With knee osteoarthritis, exercise is the core treatment recommended by international guidelines. At home you can safely do, among others, quadriceps tightening, straightening the leg while sitting, straight leg raises and standing up from a chair – 2–3 times a week, 2 sets of 8–10 repetitions, within a range in which the pain does not go above 3 on a 0–10 scale.
Below: 6 exercises with dosage, rules about pain, what to avoid and which symptoms mean you should see a doctor first.
In brief
- Strengthening exercises are the first-line treatment for knee osteoarthritis according to the OARSI and NICE guidelines.
- Starting dosage: 2–3 times a week, 2 sets of 8–10 repetitions.
- A hot, red knee with a fever, or sudden swelling after an injury, requires urgent assessment by a doctor.
- A physiotherapy consultation in Rydułtowy costs 180 PLN, no referral needed.
- The clinic sees private patients only (not covered by NFZ, the Polish public health fund), Mon–Fri 7:00–20:00.
Contents
Can you exercise with knee osteoarthritis?
Yes – and it is one of the most important things you can do. Stronger thigh and hip muscles absorb loads better, and regular movement improves joint mobility and reduces stiffness. The OARSI guidelines from 2019 and NICE guidelines from 2022 recommend exercise for everyone with knee osteoarthritis, regardless of age and how advanced the changes are.
Changes visible on an X-ray do not always match how severe the pain is. Typical symptoms are pain when getting up from a chair and going down stairs, and brief stiffness after sitting for a long time. We write about pain when going down stairs in our article knee pain when going down stairs.
When should you see a doctor first?
See a doctor first if your knee is hot, red and swollen and you also have a fever, if a large swelling appeared quickly after an injury, or if the knee locks or “gives way” and you cannot stand on it. Sudden swelling and pain in the calf, and night pain at rest with weight loss, also need prompt assessment.
A hot, swollen knee with a fever may mean a joint infection or an attack of gout – these are situations that need quick diagnosis, not exercise.
Which exercises for knee osteoarthritis can you do at home?
A safe home set includes mobility and strengthening exercises: heel slides, quadriceps tightening, straightening the leg while sitting, straight leg raises, side-lying leg raises and standing up from a chair. Do them slowly, without jerking, and warm up beforehand by marching on the spot for a few minutes or walking around your home.
- Heel slides. Lying on your back, slide your heel along the floor towards your buttock, bending your knee, and slowly straighten it. 10 repetitions with each leg.
- Quadriceps tightening. Lying down, place a rolled-up towel under your knee and press down on it, tightening the front of your thigh. Hold for 5 seconds. 10 repetitions.
- Straightening the leg while sitting. Sitting on a chair, slowly straighten your knee, hold for 3 seconds and lower it. 2 sets of 8–10 repetitions.
- Straight leg raise. Lying on your back with one leg bent, raise the other – straight and with the thigh tightened – to the height of the other knee. 2 sets of 8–10.
- Side-lying leg raise. Raise your upper, straight leg slightly to the side and back, without rotating your pelvis. 2 sets of 8–10 on each side.
- Standing up from a chair. Stand up from a chair with a backrest and slowly sit down again, helping yourself with your hands at first. 2 sets of 8.
If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.
How often should you exercise and how much pain is acceptable?
Do strengthening exercises 2–3 times a week, and mobility exercises such as heel slides even every day. During exercise, pain up to about 3 on a 0–10 scale is acceptable, as long as it does not increase with further repetitions and returns to its starting level by the next morning. If it lasts longer, reduce the number of repetitions.
Increase the load gradually and only one element at a time: first the number of repetitions, then the sets, and finally the resistance, e.g. a light ankle weight. Exercise is well complemented by everyday movement, e.g. walking as rehabilitation.
What to avoid with knee osteoarthritis?
Avoid kneeling for long periods, deep squats with weights, jumping and running on hard surfaces when you are just starting to exercise, and sitting for a long time without changing position. However, do not give up movement altogether, because weaker muscles usually make the symptoms worse. If you are overweight, even a small reduction in body weight reduces the load on your knees with every step.
During a flare-up with swelling and warmth in the knee, cut back on weight-bearing exercises for a few days and stick to gentle mobility exercises. Comfortable, cushioned shoes and a walking stick held in the hand on the side of the healthy leg can take the load off a painful knee during longer walks.
How can a physiotherapist help?
The physiotherapist assesses knee mobility, the strength of the thigh and hip muscles and the way you walk, then chooses exercises and their dosage, teaches you the technique and adjusts the plan as you progress. If needed, they use manual therapy or supporting treatments, e.g. TECAR. A consultation at the clinic in Rydułtowy costs 180 PLN, and the number of visits is decided individually.
Physiotherapy consultationexamination of the knee, hip and walking, an individual set of exercises180 PLNTECAR therapya treatment that warms the tissues, considered for chronic joint pain, after a consultation150 PLNPrices valid from 08.2026. The physiotherapist decides on the number of visits individually after the consultation.
Good to know: for your first visit, bring your knee X-ray or ultrasound results and the shoes you wear most often.
Summary
With knee osteoarthritis, exercise is the core of treatment: 6 simple home exercises, 2–3 times a week, 2 sets of 8–10 repetitions, with pain no higher than 3 on a 0–10 scale. A hot, red knee with a fever, sudden swelling after an injury or a locking joint require a visit to a doctor first.
Frequently asked questions
Is an exercise bike good for knee osteoarthritis?
Yes, for many people it is a safe form of exercise, because the knee works through a repeated range of movement without impact on the ground. Start with low resistance and set the saddle so that your knee is almost straight when the pedal is at its lowest point. A saddle that is set too low increases knee bending and may make the pain worse.
Can exercise rebuild cartilage in the knee?
There is no evidence that exercise rebuilds lost joint cartilage. However, studies show that regular exercise reduces pain and improves function, and that moderate loading does not speed up degenerative changes. Cartilage needs movement, because it is nourished by joint fluid, whose circulation is supported by the joint working.
Should I exercise when my knee is swollen?
With mild swelling you can usually do gentle mobility exercises and muscle tightening without loading the joint. It is better to put off strengthening exercises with weights until the swelling goes down. If the knee is hot and red, and the swelling appeared suddenly or comes with a fever, consult a doctor first.
Is it worth wearing a knee brace with knee osteoarthritis?
A knee support or brace can help for short periods, e.g. during a longer walk, when the knee feels unstable or more painful. However, it does not replace exercise, and if worn all the time it may weaken the muscles. It is worth choosing the type of support with a physiotherapist or orthopaedist, depending on which part of the joint is most affected.
Sources
- Bannuru R.R. et al., OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis, Osteoarthritis and Cartilage, 2019.
- National Institute for Health and Care Excellence (NICE), Osteoarthritis in over 16s: diagnosis and management (NG226), 2022.
- Fransen M. et al., Exercise for osteoarthritis of the knee, Cochrane Database of Systematic Reviews, 2015.
- Bricca A. et al., Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials, British Journal of Sports Medicine, 2019.
- Messier S.P. et al., Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis, Arthritis & Rheumatism, 2005.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish licence to practise as a physiotherapist). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile.
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
