Exercises for Knees with Osteoarthritis — A Practical Guide

Why are exercises the most important treatment?

It might seem counterintuitive: 'My knee hurts—and I have to move it more?' Yes. The muscles around the knee act as a natural shock absorber. The stronger they are, the better they protect the joint. Studies show that a regular exercise program can be as effective as an anti-inflammatory—without the side effects.

General Principles

• Movement, not performance. The goal is not to break records.
• Mild pain = acceptable. Strong pain = you've overdone it.
• Consistency beats intensity. 15-20 minutes daily is more valuable than one hour per week.
• Warming up matters. 5 minutes of light walking before exercises.

Recommended Exercises

Quadriceps sets — Seated on a chair, straighten the affected leg, firmly contracting the thigh muscle. Hold for 5 seconds, then relax. 10-15 repetitions, 2-3 times a day.

Straight leg raises — Lying on your back, one knee bent, the other straight. Lift the straight leg 15-20 cm, hold for 5 seconds. 10-15 repetitions.

Heel slides — Lying on your back, slide your heel towards your buttocks, bending the knee as much as pain allows. 10 repetitions.

Wall mini-squats — With your back against a wall, slowly lower into a slight squat (max 45°), hold for 5-10 seconds. 10 repetitions.

Hamstring stretch — Seated on the edge of a bed, one leg on the bed with the knee straight. Gently lean forward. 20-30 seconds, 3 repetitions.

Recommended Physical Activities

• Walking—the simplest and most effective exercise
• Swimming and hydrotherapy—water supports the body's weight
• Cycling—an excellent exercise with zero impact on the joint
• Yoga and tai chi—improve balance and flexibility

What to Avoid

• Running on hard surfaces
• Deep squats below 90°
• Impact sports (soccer, basketball, intense tennis)
• Total immobility—it is more harmful than moderate movement

When exercises are not enough

When osteoarthritis is advanced, additional treatments may be necessary: hyaluronic acid or PRP injections, or knee replacement.

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