Even if your knee osteoarthritis causes notable pain, and you’re not ready for surgery, there’s certain exercises you should do that will benefit the diseased joint.
A major study published in The BMJ found that aerobic exercise comes out on top for managing knee osteoarthritis.
This will seem counter-intuitive to many people with this common joint condition, especially if they have daily pain.
The last thing you’ll want to do to “treat” your painful knee osteoarthritis is to become sedentary and take it easy and spend much of your day in a seated position.
The study doesn’t say to jump rope or run up and down hills, but it certainly heavily recommends certain kinds of activities.
Compared to other types of workouts, aerobic activities in the study delivered the biggest improvements in pain relief, mobility, walking ability and overall quality of life.
Beneficial cardio-based movement includes walking, hiking and cycling.
Knee osteoarthritis happens when the cartilage in your knee joint slowly wears down over time.
That breakdown leads to stiffness, swelling, pain and reduced range of motion.
Nearly 30% of adults over 45 show signs of it on imaging, and about half of those people deal with more serious symptoms.
Exercise is already a standard recommendation — and this study found that aerobic movement wins.
What the Study Looked At
The team analyzed 217 randomized clinical trials conducted between 1990 and 2024, covering over 15,000 participants.
The studies compared multiple exercise approaches, including aerobic workouts, strength training, flexibility routines, mind-body exercises, neuromotor training and mixed programs.
To keep things rigorous, they rated the quality of evidence using the GRADE system, which is a standard method for evaluating research reliability.
They measured changes in pain, physical function, walking performance and overall quality of life.
They also tracked progress over different time frames: short term (about four weeks), mid-term (12 weeks) and longer term (24 weeks).
Across all of these categories, one type of exercise kept coming out ahead: cardio.
Why Cardio/Aerobic Exercise Is Great for Knee Osteoarthritis
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Aerobic exercise consistently ranked as the most effective option.
With moderate-quality evidence, it reduced pain in both the short and mid-term.
It also improved physical function across all time frames — from early weeks all the way to six months.
On top of that, it boosted walking ability and quality of life, especially in the short- and mid-term.
Other exercise styles weren’t useless — they just didn’t outperform aerobic activity overall.
- Mind-body exercises showed benefits for short-term function.
- Neuromotor training helped with walking mechanics early on.
- Strength training and mixed routines improved function over the mid-term.
But none matched the consistency of aerobic workouts. Aerobic exericse also includes light impact cardio classes.
Worried about making your knees worse?
One of the more reassuring findings: Exercise didn’t increase the risk of adverse events.
Certainly, if hiking brings on pain, you’ll want to slow down or choose a gentler course and see if that eliminates the pain.
Maybe there’s another mode of aerobic activity that you’ll take to better. Experiment and find which one suits you well.
This study is one of the most comprehensive looks at exercise for knee osteoarthritis to date.
The foundation for manageming osteoarthritis is structured exercise rather than narcotics and other pain drugs that can have side effects.
If mobility is a challenge, then water aerobics, water walking/jogging and using a stationary bike are very viable options.
