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Physical Therapy Exercises for Knee Pain: How to Reduce Arthritic Pain

April 4, 2023 · In: Mobility and Restoration, Movement

According to the Cleveland Clinic, around 46% of people will develop knee osteoarthritis (OA) in their lifetime. OA is a wearing away of the cartilage within the joint. This is commonly part of the natural aging process, but can occasionally come from injury and overuse over lengths of time. Knee pain from OA can get in the way of everything from getting up in the morning to going up and down the stairs. It can even get in the way of your athletic activities. It’s a condition that demands attention, not just for the sake of relief from pain, but to preserve the function of your knees. If you are impacted by knee pain because of osteoarthritis, engaging in physical therapy exercises tailored for arthritic management can be life altering. Physical therapy exercises for knee pain help countless people overcome their knee pain and return to their regular activities and daily life. This post will review what knee osteoarthritis is, how physical therapy is a great conservative treatment option, and what exercises you can start off with to begin managing your knee pain.

TAKE ME STRAIGHT TO THE EXERCISES!

**This is not medical advice. Please consult your medical provider for more information.

physical therapy exercises for knee pain

What is Osteoarthritis of the Knee?

Osteoarthritis (OA) occurs when there is a narrowing of the joint space. Cartilage breaks down over time and leaves less space inside of the joint. Have you ever heard of the term “bone-on-bone?” This is what it is referring to.

There are two joints that comprise the knee—the main one that allows you to flex and extend your knee, which is the tibiofemoral joint. The tibiofemoral joint is then broken down into medial and lateral compartments. The second is the patellofemoral joint. It is possible to have osteoarthritis in one or both of these joints, as well as having arthritis in the different compartments of the tibiofemoral joint.

OA is a normal degenerative process that the joints go through. OA is not something that spreads to different parts of the body. It is possible to have it in either one or both knees. If you have it in one knee, it is possible to not ever develop it in the other knee. There are many different treatment options for knee osteoarthritis. The different options will vary based on individual presentation.

What Treatments are Available for Knee Osteoarthritis?

There are a variety of treatment options for knee osteoarthritis. Your doctor can help determine the best course of action based on your presentation. Here are some available options:

Conservative Approach

  • Physical therapy (try these exercises here!)
  • Cortisone injections
  • PRP injection (platelet rich plasma)
  • Pain medication
  • Use of modalities such as heat/ice

Non-Conservative (Surgical) Approach

  • Arthroplasty (total or partial knee replacement)
  • Arthroscopic debridement
  • Osteotomy

The Role of Physical Therapy in Arthritis Management

When you are facing daily arthritic knee pain, it might seem like a daunting task to engage in physical activity, whether it be through physical therapy or normal daily activity. Contrary to popular belief, physical therapy is actually a great tool for managing arthritic pain!

First and foremost, movement helps lubricate your joints. It’s like a natural WD-40 for your joints suffering from arthritis. Movement gets your blood flowing and circulation occurs. This circulation helps bring fluid to the joints. Within this fluid is natural compounds which help lubricate those joints, making it easier for you to move them with less pain.

PT also works with you in mind. What I mean by this is that all aspects of your treatment plan are individualized. PT works to address your limitations and concerns. That is why one treatment plan to get someone’s knee range of motion back so they can comfortably sit and stand from chairs is going to be very different from the other individual looking to get back to crossfit training without flaring up their knee. On top of the exercises needed to achieve all of these things, patient education goes a long way with arthritis. Learning why you have pain, how it affects you, knowing when to cut back or modify, and understanding what all you can take is an even bigger piece of the puzzle.

This treatment approach not only provides relatively quick relief, but it sets the foundation for maintaining your joint health over time. Engaging in physical therapy exercises for knee pain transforms the management of your pain into a manageable task, empowering you to lead a life less hindered by pain and more fulfilled by movement.

What Can I Do for My Arthritic Knee Pain Right Now?

If you are someone dealing with knee OA, it can feel daunting not knowing what first steps to take to help alleviate your pain. Here are a few ideas of first steps you can take and start implementing now!

Avoid a Sedentary Lifestyle

One of the worst things for arthritis is no movement. Movement helps lubricate the joint. Think: motion is lotion! At the same time, too much movement can cause some irritation and cause more pain. The important thing to realize here is there needs to be a balance of both movement and rest.

You can incorporate small things during your day to help increase your movement and activity level without having to do a full workout. Try going for a walk if it isn’t already something that you do. It doesn’t have to be long. Start with walking to the mailbox or three houses down from yours. Think about incorporating small activities first to allow your body to adjust.

If you enjoy watching tv, stand during commercial breaks. You can stand and walk to another room and back, you can march in place, or stand and sit back down for a number of repetitions. Read more here on a few studies which look into the negative effects of prolonged sitting and how movement can positively impact health.

Incorporate a Light Warm-Up Before Activity

Try a quick walk as a warm-up or ride a stationary bike if you have one. Five minutes is all you need! If you are going for a walk and want a warm-up for that, try sitting and standing a couple times. Stretch your hamstrings. Do some heel raises. It is about finding what works for you and what makes you feel good.

Try Physical Therapy Exercises for Knee Pain

Give these exercises for knee pain a try! These exercises can also serve as your warm-up for activity!

Bridge

Lie on your back with your knees bent and your feet directly in line with your hips. This exercise is more easily performed on a firm surface. However if you can only perform this on your bed, it can work. Squeeze your glutes together like you’re holding a $100 bill between your butt cheeks! You want to feel this exercise in your glutes, NOT your back. Once you feel your gluteals turn on, lift your hips up towards the ceiling. Pause briefly at the top of the movement, then slowly lower your hips back to the starting position. Perform 10 repetitions.

exercises for knee pain
exercises to strengthen knee ligaments

Stationary Lunge

In a standing position, step forward with your right leg so you are in a split stance. Lower your left knee down towards the ground, but don’t touch your knee to the ground. Bend so your knees are roughly at 90 degree angles. Push through your legs and lift yourself back up to the split stance position. Repeat by lowering yourself back down. If balance is an issue, you may hold onto a stable surface for better support. Do 10 repetitions on one side, then repeat with the left leg leading.

physiotherapy exercise for knee pain nhs
knee strengthening exercises at home

Storks

Try using a ball for this exercise to add a bit more difficulty. If you don’t have one, don’t worry about it. A small foam roll is used to demonstrate this exercise in the image tot he right.

Stand with your right side close to a wall. While maintaining your balance, lift your right knee up so your hip is flexed to a 90 degree angle. Place a ball (or foam roll) along the outside of your right knee, gently smashing it against the wall so it doesn’t fall. Try to maintain your balance on your left leg while trying to keep the ball from falling. Maintain constant pressure into the ball in the wall. Hold this position for 30 seconds. Repeat a couple of times, then repeat on the other leg.

knee pain exercises to avoid

Sidelying Hip Abduction

Lie on your side with your bottom leg bent and the top leg straight. While performing this exercise, try to keep your ankle, hip, and shoulder all in a straight line. In other words, your leg should stay straight and directly in line with your hip joint. Do not allow your hip to flex forward. If this happens, you will activate the wrong muscle group.

knee pain exercises at home
exercises for knee pain with pictures

Lift your leg straight up towards the ceiling, then lower it back to the starting position. If your leg is aligned properly and you are activating the correct muscle, you should feel this in the side of your hip. Perform sets of 10 repetitions, then turn on your other side and repeat.

Seated Clam Iso

Place a resistance bend just above your knees. Sit with your knees and hips at a 90 degree angle. Your feet should be placed directly under your knees. Push your knees outwards against the resistance band. Hold this position for 10-30 seconds and repeat. You should feel a burn in the sides of your hips.

physiotherapy exercises for knee pain pdf
knee strengthening exercises pdf

Physical therapy exercises for knee pain can help drastically reduce pain brought on by osteoarthritis. Don’t allow arthritis to get in your way of living to your greatest potential!

The Importance of Incorporating Daily Movement Into Your Routine

The importance of integrating movement into your routine cannot be overstated. This goes for all individuals, not just those dealing with arthritis. But if you do have arthritis, it is even more important.

Aside from daily gym trips or at-home workouts, there are other ways to incorporate movement into your daily routine. Think of your daily tasks as opportunities to integrate small moments of activity. Set a timer to stand up every hour. During commercial breaks when watching tv, do a couple of leg lifts or take thirty seconds to stretch your hamstrings. Simple adjustments like choosing the stairs over the elevator or parking a bit further from the store entrance can make a significant difference.

These practical tips for daily movement advocate for a life beyond just coping with arthritis. In the end, it all works towards improving your quality of life.

Related Articles on Knee Pain and Arthritis

  • Osteoarthritis Treatment for the Knee: What You Need to Know
  • What is the Recovery Time for Knee Replacement?
  • 4 Mistakes You Don’t Want to Make After Knee Replacement Surgery
  • How to Strengthen Knees for Function and Performance
  • Knee Pain Walking Down Stairs? This Can Help!

When to Consult a Physical Therapist

When navigating knee arthritis, understanding the right time to seek expert guidance and help from a physical therapist is crucial. If you have tried various treatments with no improvement or have attempted exercising on your own only to find your knee pain gets worse, it might be time to reach out to an expert.

A physical therapist can tailor an exercise regimen that specifically targets your needs. Treatment programs aim at enhancing joint function without exacerbating pain. A PT can offer options for exercises to minimize flare ups with opportunities ranging from low-impact aquatic exercises to more aggressive crossfit-type programming to suit your needs. They can offer expertise in managing chronic pain related to arthritis and also help delay possible surgical involvement.

Remember, the goal is not just to manage pain, but to restore mobility and function. The ultimate goal is to take steps towards regaining your active lifestyle while minimizing pain.

TL;DR

Arthritic knee pain stems from worn down cartilage and leads to discomfort, pain, and mobility issues. At the same time, arthritic knee pain responds well to movement. Physical therapy exercises for knee pain are pivotal in arthritis management. They are designed to improve knee mobility, provide strength to the leg, and help reduce pain. Personalization of a PT plan can offer targeted relief and support you in your path to overcome knee OA. This post reviews both conservative and non-conservative approaches to knee arthritis with an emphasis on conservative treatment through physical therapy support.

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Tera Sandona
Tera Sandona

Tera Sandona is a licensed Doctor of Physical Therapy (DPT) and the founder of PT Complete. She helps high-achieving women break out of cycles of chronic pain, stress, and burnout through her Regulate and Rebuild Method, a sequenced approach that addresses the nervous system first and builds strength second. Her work focuses on helping women finally understand their bodies, rebuild strength, and create lasting resilience that fits real life.

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By: Tera Sandona · In: Mobility and Restoration, Movement · Tagged: capacity building, chronic pain, gentle movement, knee, mobility

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I'm a practicing physical therapist based out of sunny SoCal who loves to educate others and share information and knowledge. You can typically find me hard at work trying to manage normal life or cuddled up under a blanket enjoying coffee or desserts I can never seem to get away from!

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I hear this one on repeat. It started in your shou I hear this one on repeat. It started in your shoulder, now it’s crept into your shoulder blade, and maybe down toward your mid back. And the first thought is always the same: something new is wrong now or something else is breaking down.

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When pain spreads without a new injury behind it, it’s been part of the picture for a while, and showed up out of nowhere, it’s usually the same alarm system that’s been running in the background. It’s now been ringing long enough that the areas nearby started picking up the signal too.

Think of it less like a break and more like a smoke detector that won’t stop going off until the whole hallway of detectors starts sounding along with it. Nothing new caught fire. The system’s just been on for a long time.

If you’ve already had this checked and nothing new turned up to explain it, pay attention to that. It’s usually your best clue that this is your nervous system spreading the pain to a new area, not a new injury needing its own workup.

Comment “MINE DID THIS” if pain has crept into the area right next to where it started. I’ll send you my blog post I wrote on this exact topic that goes more in depth on what’s actually going on.
But here’s what’s actually true. You’ve probably But here’s what’s actually true.

You’ve probably been told for years that any movement counts as building strength, and in the very beginning, it kind of does. If you’re coming from little to no activity, walking, Pilates, biking, or yoga will strengthen you…at first. Your body is adapting to a demand it hasn’t had to meet before.

But that adaptation has a ceiling. Once your body reaches its load tolerance for that amount of activity, doing more of the same thing doesn’t build you past it. You’re not getting stronger anymore. You’re just maintaining the level you already reached.

This is where cardiovascular and endurance work split from strength work. Walking and biking stay focused on the cardiovascular system. They’re not increasing the load on your muscles. You’re training your heart and lungs instead.

Pilates and yoga work your muscles through holds, which builds muscular endurance and helps your muscles sustain a position under fatigue. That’s a real adaptation. It’s just not the same one as strength.

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Comment “MAXED OUT” if you just realized you’ve been maintaining instead of building for a while now.
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Nobody sees the discipline it takes to hold that together all day. They only see the version of you that’s left once it’s finally safe to stop.

If this is you, let the plans stay cancelled tonight. That’s not falling behind. You’ve already asked enough of yourself today.

Send this to someone who’s fine all day and disappears the second it’s finally safe to stop.
It’s Friday night. The week is finally behind you. It’s Friday night. The week is finally behind you. And you still don’t feel like you got anything back.

You’re not lazy. You’re using the wrong tool for the kind of tired you’re actually experiencing.

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But here’s the truth: physical stillness only covers one kind of exhaustion. If your eyes, ears, and screen never got a break, that’s sensory depletion still running underneath you. If you spent the day holding everything together for everyone else, that’s emotional depletion still running. If your brain never stopped making decisions, that’s mental depletion still running.

You didn’t fail at resting. You used the right tool on the wrong job…the screwdriver when you needed scissors.

So if you want to try this differently tonight, here’s where to start:

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You’re not lazy. You’ve just been resting the wrong thing.

Save this so you know which kind of rest to reach for tonight.
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