leading a sedentary lifestyle. It's essential to challenge this narrative and recognize that engagement in physical activity exists on a continuum, and every point on this spectrum offers its own set of benefits. Encouraging a Different Perspective Adopting this broader perspective necessitates a shift in how we, as exercise professionals, engage with our clients. It involves: Personalising the Approach: Tailoring recommendations to fit the individual's lifestyle, preferences, and capabilities, ensuring that the proposed activities are sustainable and enjoyable. Broadening the Definition of Success: Recognizing and celebrating progress in any form, such as increased daily steps, incorporating stretch breaks into the workday, or simply choosing to take the stairs. Fostering Inclusivity: Creating an environment that welcomes individuals of all fitness levels, backgrounds, and abilities, reinforcing that there's a place for everyone in the realm of physical activity. Conclusion As we continue to advance in our understanding of exercise science, let us not lose sight of the fundamental principle that movement, in any capacity, is beneficial. By embracing a more inclusive and flexible approach to physical activity, we can better serve our clients and the broader community, encouraging a healthier, more active society. This perspective does not undermine the value of structured exercise programs but rather complements them, recognizing that the journey towards health and well-being is both personal and varied. In fostering an environment that celebrates all forms of movement, we pave the way for a more inclusive and holistic approach to fitness and health. Let this serve as a call to action for my fellow professionals to engage in this dialogue, challenging our preconceptions and biases, and ultimately, enriching the lives of those we serve by advocating for movement in its most universal form. Disclaimer This blog post is for sparking discussion and isn't medical advice. Always talk to a healthcare provider for exercise recommendations, especially if dealing with pain or injury. This conversation is meant to open our minds and encourage a more inclusive view of fitness, acknowledging the complexities of managing pain within the context of exercise.
As an accredited exercise physiologist, I’m determined to peel back the layers of conventional wisdom in our field. Consider this: Could it be that the strength clients appear to develop over time is something they had the capacity for right from the start? It might not be as far-fetched as it seems. Imagine Alex, who embarks on a new strength program. Initially, she lifts 20 kilograms. Six weeks in, she's proudly lifting 30 kilograms. Great progress, right? But what if, with the right mental approach, technical guidance, and optimal conditions, Alex could have managed that 30 kilograms in her initial session? It is entirely possible. This scenario challenges us to reflect: Is Alex truly getting stronger, or is she simply unlocking an inherent capability? To see how this could be true, let us consider some underlying factors that make it possible. 1. Neural Adaptations: Tapping Into Hidden Strength Initial surges in strength often stem from the fact that the brain is a controlling factor in our movement, strengthening connections it uses regularly and eroding ones it doesn't - much like mastering a dance sequence – a clumsy start leading to a graceful flow. 2. The Psychological Edge: The Weight of the Mind The mental dimension in training is profound. Initially, fear and the unknown can act as additional burdens and barriers. Yet, as familiarity sets in, these psychological barriers dissipate, often resulting in notable performance boosts. The critical query here is whether this represents a bona fide increase in physical strength or the shedding of inhibitory constraints. 3. The Conviction Effect: Placebo and Performance The potency of belief is a force to be reckoned with. When clients have faith in a particular supplement or program, their output may surge, spurred by their convictions rather than genuine physiological change. Thus, we must discern the true catalyst of progress. 4. Understanding Rest: Misreading the Rebound Integrating rest in training is pivotal, but is the upsurge in strength that follows truly a gain, or is it merely the body bouncing back from a state of rest? 5. The Precision of Measurement: Quantifying True Progress Variability in performance measurements can obscure true progress. Factors such as equipment, environmental conditions, and even daily physiological fluctuations prompt us to ask: How can we accurately gauge progress? So what can you do to push the boundaries of your inherent capabilities? Consider these approaches: Consistent Conditions: Aim for consistency in your training environment – lift at the same time of day and use the same equipment to better measure true strength gains. Incremental Overload: Progressively increasing load ensuring each increase is manageable and takes into consideration how you feel including managing your sleep and stress To truly understand our strength, incorporating varied methods like isometric strength assessment and adjusting our training methods based on how we are feeling might offer more definitive insights. It's about enhancing our understanding of strength training and its outcomes. The intent here is not to undervalue our profession or the efforts of our clients but to foster a more critical and layered understanding of what constitutes 'progress.' Let's aspire to be the practitioners who question, scrutinize, and affirm that the achievements we applaud are founded on authentic physiological improvement, not merely the semblance of it. We have an incredibly important role in unlocking what is possible with our clients. The nuance might be that the path is not always as obvious and the skill of the practitioner is equally in building relationships, understanding barriers and helping clients move past their own internal beliefs and biases to achieve progress. *Disclaimer: This discussion aims to ignite conversation and self-reflection, inviting both professionals and clients to examine the broader narrative surrounding strength training.*
