While there can be many causes of knee pain, I will be focusing on the most common joint disease, osteoarthritis. The knee is the most common joint that OA affects. OA, also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. It mainly affects people over the age of 45. Knee OA is a progressive condition, however there are exercises that you can do to slow the progression and perhaps reduce the risk for surgery.

Studies have shown that exercises and a home exercise program can produce the best results for reducing the progression of OA. It is important to note that these improvements are lost after 6 months if exercises are stopped. Therefore, exercise is a lifelong commitment!  In addition, weight loss can be an effective way to reduce knee pain due to OA. Exercise has been shown to:

  • Strengthen the muscles around your knee
  • Help maintain bone strength
  • Control of weight
  • Reduce knee pain and inflammation
  • Improve balance

How does exercise reduce pain and inflammation? There are a few factors involved.

  • Synovial fluid, which acts like oil in an engine, allows your bones to move more fluidly within your joints.
  • Physical activity encourages circulation of synovial fluid coming from the synovial membrane.
  • Exercise also promotes increased blood flow which helps to bring oxygen and nutrients to the knee. When you are practicing weight bearing exercise, the weight that bears down into the knee when weight bearing is forced out like a sponge, and when the weight is lifted it allows water to return into the cartilage, bringing new nutrients and oxygen back into the knee. Examples of weight bearing exercise include squats and lunges.
  • Joint repair genes are switched on when exercising. Recent research has shown that when exercising, joint repair genes get activated.
  • Exercising increases muscle, ligament, and tendon strength. This results in improved stabilization and function of your knee.

What exercises should I perform?  Land based exercises have been shown to be particularly effective against the progression of OA of the knee. These exercises include walking, Tai Chi, and muscle strengthening exercises. Below are some of my favorite weight bearing exercises for combating knee OA. Cycling and yoga can also be effective against the progression of OA for some individuals.  Some exercises may not be appropriate for a specific individual, based on a number of factors including pain levels, general fitness level, and the level of progression of OA in a given subject. Therefore it is important to talk to your trainer and/or physical therapist when exercising with OA.

Assuming readers of this newsletter already know the core basic weight bearing exercises such as squats and lunges, here are 3 other examples of land based exercises. With these exercises, it is important to practice good form. Your hip, knee, and ankle should be in a straight line.

Single leg 4-way directional toe taps:

Diagonal forward Reaches:





Resisted Side Stepping:





 Written by: Michael Root, DPT Pivot Physical Therapy