- Specific exercises significantly reduce knee pain and improve overall functioning.
- Almost 30% of adults over 45 experience some degree of knee osteoarthritis.
- A new study found exercise is safe for knee osteoarthritis.
Achy knees? Trouble walking because of the pain? A new study that looks at 217 trials suggests that specific exercises are best for those struggling because of knee osteoarthritis, which is the most common form of arthritis, impacting millions of Americans.
It’s a malady that gets worse with age as cartilage breaks down and pain, swelling and stiffness are commonplace. Many people struggle to figure out what they can do to find relief.
The BMJ medical journal this week published a large review by an international group of researchers that looked at trials that collectively included 15,684 participants. The review identified the activities that are most helpful in providing relief.
Think aerobics: specifically walking, cycling and swimming.
According to a release on Science Daily, those activities “were found to provide the greatest improvements in pain, physical function, walking ability and overall quality of life.”
They’re not the only forms of exercise that help, but the researchers said that other exercises like strength training and mind-body exercises should be used along with the aerobic activity and should not replace it as the main approach to finding relief.
The researchers recommend aerobic exercise as a “first-line intervention for knee osteoarthritis management, particularly when the aim is to improve functional capacity and reduce strain.”
What causes knee osteoarthritis?
Osteoarthritis is the result of cartilage, which cushions bone ends, breaks down. It hurts, often leads to swelling and can make movement uncomfortable or even hard to do. The researchers said that knee osteoarthritis is so common that almost 3 in 10 adults over age 45 have some degree of knee osteoarthritis. About half of those have severe symptoms.
The Osteoarthritis Action Alliance reports that 32.5 million U.S. adults have some type of osteoarthritis and knees are especially susceptible, with the highest incidence between age 50 and 64.
Rheumatoid arthritis is also possible in the knee, and occurs when the synovial membrane that covers the joint begins to swell. It is not as common as osteoarthritis in the knee.
While patients are usually told to exercise because it will help, they are not always told which types of exercises are beneficial.
The American Academy of Orthopaedic Surgeons reports that it is often caused by age, excess weight or injury. The group notes that “many people with arthritis note increased joint pain with changes in the weather.”
Studying exercise types
The 217 trials researchers looked at took place between 1990 and 2024 and many different exercises were compared, from the aerobic to those that were supposed to improve flexibility, strength, mind-body neuromotor and others, all tested against control groups.
The trials were not all equally high-quality, but the researchers were able to use a well-recognized and validated system to evaluate the reliability of the data, per the Science Daily article.
The endpoints that mattered were pain levels, physical function, gait performance and quality of life, each measured at four-week, 12-week and 24-week follow up. Aerobic exercise consistently proved to be the most effective.
The researchers said aerobic exercise reduced pain in both the short term and over time. Meanwhile, mind-body “likely improved short-term function, while neuromotor training likely boosted short-term gait performance,” per the release. Strengthening and mixed exercise programs appeared to improve function at mid-term follow up."
They deemed it important to note that none of the exercise types created adverse events compared with control groups. “This supports the idea that exercise is a safe and reliable treatment option for knee osteoarthritis,” the researchers said.