Exercise Therapy for Knee Osteoarthritis: What Works, What Doesn’t & Why You Shouldn’t Give Up

If you’ve been recently diagnosed with knee osteoarthritis (OA), you’re not alone—and you’re likely facing a flood of advice. Among the top recommendations you may have received is exercise therapy. But maybe you’ve tried it before without success. Or you’re worried it might make things worse. Let’s unpack what the evidence says, how to do it right, and why giving exercise another chance—this time with expert support—could be the best decision you make for your knees.

Why Exercise Therapy Matters in Knee Osteoarthritis

Knee osteoarthritis isn’t just “wear and tear.” It’s a complex condition involving inflammation, joint changes, and muscle imbalances. Exercise therapy for knee osteoarthritis is one of the most effective non-drug treatments—and this isn’t just opinion. It’s backed by a mountain of evidence.

📊 A 2022 Cochrane Review of over 10,000 participants found that exercise therapy reduced pain by approximately 20% and improved function by around 23%, comparable to non-steroidal anti-inflammatory drugs (NSAIDs)—but without the side effects. [¹]

Unlike medications, exercise therapy also improves joint stability, strength, and quality of life over time.

How Exercise Helps Knee Osteoarthritis Pain

When designed correctly, an evidence-based knee OA exercise program targets the root causes of pain:

• Strengthens the quadriceps and hamstrings, reducing load on the knee joint

• Improves joint alignment and biomechanics, helping you move more efficiently

• Enhances stability and balance, preventing falls and reducing stress on painful joints

• Boosts cardiovascular fitness, which plays a role in inflammation control and weight management

These benefits compound over time—and yes, they’re achievable even if your knees feel sore to start.

Common Fears (and the Truth Behind Them)

“What if I make it worse?”

A reasonable concern. But research shows properly guided exercise therapy is safe—and in fact, not exercising often leads to worse outcomes.

✅ A 2018 study in Osteoarthritis and Cartilage found that individuals who avoided exercise due to fear of pain experienced greater functional decline over 12 months compared to those who participated in tailored programs. [²]

“I’ve tried exercise before—it didn’t help.”

The key difference? Personalization and support. Not all programs are created equal. A generic “do these 3 exercises” sheet isn’t enough. Success depends on:

• Matching your current strength and pain levels

• Progressing at the right pace

• Incorporating multiple elements: strength, aerobic, neuromuscular, and behavioral strategies

Safe Exercises for Knee Osteoarthritis (That Actually Work)

There’s no one-size-fits-all, but some of the best exercises for knee osteoarthritis include:

✅ Strength Training

Focus on quadriceps, hamstrings, and hip muscles using resistance bands, body weight, or light weights.

✅ Low-Impact Aerobic Activity

Options like walking, cycling, and aquatic therapy improve joint lubrication and cardiovascular health without overloading your knees.

✅ Stability & Neuromuscular Training

Exercises like single-leg balance, step-ups, or controlled functional movements retrain coordination and protect your joints from further strain.

💡 Pro Tip: If pain increases slightly after exercise but settles within 24 hours, that’s usually OK. Sharp or lasting pain signals you may need to adjust.

Exercise vs. NSAIDs or Surgery: How It Stacks Up

Treatment	Pain Relief	Functional Improvement	Side Effects	Long- Term Benefits
Exercise Therapy	Moderate to High	High	None	Yes
NSAIDs	Moderate	Low	Gastrointestinal, cardiovascular risk	No
Surgery (e.g. TKR)	High	High	Invasive, long recovery	Yes (but not for early/moderate OA)

One-on-One Support: Why It Matters

What sets my approach apart is how I combine science with personalized guidance. As a physiotherapist with over 10 years of experience, I offer online, one-on-one programs tailored to your life, pain level, and goals. My approach includes:

• Strength & stability training

• Aerobic fitness coaching

• Behavioral & habit-based strategies

• Biomechanical analysis

• Ongoing accountability & support

You’re not just given a plan—you’re coached, guided, and supported every step of the way.

🗣️ “I’d tried YouTube exercises before, but this was totally different. I finally feel confident and in control again.” - Thomas

Ready to Take the First Step?

You don’t need to tackle knee osteoarthritis alone—or guess your way through generic routines. Whether you’ve struggled with exercise therapy in the past or are starting fresh, I’m here to help.

👉 Book a free consultation today and let’s create a knee OA exercise program that’s safe, effective, and built around you.

Get Started Here

References

[1] Fransen M, et al. (2022). Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev.

[2] Pisters MF, et al. (2018). Avoidance of activity and disability in patients with osteoarthritis of the hip or knee: a 12-month prospective study. Osteoarthritis and Cartilage.