Which exercises help knee arthritis without making it worse?

Why exercise works for arthritic knees

Strong quadriceps, hamstrings and hip muscles absorb force before it reaches the joint, steady the knee and improve balance. Regular movement also nourishes cartilage, which gets its nutrition from joint fluid pressed in and out as you move. International guidelines recommend exercise for virtually everyone with knee osteoarthritis, whatever the X-ray shows.

A simple starting programme

• Straight leg raises lying on your back, holding a few seconds at the top
• Sit-to-stand from a firm chair, using your hands less as you improve
• Short-range squats or wall sits, staying within a comfortable depth
• Side-lying leg lifts or band walks for the hip muscles
• Step-ups onto a low step
• Calf raises holding a counter for balance

Start with two or three sets of 8 to 12 repetitions, three times a week, and add resistance gradually. A physiotherapist can tailor it to which part of your knee is affected.

Cardio that is kind to the knee

Cycling, including a stationary bike, swimming, aqua aerobics, the elliptical trainer and walking on even ground are usually well tolerated. Aim to build towards about 150 minutes of moderate activity a week, split into sessions that suit you. During the Qatari summer, an air-conditioned gym, a pool or a walk in a mall or indoor track is more realistic than the corniche at midday; in the cooler months, early mornings and evenings work well outside.

The pain rule and when to adjust

Some discomfort during exercise is normal and not a sign of damage. A useful guide is that pain during exercise should stay mild, and the knee should be back to its usual level by the next day. If it is more painful or swollen the following day, reduce the amount or depth and build up more slowly. Deep squats under heavy load, repeated jumping and long runs on hard ground are the activities most likely to aggravate arthritic knees.

If exercise keeps causing flares despite adjustments, or the knee locks or gives way, ask for an assessment. At Aman Hospital, Dr. Gelber can check whether a mechanical problem or alignment issue needs a different approach.