The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Exercise Options for Bad Knees

Written by
Michael Harper, MEd
Posted in
Move more

Tuesday, Apr 02, 2013

When thinking of bad knees, the term osteoarthritis often comes to mind. Osteoarthritis is a degenerative condition of the cartilage of synovial joints, commonly affecting the knee joint, and is relatively pervasive in society today, including in those with an athletic and active lifestyle. While athletic activity does not have a cause and effect relationship with osteoarthritis, traumatic injury often resulting from athletic pursuits can increase the likelihood of its occurrence, which I think may explain the issues that have plagued me and my knees. Currently I have been able to manage the effects of osteoarthritis and have been able to remain active, but not without the incorporation of a few exercises like those below (Thomas et al, 2013) to help maintain the strength around my knees and that are designed to protect the cartilage that is left in my knees.

  • Knee Extensions against manual resistance – similar to performing a machine knee extension, but instead have a partner apply resistance on the front of the shin that allows movement through full range of motion.
  • Stretching of the quadriceps, hamstrings, hip flexors, gastrocnemius, and soleus. Specifically, use of proprioceptive neuromuscular facilitation (PNF) stretching has been shown to provide significant benefits.
  • Hip Abduction and Hip Adduction exercises
  • Other exercises showing benefit included exercises such as the leg press, leg curl,  straight leg lift, and calf raise.
In 2005, approximately 27 million US adults were diagnosed with clinical osteoarthritis (OA) affecting quality of life through pain and functional limitations. This number is projected to rise to 67 million by 2030, thus paving the way for a definite need to find ways to take care of our knees (Murphy et al, 2012). Thus, in addition to the above exercises, below are a few suggestions that can be used by individuals without osteoarthritis as well as those who currently are dealing with pain from osteoarthritis:
  • Weight loss - Arguably, one of the most influential risk factor associated with knee issues is increased body mass. Research has consistently shown a significant correlation between obesity and both the incidence and progression of knee osteoarthritis, thus weight management, and ultimately weight loss, is an important consideration for those dealing with osteoarthritis or wanting to help prevent onset.
  • Shock-absorbing insoles – These are especially useful for those who are overweight, obese or have a heavy heel strike in walking and running. Otherwise, for those with a mid-foot strike, a minimal shoe is appropriate.
Upon discussion with a physician, other simple options, such as braces, may be available in addition to those above. Yet it is still suggested as both a preventative measure and for rehabilitation that the middle-aged athlete continue recreational sport and activity, if pain-free, as there is a positive association with activity and improved function, performance and reduced pain. Of course, with any injury, it is suggested that individuals consult their physician for diagnosis and additional treatment options. Finally, it is also suggested that if pain is present that individuals seek medical advice from their physician.


Murphy L, Helmick CG. The impact of osteoarthritis in the United States: a population-health perspective. Am J Nurs. 2012;112:S13–S19

Thomas, A., Band-Entrup, D., Kuhn, S., Legere, L., Et al. Physical Therapy Management of Knee Osteoarthritis in the Middle-aged Athlete. Sports Med and Arthroscopy Review, 2013:21(1):2–10. doi: 10.1097/JSA.0b013e318272f530