Using a Treadmill With Knee Pain

Medically Reviewed by Tyler Wheeler, MD on August 28, 2022
3 min read

When you have osteoarthritis, exercise can make you stronger, improve your balance, and lessen knee pain. Walking is an easy, low-impact way to start working out. A treadmill allows you to stay active and walk no matter the weather and doesn’t make your joints move much differently than if you were outside.

If your knees are bothering you before walking, apply heat for 15-20 minutes to relax muscles and ease aching. You can take a warm shower or wrap a warm towel around your legs.

When your body feels ready to go, it’s important to put on the right footwear. Supportive, closed-toe athletic shoes with soles 1-inch high or lower are the best choice to avoid hurting your ankles. You need to thread the shoelaces all the way through the top loop for a secure fit.

Safety should be a top priority before you start walking on a treadmill. You don’t want to injure yourself or cause more damage to your knee. Make sure you use a full-size unit with a belt that’s at least 50 inches long and 22 inches wide. A cushioned tread belt also protects your joints.

Your treadmill should also have:

  • Handrails on each side, not just the front
  • A safety clip you can attach to a piece of your clothing that will stop the treadmill if you fall
  • An emergency stop button

You should also figure out how the buttons work so that you can use them correctly.

Before you walk, do some light stretches to loosen your joints and muscles.

When you’re ready, step onto the machine. You should stand next to the belt and hold the handrails. You can start the treadmill on a slow speed and step onto the belt.

Warm up with a slower speed for 3-5 minutes and then work your way up to a pace that feels good. You should be walking in the center of the belt. If you’re holding the handrails, your speed may be too fast. Stay focused while you work out and look straight ahead to maintain your balance.

You can set a small incline to reduce the force on your knees, hips, spine, feet, and ankles. Don’t go any steeper though, or it’ll have the opposite effect.

If you haven’t worked out recently, start with shorter walks -- as short as 3 to 5 minutes -- and build up to longer ones. You can work your way up to 150 minutes or 2 1/2 hours of moderate walking (or another form of aerobic activity) a week. You should be able to carry on a conversation at that level of intensity.

Walk on a slow speed for a few minutes to cool down when you’re ready to end the workout.

Your body may need 6 to 8 weeks to adjust to a new workout routine. You may have some pain, swelling, and stiffness throughout this time, but you’ll feel better in the long term. You can go on shorter walks or do them less often throughout the week during this period as you ease into it.

Soreness after a workout is normal, but if you think you overdid it and your knees start to hurt and swell, put an ice pack or bag of frozen vegetables wrapped in a towel on them for 15-20 minutes.