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Paige Waehner

Exercising with Knee Pain

By February 6, 2014

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As someone who's been exercising for a long time, I know what it's like when joints start to get a little creaky. In fact, of all of my clients over the age of 40, there isn't one who doesn't have some kind of joint pain, the most common being knee pain. I thought of this as I was reading a comment from one of my readers who said: "I want to exercise, however I have gone through many injuries and falls this year, and my knees are a problem for me right now...which exercises would you recommend for someone with knee injuries?"

My first recommendation won't surprise you: See your doctor if you have any kind of knee pain that lasts more than a couple of weeks. Knee pain can be caused by so many things, it helps to get a proper diagnosis so you can figure out exactly where the pain is coming from.

That said, what I do with my knee-pain clients is this:

  • Find ways to exercise safely with knee pain - Sometimes we have to experiment with different activities to find what works. Most of them agree that water exercise is one of the best options if you have joint pain - the water supports your body and allows you to exercise without impact on your joints. Many of them can also walk without too much trouble, although, again, you may have to experiment.
  • Stick with low impact exercise - There are lots of great low impact cardio exercises you can do that won't require a bunch of jumping around to get your heart rate up. You may have to experiment to find what feels good to you, but these workouts will give you some ideas: Low Impact Cardio Blast and Low Impact Challenge. The elliptical trainer and/or the stationary bike are also options, although, again, some people can tolerate these activities and some can't. It goes without saying - If it hurts your knee, skip it.
  • Learn how to strengthen the muscles that support the knee - There are some basic exercises you can do to strengthen the muscles around the knee. Typically, I'll get an okay from my client's doctor before doing any of these exercises and, often, the doctor may recommend physical therapy before doing anything more strenuous.

Now, it's your turn. For those of you with knee issues, how do you exercise? What has your doctor recommended? Most importantly: If you're overweight, how do you deal with needing to lose weight to take the pressure of your knees...yet your knees hurt too much to exercise? Leave a comment and give us your insights into knee pain and exercise.

August 12, 2010 at 11:52 am
(1) Debbie says:

Love your articles. I haven’t injured my knees per se, but I was overweight for awhile. Having lost weight I can now hear and feel some crunchiness in my knees, especially when I’m walking down stairs and at times its painful. I’ve found that stretching my hamstrings and calves combined with squats and other exercises to strengthen my legs really helps. Of course losing weight helps too.

August 12, 2010 at 12:31 pm
(2) Judy Graham says:

I fell several years ago fracturing my patella in three places. I have since developed osteoarthritis. I have found that exercise, especially those that build muscle surrounding the knee, gives me greater ability to continue being active. My knee does hurt when I exercise but I know that it is better for me to be active than to be inactive. I have also found that taking ibuprofen before exercising helps, as does ice/heat packs.

August 12, 2010 at 12:41 pm
(3) michael basila says:

i dont know what to do anymore everytime i try to exercise
my knees they hurt worst especially lifting weights just 20 lbs
my left knee is so bad i cant bend it when i walk i have to keep it straight or it fills like a knife slice through it. can u help.

August 12, 2010 at 1:31 pm
(4) Yosh says:

My ortho doc highly recommends bicycling as a knee exercise.

August 12, 2010 at 2:57 pm
(5) Devorah says:

I have severe osteoarthritis in one knee and do deep water exercise as my main fitness activitiy. In 12 ft of water wearing a flotation belt, it’s a total body workout but zero ipact. Still need to be mindful of extension and twisting but it’s a great way to get some good cardio and strength building while still sparing the knees.

August 12, 2010 at 4:13 pm
(6) Fitness fan says:

I tore the outer cartilage in my right knee some time ago. The knee would stiffen up and tingle on a regular basis until I rested the knee for a year. Subsequent cardio exercising on a treadmill and now an elliptical machine has strengthened and conditioned the knee to where I have every confidence in using the knee, and stiffness or tingling is now a rare occurrence.

Paige’s “Exercise and Knee Osteoarthritis” is a great article on this topic. And it’s great to see people coming up with workable alternative exercises.

There is hope in the form of research targeting the stem cell treatment of osteoarthritis.


Here’s hoping we see real application sooner than later.

August 12, 2010 at 5:27 pm
(7) Gwen says:

I have had knee pain for most of my adult life (39 yrs old) and found out last November that I have osteoarthritis. I continue to exercise which doesn’t bother me & doc says will help when knee replacement comes around (much later in life). I have severe stiffness usually only in the mornings, but once I move around it’s not so much. I do exercises like squats & lunges, but I love learning new exercises to do for my lower body (it’s my problem area) Thanks for the article!!

August 13, 2010 at 9:56 am
(8) Fitness fan says:

This just came out on the KABC7 news last night, an electronic knee sleeve is available as a treatment for osteoarthritis. The sleeve takes pressure off the knee and recharges the cartilage cells. It may delay or render surgery unnecessary. Medicare and some insurance companies may cover the sleeve which, while expensive, is cheaper and less invasive than surgery.


August 14, 2010 at 12:51 am
(9) Kaye Rochlin says:

I have a torn meniscus and problems with pain in the area of the knee from statin drugs.
I had Magnetic Resonance Imaging, and afterword I noticed continuing lessened pain. I have an old electromagnetic disk eraser, and decided to try that on my knee. It helps enormously. There is very recent research about this, using a machine sold in the UK. Try it.
Kaye R

August 16, 2010 at 4:43 pm
(10) Nick- The 6 Week Workout Program says:

The simple workout for knee OA look very effective! I have had people tell me that they don’t workout because of pain. There are solutions and alternatives out there!

August 16, 2010 at 7:17 pm
(11) Glenda says:

I read a comment by an geriatric doctor who said,”the greatest predictor of fraility in old age is having weak thigh muscles”. I lead a “Silver Sneakers” class for people 50 and up- we meet 3 times a week…I told them “we will not have weak thigh muscles!” We do 30 chair squats, lunges, squats with hand weights, etc.
My doctor told me I need both knees replaced as they are “bone on bone and wearing the bone away”. I told him they don’t really bother me, and he said that is because I have strong thigh muscles- to call him when I’m ready. So keep exercising!!

August 16, 2010 at 7:49 pm
(12) Cylb says:

Two years ago I took a fall and blew out my knee. The ACL was damaged. I had an operation and afterwards the doctor told me I also had arthritis in the knee. He said I may have a limp always.

For me this was the worst accident to happen. My knee swells when I try to walk and I’ll be limping badly before a 30 minute walk is done. One thing, I seem to be able to do is use a stationary bike.

How long should I use a stationary bike to possibly lose weight?

August 16, 2010 at 8:12 pm
(13) Eagle says:

I’ve torn the cartilege in my right kneww once, then the ligament, and then a minor meniscus tear. Each time my knee has recovered over a period of time because of swimming and light water exercises. I wear flippers/fins & use a kick board, for front movement, & start with 3-4 lengths (25m.), and then increase the series up to 10 lengths. I do the same on my back, without the kick board. And alternate back & front. As my knee gets better & stronger – & of course the other knee is keeping up – I sometimes vary the exercise with a dolphin kick (both legs together at the same time – good for the tummy too) for 3-4 lengths. As well I swim lengths with my arms & let my legs just idle behind, which is relaxing for them. Finally I do a few minutes of gentle water running. In this way little pressure is put on the damaged knee & over time (3-8 or 9 months) it really improves & lets one walk on firm ground. It is best to do this about 3 times a week, alternating days. Overall one feels really toned up & relaxed.

August 16, 2010 at 9:08 pm
(14) Paul says:

I had my left knee replaced in 2009, after spending many years in martial arts and working on towers. The most important muscle group to strengthen is the Quadriceps. Using ankle weights lying on the floor and doing sets of leg lifts is vital to keep pressure off the knee when walking and climbing steps. Also, every pound of weight lost is the equivilant to ten pounds off the knees. If 60lbs is lifted by the Quads then 40lbs (2/3) s/b lifted by the Hamstrings this is the ratio. As we age use it or lose it.

August 16, 2010 at 11:01 pm
(15) mary says:

i was starting up tennis after a 20 yr hiatus that included a profession where i sit for 8-10 hrs a day as a clinical psychologist…knee pain got unbearable..thought i had fractured my knee but went to a great physical therapist before the surgeon and did 8 weeks of 2x a week knee lunges, squats and stretches and became so nimble and agile and pain free that my tennis game resembled me as a 35 y r old..no kidding…i was convinced….but now i’ve neglected my self care and the pain is returning. i now know i have to do these exercises regularly forever or suffer….good luck ..

August 17, 2010 at 12:15 am
(16) Rodney hughes says:

I have tears in both rotator cuffs and my shoulders locked down. I could only lift 2olb dumbells 4 reps when I started. I did light weights to build my shoulders up until I have approx. 95% mobility in both now thanks to a good personal instructor at my gym.

August 17, 2010 at 2:54 am
(17) Geralee Baughman says:

I also have had osteoarthritis for several years. THEN, bursitis kicked in on the right inside knee. It has been terribly painful. I went to physical therapy where I strengthend my quads and hamstrings. I also got a new pair of walking shoes with the “roll” bar in them. The key to my pain-free knee was learning to walk/exercise with the pressure on the right inside of the foot. I’ve strengthend – llike Mary – and now it is much better. I will get to my regular walking/water aerobics…thanks, physical therapy!!

August 17, 2010 at 11:28 am
(18) Frieda says:

Following a work related accident, I was told that I have meniscus tears in both knees. I had surgery in each knee at 6 month intervals. After the first surgery, I was told that I wouldn’t/shouldn’t run again. I waited 3 months and started running (slowly easing into my distances) on a treadmill. When I came out of the OR after my second knee was done, the surgeon agreed that I would/should be able to try the treadmill in three months. I am in my fourth month now and I have started short runs. I have been walking since the second week after surgery. I am going to walk the Honolulu Marathon in December, and the half Marathon in Toronto in September. Yes, it does hurt but each day it hurts a bit less. As my quads and hamstrings get stronger so does my walking. I can now do a 13 minute mile. I ice my knees when I get home, take glucosamine and MSM, and take a day off when my body tells me…but only one. I am 61 and the surgeon says I am good for another 10 years. I am betting more on 50. Think positive….you can do it. Don’t let arthritis get you

August 17, 2010 at 1:21 pm
(19) Brigid says:

I have a genetic defect of the knee that doesn’t hurt now, when I’m 24, but will cause me great pain later in life and probably lead to a knee replacement by age 60. My doctor explained that, although I feel fine now, every step I take will be one I won’t be able to take in the future as my cartilage wears. Pain won’t tell me when I’m wearing out my knee, so I have to be a little mindful of my actions, deliberately strengthen the knee without wearing it out.

The adjustments I made are very simple. I avoid running, don’t wear high heels, wear shoes with lots of support around the house, and place my whole foot on a step while going up or down stairs. Substituting low impact exercise is easy and can push me to try different workout strategies that keep things interesting. Most importantly, I am aware of my knees all the time, not just when I’m working out.

August 17, 2010 at 3:46 pm
(20) Jenny says:

I have a knee problem. Some years ago I had therapy that really works! My therapist told me I can’t ride bike, but I love it! I always do, so I start bike again slowly just for few times. Now I ride bike almos every day for 30 min to 1 hr and I feel a little bit beter, even though, the crashes are still on my knee, I just accommodate it and that’s it!
Excersise is always good. but no excess!

August 20, 2010 at 11:46 pm
(21) iftekhar says:

when i walking some times my knees very weak fall down and my wt now 82 kg ,60 yrs , but i am bp taken medicine regularly how i can loss weight and avoid my laziness,so u suggestion much helpful to me strong body ,stamina ,etc,

August 28, 2010 at 10:55 pm
(22) Brad says:

Having had knee problems all my life from displaced cartlidge, now by the age of 56 the best forms of exercise are zero impact. Read bicycle riding, swimming etc. Reduces pain, swelling and actually improves function and reduces pain for significant time. Routine riding 2-3 times a week work best. Never 2 days in a row! Start with once a week and slowly move up, back off if it feels like you are overworking it.

August 28, 2010 at 11:01 pm
(23) Brad says:

Having had displaced cartlidge in both knees since an early age, discovered bike riding and swimming are best to reduce and eliminate pain, zero impact. Now at 56 if you can start riding once a week and maybe progress to 2 or 3 works best. But never 2 days in a row.

October 20, 2010 at 2:51 am
(24) lizatulziana ahmad termizi says:

i use to warm up my body before exercising.i will gradually increase the REP and stop the exercise when it’s start to have pain or discomfort.i avoid sitting or bent the knee longer then 15 0r 30 min in cold wheather or air-cond.

November 28, 2010 at 2:04 pm
(25) ANNE HEWITT says:

Hello ,i would like to tell my story on improving knee athritis,i saw a surgeon who said i need a new knee,like today,i have bone on bone wear and tear,he cannot operate as i have a severe narrowing of my carotid artery ,which is too dangerous to operate on,he said he would hate for me to go ahead with the op then have a stroke and not be ablle too use my new knee,i asked what i could do to help my self as that was my only option,he said to lose weight and exercise,i have lost 38lbs in 5 months and i bought an exercise bike, i go on 3 times a day for 15 minutes,i can now walk further than ever dont have to rely on pain killers ,feel happier,dont get out of breath and my blood pressure is the lowest it has been in 15 years,my energy levels have doubled and my outlook on life has changed,i still need to lose a bit more weight and i am still on my low fat diet so i will lose the extra pounds,i feel 20 years younger and i am told often i look happier than i have done for a long time.If anybody else in my position,dont despair take control yourself and you will be suprised with what you can achieve if you are positive. Anne

October 9, 2011 at 11:20 am
(26) plodder46 says:

At 65 I have been diagnosed with OA in both knees, I had entered a triathlon ealier this year but could not do it because i had a torn knee cartildge. I am now back training and hope to enter a triathlon next year but a bit worried as I have not started running yet as knees are very stiff, I can cycle and swim but even walking is painful. From other comments i think I need to loose some weight which i hope will take some pressure off my knees, I only want to do one Tri then just concerntrate on cycling and swimming. Its a visious circle because if you don’t exercise you cease up and if you do you get aches and pains.

August 21, 2012 at 5:00 pm
(27) David Pietz says:

This is a nice strength workout.
Do you have the same for cardio or weightloss after your knees go bad?
I have access to a pool only some of the time.

August 28, 2012 at 7:18 pm
(28) walaa says:

looking for some help here please. I have been having pain in my right knee for almost 2 years now. I was told I have wear and tear in my right knee. I have done a scan 2 days ago and my new consultant advised that the wear and tear is right at the back of my knee cap- a very difficult spot to operate on and a very difficult one to ignore as well.

it’s really painful now to climb up stairs, walk at a speed…etc but now swimming also hurts!! I do the front crawl and my knee is starting to hurt a lot.

Any ideas/advice on appropriate exercise, please?

March 16, 2013 at 9:49 am
(29) Peter says:

Hi my name is Peter I am 52 I had one TKR on 6 September 2012 and had the next one done on14 Febuary 2013 I have been so depress because I am having trouble getting around I also Have asto arthritis I legs ankles and spine and due to that I am obeast and have put on a lot of weight ang I need to get it off for the pain can any one help I am so depressed

May 15, 2013 at 11:34 am
(30) chuck ebel says:

Both knees kick out causing me to fall at times; itried all kind of exerciises but I still cant walk too far.
Any ideas?

February 6, 2014 at 3:28 pm
(31) G Rose says:

i am 68 and have always been active, I have had two scopes, one on each knee and have osteoarthritis, the last Dr said I would be back in his office within 3 years to have knee replacements. I am not wild about having something metal in my knees. I have just given up my 3x’s weekly tennis doubles during the past summer and Pickle Ball too. I can do it on occasion but suffer for several days after. What I can do is still walk, bike, xc ski, snow shoe (although that hinge motion sometimes feels ouchy) and of course swim. I am slight in build which I am thankful for otherwise I don’t know what I would be like! I do know that it is important to keep doing what I can to be active, when you stop, you rust! I am interested in what they are doing with stem cell/ plasma rich white cells/ bone marrow. I know there are some Dr’s doing that but it is not covered by insurance and is expensive. What does anyone know about this? Anyone had this treatment done? What kind of results?

February 7, 2014 at 11:01 am
(32) Alicia says:

Hi, Paige. As a massage therapist, I have had many clients with knee pain. Some have had torn cartilage or ligaments. What I have found, is that most often, these clients have very tight muscles, specifically hamstrings and quads, and sometimes adductors also. The IT band is often glued down to the hamstrings and the quads and needs to be released through myofascial release work. The glut med and min often have trigger points (they also attach to the IT band.) And the TFL as well. A good massage therapist can get in there and release these muscles and help relieve and sometimes eliminate knee pain.
It will probably take several sessions, and possibly more, depending on how long the problem has built up and what the client’s pain threshold is (Releasing deep knots can be painful, and some client’s can only endure so much work on them at a one time.) When there are lots of knots, it can take a while to work them out.
Another helpful tip is to lay on one’s side on a foam roller, which can hurt like the dickens but will help eliminate knots and trigger points and unglue fascial adhesions.

February 10, 2014 at 1:45 pm
(33) Carlotta says:


Hi guys, I just wanted to share with you all – I am only 35 and have lost most of my range of motion. The only thing I can do normal is walk. My knees have started to turn inward and I cannot sit for long periods of time or stand. I used to run, ride a motorcycle, and ride my bike; now I cannot do any of them. My knees do not bend far enough to get on a bike or rotate. I am stuck. I cannot sit in low chairs or bar stools. My knee cap gets out of place at times as well. I had torn my first ACL when I was in 8th grade and now I have full blown osteoarthritis more than a 60 year old would have. But there is no cure for me. People laugh at me for parking in handicap based on how I look. I cannot sit indian style, sit on the floor, ball up in a little ball to watch tv ever again. ) :
I am too young for knee surgery.
I still remain active – but i am going down hill pretty fast.
My boyfriend has to put my shoes on for me. ) :

February 10, 2014 at 10:32 pm
(34) scubaJim says:

Thanks for all your geat articles & encouragement.

I have a mild ACL strain that won’t heal & not bad enough to require surgery. I’m prone to slight hyperextensions which aggravate it. If I walk for exercise without paying attention to avoid too long a stride, it’ll aggravate it. So, I walk keeping knees bent very slightly. But, I’ve found that a good old fashioned Stairmaster is awesome. Now worries about locking back my knee, can set any pace I want and I believe it strengthens the small muscles around the knee. I also use a wobble board regularly. I tarted by just doing quarter squats. I do them facing a wall so that I can reach out to briefly help balance if I need to. These are great for quads, glutes & those small muscles that stabilize the knee all at once.

February 11, 2014 at 2:05 am
(35) wilbur says:

The secret to weight loss is fat burning. This is best done by exercising for about an hour before eating in the morning. I’m 82 and after walking for about 25 minutes, a flushed warm feeling (second wind) occurs. This is when the tiny veins used to deposit the fat operate in reverse by carrying it out to be consumed. During the hour my pulse begins at 70, gradually increases to 120 after 25 minutes, then levels out at about 85 to the end of the hour. If you eat before exercising, those calories will be used to prevent fat burning.

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