The Best Types of Exercise for Sore Knees

A rule of thumb is that if you can’t bear weight without pain, or if the pain doesn’t resolve with rest, icing and the use of pain/anti-inflammatory medications , you should seek medical attention, says HSS physical therapist Kimberly Baptiste-Mbadiwe, PT, DPT, OCS, SFMA. The same goes for pain that results from an injury or other trauma.

But otherwise, exercising should be okay even if workouts sometimes feel uncomfortable, she adds. For example, “if you’re stretching a tight muscle, it will feel uncomfortable initially. However, as you continue to stretch over time and the muscle becomes more flexible, the stretch will feel more tolerable. The same goes for a weak muscle—initially the exercise may feel challenging, but as the muscle strength improves, the workout will feel more manageable.”

Focus on Flexibility and Strength

One goal to keep in mind for people with knee pain when exercising is to aim for a good balance of strength and flexibility in the muscles and other structures surrounding your knee joint that might be weak or tight, says Baptiste-Mbadiwe. These include your quadriceps, hamstrings, iliotibial bands (along the outside of the leg), gastrocnemius (in the calf) and adductors (in the inner thigh). 

You should also pay attention to the quadriceps (the front thigh muscles), which are important muscles that help support the knees and, when tight or weak, can trigger pain in or around the area. “Keep in mind that strong hips and core muscles also are just as important in supporting a strong, happy knee,” she adds.

So how do you know what types of exercise are safe? The key is simple: If it feels okay, do it. “Generally speaking, any low-impact movement that doesn’t cause pain should be fine,” says Baptiste-Mbadiwe. On the other hand, you might find that sudden or twisting movements such as those required in sports like soccer, skiing and tennis, may be too hard on painful joints and should probably be avoided, if unable to modify the activity. 

Some low-impact ideas:

• Water aerobics. Water aerobics is an excellent choice of workout for people with knee pain. “Not only is water aerobics one of the best forms of aerobic exercise that works the entire body, but the water also takes weight off the joints,” says Baptiste-Mbadiwe. “As a result, people with knee pain can tolerate many exercises in the water that they wouldn’t normally be able to perform on land – things like squats, leg raises and lunges that over time can build up the muscles around the knee and reduce pain.”
• Biking. Biking is great for improving range of motion, flexibility and strength. It’s easier on the knees and can be aerobically strenuous with added resistance gradually as tolerated
• Yoga. Yoga is wonderful for flexibility, especially for the areas around the knee that might be tight. More advanced poses, such as chair pose, can help build muscle strength and endurance, says Baptiste-Mbadiwe. 
• Walking. “Walking can improve both strength and flexibility while boosting circulation,” says Baptiste-Mbadiwe. “Best of all, it requires no special equipment. Just get out and walk! Of course, you can vary the intensity of a walking workout by walking faster or slower, up or down a hill and by upping the distance. If you start to experience pain, slow down a bit or end early and try again the next day.” 

When to Stop Exercising If You Have Knee Pain 

If something you’re doing is causing pain that lasts days into weeks and that does not improve when you modify the activity or with rest, it’s time to find something else, says Baptiste-Mbadiwe.

Don’t try to push through and exercise with increasing amounts of pain because you’ll probably end up making the cause of the discomfort worse, she adds. 

The most important thing for people with knee pain is to find an activity that keeps you moving safely and comfortably. For some, that means finding creative ways to exercise. If a 30-minute walk is too painful but shorter intervals feel better, try breaking up your exercise regimen into three 10-minute walks. If that doesn’t help, and if other modifications don’t work either, it’s time to talk to a joint specialist.