Exercises for Bad Knees: Gentle Ways to Keep Moving With Knee Pain
Having painful knees can put you in a frustrating position when you’re trying to become more active. Exercise is constantly recommended for our health, but that’s not particularly helpful when walking, bending your knees or getting out of a chair already hurts.
It can feel even more complicated if you’re overweight. I’ve exercised at very different weights over the years, including before, during and after losing more than 10 stone, and I know that some exercises simply feel different in a larger body. Movements involving getting down onto the floor, jumping or repeatedly putting a lot of pressure through your knees aren’t necessarily the most comfortable place to start.
The answer isn’t always to avoid exercise completely, though. Depending on what’s causing your knee pain, finding gentler ways of moving and gradually strengthening the muscles around your knees may actually be helpful.
The important part is finding exercise that is appropriate for your knees, rather than deciding that everyone with a “bad knee” needs exactly the same workout.
Before you start exercising with knee pain
I use the phrase “bad knees” in this article because that’s what many of us actually type into Google, but it isn’t a diagnosis.
One person might have osteoarthritis, another might have an old injury and somebody else might suddenly have knee pain without knowing why. The exercise that’s suitable for each of those people could be quite different.
If your knee is very painful, you can’t put weight on it, it is badly swollen or has changed shape, or it is hot and red alongside feeling unwell, the NHS recommends getting medical advice rather than simply trying to exercise through it. Persistent knee pain that isn’t improving is also something to get checked.
If you’ve already been diagnosed with a knee problem, a physiotherapist can be particularly useful because they can recommend exercises based on what’s actually happening with your joint rather than giving you a generic list from the internet.
For everyone else, think of the ideas below as possibilities for staying active rather than a rehabilitation programme for an injured knee.
Walking can still be an option
Walking probably sounds far too obvious to include in an exercise guide, but I think we sometimes dismiss simple movement because it doesn’t feel enough like a “workout”.
You don’t have to go out and walk five miles.
If your knees tolerate walking reasonably well, you might begin with a short walk and see how they feel afterwards. A flat route may be more comfortable than hills, and you can gradually increase the distance rather than suddenly deciding you’re going to hit 10,000 steps every day.
This is especially important if you’ve been inactive for quite a while. Your motivation can increase much faster than your body’s ability to cope with suddenly doing several times more activity than usual.
Good footwear matters too. I’ve written separately about choosing comfortable trainers for walking, including options worth considering if you’re heavier and want plenty of cushioning and support.
If walking consistently makes your knee considerably more painful, however, I’d look at other forms of activity rather than repeatedly forcing yourself through it.
Walking trainers – how to choose the best trainers for walking
Cycling gives you another way to move
An exercise bike can be a useful option because you’re sitting down and aren’t repeatedly landing your body weight through your knees in the way you would with running or jumping.
The smooth movement can feel much more manageable for some people with knee problems, although the setup of the bike matters. Having the seat at an unsuitable height can make cycling uncomfortable, so don’t assume that pain simply means cycling isn’t for you without checking how the bike is adjusted.
Start with low resistance and an amount of time that feels manageable rather than immediately turning it into a hard workout.
If you’re exercising in a larger body, do check the maximum user weight of any exercise bike you’re considering. I’ve got a separate guide to higher-weight-capacity exercise bikes because finding fitness equipment that’s actually designed to support you can be surprisingly frustrating.
A recumbent bike is another possibility. These have a larger seat and back support and can feel more comfortable if balance, mobility or back problems make an upright bike difficult.
Swimming and exercising in water
Water is one of my favourite suggestions when somebody wants to exercise without lots of impact through their joints.
Swimming is one possibility, but you don’t actually have to be a confident swimmer to exercise in a pool. Walking through waist- or chest-deep water gives you resistance while the water supports some of your body weight, and many leisure centres also offer aqua aerobics or gentler pool exercise sessions.
This can be particularly appealing when you’re overweight because movement that feels difficult on land can sometimes feel considerably easier in water.
There is another benefit that isn’t really about knees at all: nobody can see very much of what you’re doing once you’re in the water!
I know confidence can be a much bigger barrier to exercise than fitness sometimes, especially if you’re worried about being the largest person in an exercise class. A supportive pool session can be a lovely way of becoming more active without feeling that you need to keep up with somebody else’s pace.
Not every swimming stroke will suit every knee problem, though, so if a particular movement hurts, don’t assume you need to keep doing it simply because swimming is generally described as low impact.
Exercising in water even if you can’t swim
Chair exercises aren’t only for people who can’t stand
I used to think chair exercise was something aimed exclusively at elderly people or those with very limited mobility. It actually makes a lot of sense whenever you want to move without putting your full body weight through painful knees.
You can do an entire upper-body workout sitting down using nothing more than your arms, or add light weights or resistance bands if that’s appropriate for you. Seated marching and gentle leg movements may also be possibilities depending on what your knees tolerate.
This is where I’d be cautious about copying random “bad knee exercises” online, though. If the exercise is specifically moving or strengthening the painful knee, I’d rather you used exercises recommended by an NHS physiotherapy service or your own physiotherapist than trust me to decide which movement your particular knee needs.
There is still plenty you can do while giving a painful knee less work. Seated punches, arm raises and other upper-body movements can increase your activity without turning every workout into a knee workout.
I’ve got a full guide to chair exercises if you’d like more ideas.
Strengthening your legs may help, but it needs to be appropriate
This is probably where the original version of this article was too prescriptive.
Strengthening the muscles supporting the knee is commonly included in physiotherapy for knee problems, and NHS musculoskeletal services provide exercises designed to build strength and maintain movement. That doesn’t mean every strengthening exercise is right for every painful knee.
Rather than giving you a collection of wall sits, squats, bridges and lunges and telling you to work through them, I’d much rather point you towards properly demonstrated exercises from a physiotherapy service.
Some knee programmes begin with very gentle movements such as bending and straightening the knee or contracting the thigh muscles before progressing to more demanding exercises as strength improves.
That makes far more sense to me than starting with whichever exercise happens to look impressive on Instagram.
If you’ve been given exercises by a physiotherapist, do those rather than substituting something from this page. They have actually assessed your knee; I haven’t!
Don’t forget the rest of your body
Having painful knees can make exercise become entirely about your knees, when there is plenty of the rest of you that can still move.
You could use resistance bands or light weights for your upper body, try seated cardio, use an arm cycle at a gym or concentrate on movements that don’t aggravate your knee.
This can be especially useful if you’ve previously relied on walking for exercise and suddenly find you can’t do as much. Instead of thinking, “I can’t exercise because my knee hurts”, it can help to ask, “What can I comfortably do today?”
Sometimes the answer might still be very little because your knee needs attention, and that’s okay too. Exercise isn’t something you have to do at any cost.
How much should exercise hurt?
This is a difficult question because advice to “stop if it hurts” can be too simplistic when we’re talking about persistent joint problems.
Some NHS physiotherapy services explain that a degree of discomfort during rehabilitation exercise can sometimes be acceptable, provided it settles reasonably quickly and doesn’t leave symptoms significantly worse afterwards. What is appropriate depends on your condition and the exercise you’ve been given.
That’s quite different from suddenly experiencing sharp or severe pain and deciding to push through it because somebody once told you “no pain, no gain”.
I really dislike that phrase.
If an activity repeatedly leaves your knee substantially worse, causes new swelling or you’re worried about what you’re feeling, get advice rather than continually testing it to see whether it’ll magically stop hurting.
A useful thing to notice is how you feel later that day and the following day, not only while you’re exercising. That can help you recognise when you’ve increased your activity too quickly.
If you’re overweight and your knees hurt
This deserves its own discussion because advice around weight and joint pain can become very unhelpful very quickly.
If you’re overweight and go to a doctor with painful knees, there’s a fair chance weight loss will come up. There are sensible reasons for this because body weight affects the load going through weight-bearing joints, and weight management can form part of treatment for some knee conditions.
The frustrating bit is being told to lose weight through exercise when exercising is precisely the thing that’s hurting!
I’ve lived in a much larger body myself, and I think the answer has to be more practical than simply saying “move more”. If walking hurts, perhaps water exercise works better. If standing for long periods is difficult, perhaps you can start with seated exercise. If gym equipment isn’t suitable for your size, look for equipment with an appropriate weight capacity rather than trying to squeeze yourself onto something that wasn’t designed for you.
Exercise also doesn’t have to carry the entire burden of weight loss. When I lost more than 10 stone, what I ate played an enormous part in that. Becoming more active has lots of benefits, but you don’t need to destroy your knees trying to burn off every calorie you eat.
Finding movement you can tolerate and gradually building your fitness is a much more realistic place to start.
Exercise for obese or overweight beginners
Don’t set yourself a rigid exercise timetable
The previous version of this article had a lovely neat schedule telling you how many minutes to exercise during weeks one and two, then weeks three and four and so on.
Real knees aren’t quite that cooperative.
Two people could start with exactly the same amount of exercise and respond completely differently. You might comfortably increase what you’re doing after a week, while somebody else might need several weeks at the same level.
I’d rather increase one thing gradually and see how my body responds. That might mean walking for a few minutes longer, adding a little resistance to an exercise bike or doing an extra pool session.
If your knee is noticeably complaining afterwards, that’s useful information. You don’t have to keep increasing something simply because a schedule says it’s time.
What exercise is best for bad knees?
There isn’t one exercise that wins because it depends on why your knees hurt and what movements you tolerate comfortably.
For general activity, walking, cycling, swimming or water exercise and seated exercise are all possibilities worth exploring. If you’re specifically trying to strengthen or rehabilitate your knee, I’d use exercises from an NHS physiotherapy programme or, ideally, exercises recommended for you by a physiotherapist.
What I wouldn’t do is decide that painful knees mean exercise is completely off limits forever.
I’ve learned over the years that exercise doesn’t need to look like the workouts we’re shown in fitness adverts. You don’t need to run, jump, burpee or squat your way through an hour-long class for movement to be worthwhile.
If ten minutes on an exercise bike feels okay, start there. If walking in a swimming pool is more comfortable than walking around the park, do that. If your knee is having a particularly bad day and upper-body chair exercises are all you can comfortably manage, they still count as movement.
The aim isn’t to prove that you can exercise despite being in pain. It’s to find ways of being active that work with the body you’ve got at the moment, while getting proper help for the things that need it.
