Knee and Hip Exercises for Osteoarthritis

If you have osteoarthritis (OA) in your hips or knees, exercising may be the last thing you feel like doing. Symptoms like pain and stiffness in your joints can make it tough to work out.   

But moving is important for hip and knee OA. It causes your joints to compress and release, bringing blood flow, nutrients, and oxygen into the cartilage. “This can help prolong the function and longevity of your joints,” says Eric Robertson, DPT, a physical therapist and associate professor of clinical physical therapy at the University of Southern California.

Physical activity can also help you feel better. “Along with boosting your overall health, exercise can improve your OA symptoms” like pain, stiffness, fatigue, and even depression, says Leigh F. Callahan, PhD, associate director of the University of North Carolina Thurston Arthritis Research Center. One study found that people with knee OA who worked out regularly lowered their pain by 12% compared to those who didn’t.

Ready to lace up your sneakers? No single workout is best. But some moves are better for hip and knee OA. Experts recommend doing a mix of the following three exercises. But first, remember to check in with your doctor before you start any new physical activity.

Aerobic Exercise

This is the type that strengthens your heart and helps your lungs work better. “It also burns calories, which can help you lose or maintain a healthy weight,” Callahan says. That’s important, because extra pounds add stress onto your hip and knee joints.

If you’re new to exercise, start with low-impact activities. They’re gentle on the joints. Good options for hip and knee OA include:

  • Walking
  • Swimming
  • Biking
  • Elliptical training
  • Cross-country skiing

To ease the pain and lower your odds of an injury, don’t try to do too much at once. “Start with just 10 minutes,” says Arina Garg, MD, a rheumatology fellow at The Center for Excellence for Arthritis and Rheumatology at the Louisiana University Health Sciences Center. “Every few days, increase that time by 5 to 10 minutes.” Your goal is to work up to 30 minutes of aerobic exercise, 5 days a week.

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Strengthening Exercise

Strong muscles support and protect your joints. “Strengthening the lower body takes some of the pressure off of the hip and knee joints,” says William Oswald, DPT, a physical therapist and clinical instructor of rehabilitation medicine at NYU Langone Health. This can relieve some of the pain and protect against more damage. “It can also make daily tasks, such as climbing the stairs, easier,” he says.

A physical therapist can teach you the best leg-strengthening exercises for your joints. You may use a stretchy resistance band or light weights. “Yoga and tai chi can also build strength and improve your balance,” Callahan says. Look for classes that are geared for people with arthritis.

But you don’t have to sign up for a class or hit the weight room. You can also use your own bodyweight. These moves target the muscles that support your hip and knee joints:

  • Sit to stand. Sit in a chair. Slowly stand up, and sit back down again without using your hands. Focus on keeping your feet shoulder-width apart and knees over your feet. If you need help, use the armrests to lower yourself down. Repeat for 30 seconds.   
  • Mini wall squats. Stand with your head and back against the wall. Place your feet shoulder-width apart. Squat down slightly, so that your knees bend at a 30-degree angle. Press back up to stand. Repeat 10 times.
  • One-leg balance: Stand next to a counter or table, and place one hand on it for support. Lift one leg and balance on the other for up to 10 seconds. As you get stronger, you can use one finger or let go of your support altogether. Repeat on the other side.

Range-of-Motion Exercise

Try these moves to ease the stiffness in your hips and knees. They can help improve your flexibility and how well you can move around. To get started, do the following hip and knee moves a few times a week. Try to build up to doing them daily.

For the knee:

  • Sitting knee extension. Sit in a chair. Slowly extend one leg as much as you can, or until it’s parallel to the floor. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.
  • Sitting knee flexion. Sit on the edge of a chair. (Make sure the chair is stable and won’t tip over.) Lift one knee and place your shin in your hands. Gently pull your shin toward your thigh. Hold for 1 to 2 seconds; lower back to the ground. Switch sides. Repeat 10 times.

For the hip:

  • Standing hip flexor stretch. Step one foot forward so that your feet are hips-distance apart. Bend your back leg slightly, and slowly bend your front knee, keeping your upper body upright. (Don’t let your front knee go past your toes.) Hold for 5 to 20 seconds. Repeat 10 times. You may need to hold onto a wall or the back of a chair for support.
  • Knee to chest. Lie on the floor on your back with your knees bent and feet flat on the floor (or straighten your legs in front of you). Bring one knee into your hands. Gently pull your knee toward your chest. Hold for 1 to 5 seconds. Repeat three times; switch to the other side.

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What Exercises Should You Avoid for Hip and Knee Osteoarthritis?

Experts used to ban high-impact exercises, such as running and jumping, for people with hip and knee OA. The idea was that they could overload and damage the joint. But the opposite may be true for people with mild to moderate OA. “The impact may stimulate cells that repair in the cartilage,” Oswald says.

But this doesn’t mean that you can hop on a treadmill right away. If you’re just starting out, you need to build up your strength and endurance first. This can prevent injury. “Then slowly add in high-impact exercises,” Robertson says. “For instance, begin with just 5 minutes of jogging.”

Is your OA severe? Chances are you’ll need to steer clear of high-impact exercise altogether. Be cautious about the following workouts; check with your doctor if you’re able to do them.  

  • Running, especially on uneven surfaces
  • Tennis, basketball, and other activities where you change direction quickly
  • Step aerobics and other workouts that involve jumping
WebMD Feature Reviewed by Michael W. Smith, MD on December 14, 2017

Sources

SOURCES:

Eric Robertson, DPT, physical therapist; associate professor of clinical physical therapy, University of Southern California; spokesperson, American Physical Therapy Association.

William Oswald, DPT, physical therapist; clinical instructor of rehabilitation medicine, NYU Langone Health.

Arina Garg, MD, rheumatology fellow, The Center for Excellence for Arthritis and Rheumatology, Louisiana University Health Sciences Center.

Arthritis Care Research: "Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross-Sectional Study from the Osteoarthritis Initiative."

Medicine & Science in Sports & Exercise: “Effects of Exercise on Patellar Cartilage in Women with Mild Knee Osteoarthritis.”

American Journal of Sports Medicine: “Running and Knee Osteoarthritis: A Systematic Review and Meta-Analysis.”

Arthritis Foundation: “Standing Hip Flexors and Quadriceps Stretches.”

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