The best exercises for arthritic knees – and how they can help delay surgery

From mensfitness.co.uk

Arthritis can make every step feel harder, but avoiding exercise often makes things worse. An orthopaedic expert explains how stretching, strength training and low-impact cardio can reduce pain, improve mobility and help keep your knees healthier for longer

Roughly one in seven people in the United Kingdom lives with arthritis – and often this has a significant impact on day-to-day living. But research funded by Arthritis UK has found that exercise is the best way to reduce pain, improve mobility and stay independent for longer. With that in mind, we have spoken to Orthopaedic Doctor, Dr Thomas Naylor, to learn specifically which exercises to do, how to do them, and why they can help our creaking knees.

Which types of exercise are good for arthritis?

People will have different physical abilities depending on what stage and severity they are at with their knee symptoms and overall health, but the three areas exercise can help with are “stiffness, strength, and pain symptoms,” says Dr Naylor, adding that focusing on these will help to avoid pain, maintain range of movement, and to help keep movements controlled to generally protect the joint.

How to reduce stiffness in knee joints through exercise?

We know the phrase ‘use it or lose it’ rings true when it comes to strength training; turns out it is the same for joint health. “A knee joint will manage a full range of possible movement if it regularly does that movement,” says Dr Naylor. 

This means we have to keep moving our joints; if we don’t, they will stiffen, restricting the range of motion. “It is much harder to get a stiff joint moving again than it is to retain movement.” Says Dr Naylor. 

The exercise to prevent stiffness is stretching. “Bending the knees fully (bringing your heel up to your bum), and pushing them straight (forcing the back of the knee flat onto the floor with a towel, raising the ankle up).” Dr Naylor says. 

How to increase joint strength

A large volume of scientific evidence shows that exercise and strength training improve symptoms of knee arthritis and delay the need for joint replacement surgery. Dr Naylor feels that “specific exercises are probably less important than actually doing something that works well for your body and is consistently manageable”.

The idea being, any exercise is better than none, and doing what won’t feel like a chore means you are likely to stick at it, the same logic that steady weight loss can be achieved through, or any long-term goal.

That being said, Squats are obviously the king of lower-body strength exercises. “These can be performed with body weight only, focusing on a full range of movement, or weighted in whichever form works best for you. Hex bar squats are potentially more comfortable for people who have back pain,” says Dr Naylor.  

Leg press, hip thrusts and knee extensions are also going to help, but you should be cautious with weight and steadily build up. Unilateral lunges are also great for strengthening the muscles around the knee, as well as encouraging more balance between both legs, which is only going to help the load your knees take. 

How to reduce pain while exercising

Dr Naylor says that “a little pain is fine, but you should avoid the activities that seem to result in continuously worsening pain.” For instance, Dr Naylor mentions that running can be protective against developing knee arthritis, as cartilage needs movement and forces to be applied to it to keep it healthy.

But, the relatively hard repetitive impact caused by running means that if it is making symptoms worse, it should be avoided, or managed in terms of intensity. Dr Naylor says gel-based over-the-counter pain killers are fine to use, and offer fewer complications than pills, also. 

If you can’t live without running, then using (or subsidising some runs with) a treadmill or softer surface (grass rather than street) reduces forces across the knee joint. “Cycling is great for knee health, and often better tolerated than running.” Dr Naylor offers. 

How exercise can prevent arthritis  

As well as helping symptoms, exercise can help prevent arthritis symptoms from forming, both as a result of strengthening joints and the surrounding muscles, but also through weight management. Maintaining a healthy weight significantly decreases loads put onto the knee and reduces inflammatory markers in the joint.

“Being overweight or obese significantly increases the likelihood of developing arthritis or needing a knee replacement,” says Dr Naylor.

https://mensfitness.co.uk/features/exercises-for-arthritic-knees/ 

Exercise Your Way to Less Arthritis Pain

From wth.org

Arthritis affects millions worldwide and is a leading cause of chronic pain and disability. While medications, injections, and surgery can be a part of managing symptoms, sometimes you can avoid all those with a less medical approach. Regular exercise is one of the most effective, low-risk strategies to reduce arthritis pain, improve function, and enhance quality of life. 

It is estimated that in the United States alone, 58.5 million people aged 18 years and older have arthritis.  It is a leading cause of disability, with 25.7 million adults reporting activity limitations. Projections suggest that by 2040, an estimated 34.6 million adults with arthritis will report arthritis related activity limitations, which is due to the growth of an aging population. Osteoarthritis is the most common form, affecting over 32 million adults. Arthritis is a major driver of medical costs and loss of productivity.

Mark Cutright, MD

“Exercise helps reduce arthritis pain and inflammation in several ways,” said Mark Cutright, MD, an orthopaedist with West Tennessee Medical Group’s Innovative Orthopaedics. “Regular movement stimulates blood flow, which delivers nutrients and removes inflammatory by-products. Exercise also triggers the release of endorphins, which are the body’s natural painkillers and can lower the levels of inflammatory chemicals over time.”

Regular exercise strengthens muscles. Strong muscles act as shock absorbers and stabilize joints, reducing stress on cartilage and connective tissue. This is especially important for weight-bearing joints like knees and hips. Exercise increases joint range of motion and flexibility. Gentle stretching and full-range movements prevent stiffness, maintain mobility, and make daily activities easier. It can also improve balance and coordination, which can reduce the risk of falls. Exercise can help you maintain a healthy weight, which reduces the load on joints, which can directly lower pain and slow the progression of the disease. 

Numerous studies and clinical guidelines support exercise for osteoarthritis and rheumatoid arthritis. For knee and hip osteoarthritis, there is evidence that shows exercise reduces pain and improves function.

“A balanced exercise program that can be beneficial for arthritis pain should include aerobic, strength, flexibility, and balance training. As each component contributes differently to pain reduction and joint health,” said Dr. Cutright. “Low-impact exercise is essential for reducing arthritis pain, as it strengthens muscles, improves joint flexibility, and lowers stiffness. Consistent movement reduces stiffness, while strength training protects joints.” 

The top exercises for arthritis include walking, water aerobics, swimming, yoga, and tai chi.

Aerobic exercise improves cardiovascular fitness, helps with weight control, and reduces systemic inflammation. Low-impact walking on smooth surfaces, cycling, or using an elliptical reduces pressure on joints. Other options include swimming, water aerobics, and low-impact dance classes.

Strength training builds muscle around affected joints, improves joint stability, and supports daily activities. It has also been shown to decrease pain and increase strength and mobility. 

Examples of this type of exercise include resistance bands, bodyweight exercises, free weights, weight machines, and Pilates-style controlled resistance.

Flexibility and range-of-motion exercises maintain or increase joint mobility and reduce stiffness. These include gentle stretching, modified yoga, tai chi, joint-specific range-of-motion activities, and improve range of motion, balance, and reduce stress. Balance exercises such as standing on one leg with support, heel-to-toe walking, tai chi, and stability ball routines decrease fall risk and improve functional stability. Mind–body practices like tai chi and yoga also provide moderate benefits for pain, function, and psychological well-being.

Exercise is a cornerstone of arthritis management. Regular, well-chosen movement reduces pain, strengthens muscles, maintains flexibility, and improves overall function and mood. A successful program combines aerobic activity, strength training, flexibility, and balance work that is tailored to your condition, abilities, and preferences. Start gently, progress gradually, listen to your body, and seek professional guidance when needed. With consistency and the right approach, you can significantly reduce arthritis pain, allowing you to enjoy more comfortable, active days.

https://www.wth.org/blog/exercise-your-way-to-less-arthritis-pain/ 

Try These Top-Recommended Tips for Psoriatic Arthritis Pain

From healthcentral.com

Ease the ache with expert-approved tips for managing pain and stiffness 

Psoriatic arthritis (PsA) pain is driven by inflammation that can affect joints and tendons. Inflammation may start where tendons attach to bone, known as enthesitis, leading to discomfort in areas like the shoulders, elbows and knees, says Bret Sohn, M.D., a rheumatologist at Stamford Health in Stamford, CT. As inflammation spreads into the joints, the immune system attacks synovial cells that produce joint-lubricating fluid, causing red, swollen joints and stiffness—often worse after rest or inactivity. The good news? There are effective ways to manage PsA pain, starting with the strategies here.

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Heat Therapy: When Warmth Works Best

Heat helps chronic psoriatic arthritis pain by reducing stiffness, improving function, and suppressing inflammatory mediators. Try morning hot showers, apply heating pads before workouts, experiment with warm pool exercises, or explore paraffin wax treatments. However, avoid heat on new, acute pain—it can worsen inflammation during a PsA flare. Also, “any topical use of heat should be discussed with your physician,” says Julius Birnbaum, M.D., an associate professor of rheumatology at University of Pittsburgh Medical Center in Pennsylvania.

Cold Therapy Brings Relief

For acute arthritis pain and swelling—like after exercise, during a flare-up, or in the initial few days after an injury—applying a cool compress can help. “Cold therapy can reduce inflammatory proteins in a joint and provide modest pain relief in these situations,” says Dr. Sohn. Cold also constricts blood vessels, which reduces blood flow to the area to relieve swelling, and it interrupts pain signals as they travel across nerve fibres. Press an ice pack (or a bag of frozen veggies in a pinch) to the sore area for 15 minutes a few times a day.

Topical Relief Options

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Topical pain relievers may irritate psoriasis plaques, experienced by one in three people with PsA. “Topical treatments aren’t typically recommended for PsA joint pain,” says Dr. Sohn. However, many people with psoriatic arthritis also have osteoarthritis, which can contribute to symptoms. In those cases, topical NSAIDs such as diclofenac or ketoprofen may help, particularly for knee or hand pain. These creams contain the same active ingredients as oral NSAIDs but with lower gastrointestinal, cardiovascular, and kidney risks because they aren’t absorbed through the digestive system.

Gentle Movement Reduces Pain Over Time

When you’re uncomfortable, you might feel inclined to take it easy and avoid strenuous activity. But regular, consistent movement actually helps calm inflammation. And strengthening your muscles eases the burden on your joints. “In general, exercise and physical activity can reduce pain and improve overall function for people with psoriatic arthritis,” says Dr. Sohn. “Studies demonstrate that physical activity correlates inversely with disease activity, meaning that more activity is associated with less pain and inflammation.” Consider low-impact workouts like yoga, tai chi, swimming, cycling, or walking.

Pacing Your Activities Protects Joints

The benefits of movement outweigh the risks, but it’s important to avoid overdoing it. “Excessive mechanical stress, especially at the spots where tendons attach to bone, may trigger or worsen the inflammatory process in people with psoriatic arthritis. There’s no clear threshold where beneficial exercise ends and harmful overloading begins,” says Dr. Sohn. That’s why it’s important to start slow and ramp while listening to your body: Be consistent with your exercise routine, but don’t push through pain. Break workouts or strenuous tasks into shorter intervals with regular breaks and rest days in between.

Easing Morning Stiffness

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People with psoriatic arthritis often experience “gelling,” a type of stiffness after rest that can last more than 30 minutes, says Birnbaum. Medications and gentle movement help, but small routine changes can also make mornings easier. The Arthritis Foundation suggests using heat overnight or setting an electric blanket to warm up before waking. Keep topical or oral NSAIDs by your bed. When your alarm goes off, take or apply medication, then do gentle stretches in bed to get your joints moving before standing. A brief warm shower can also help loosen stiff muscles and joints.

Supportive Tools and Daily-Life Modifications

Assistive devices can make everyday tasks easier when you have sore joints or lower range of motion. An occupational therapist can help you identify tools that suit your specific needs. “Examples include splints or braces, adaptive footwear, or a TENS (transcutaneous electrical nerve stimulation) unit to relieve pain,” says Dr. Sohn. You can also adapt your home environment with modifications like safety grips and grab bars in the bathroom, an electric jar opener or toothbrush, a sock puller, a grabber tool for out-of-reach items, or a voice-to-text function on your computer or phone.

Pain Management During a Flare

During a psoriatic arthritis flare, staying in close contact with your rheumatologist is key. An individualized plan may include a short course of NSAIDs or steroids, or adjustments to your current medications, says Dr. Sohn. Rest is also essential, since added physical stress can prolong recovery. Avoid heat on painful areas, which may worsen swelling; use ice packs or topical NSAIDs instead. Finally, note what was happening before the flare—such as stress, injury, or dietary changes—to help identify triggers and reduce the risk of future flare-ups.

Building Your Personalized Pain Plan

                                                              GettyImages/pocketlight

During a psoriatic arthritis flare, staying in close contact with your rheumatologist is key. An individualized plan may include a short course of NSAIDs or steroids, or adjustments to your current medications, says Dr. Sohn. Rest is also essential, since added physical stress can prolong recovery. Avoid heat on painful areas, which may worsen swelling; use ice packs or topical NSAIDs instead. Finally, note what was happening before the flare—such as stress, injury, or dietary changes—to help identify triggers and reduce the risk of future flare-ups.

https://www.healthcentral.com/slideshow/psa-pain-management-strategies?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGfeujDbp0w1RsMzNzh6lxjMhu61Su7IvOjPGvG8FbB2SNxLvoby-Xi6hXEelboMDuNM6QAI9nNrz2gZsnawo4q_8Ll3k8k7RheIPl3gWJYotowe3g

Manage Osteoarthritis With These 8 Self-Care Strategies

From health.com

Osteoarthritis (OA) is a disease that gradually wears down joint tissue, leading to joint pain, stiffness, and swelling. OA can affect any joint but most commonly affects the hips, knees, hands, neck, and lower back.

OA can impact nearly every aspect of your life, making daily tasks like walking up stairs and gripping objects painful. It can affect your ability to work, manage household chores, enjoy hobbies, and get a good night's sleep. 

Along with following your treatment plan, self-care is important in managing OA. Self-care means taking care of your physical, emotional, and mental well-being.

Here are self-care practices that may help your osteoarthritis:

1. Get Active

Staying active with osteoarthritis can be challenging due to the pain and stiffness caused by the condition. However, regular exercise is one of the most effective ways to manage OA symptoms and maintain joint health.

Without movement, joints can become stiffer, and muscles around them weaken. This can make daily activities even harder. Regular exercise can help manage symptoms and improve overall health and quality of life.

Staying active with OA can help:

• Reduce joint pain and swelling
• Improve joint flexibility 
• Strengthen the muscles around your joints
• Manage weight, which reduces pressure on joints
• Support the health of cartilage and bone tissue
• Enhance overall fitness and cardiovascular health

Aerobic activities, like walking, swimming, or cycling, are a great way to ease into physical activity if you haven't exercised in a while. Over time, adding resistance training helps build muscle strength and further reduces joint strain. Doing both types of exercise can ease joint pain and reduce stiffness.

Each week, aim for 150 minutes of moderate-intensity aerobic activity, like brisk walking, or 75 minutes of vigorous aerobic activity, like jogging. You should do muscle-strengthening exercises twice a week for even better results.

The key to success is choosing activities you enjoy. Whether it's a group fitness class, yoga, or gardening, regular movement can help you live a more active life.

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2. Eat a Balanced Diet

​​What you eat can affect your osteoarthritis symptoms. A well-balanced diet can provide your body with essential nutrients, reduce inflammation, and support joint health.

One diet that may help with osteoarthritis is the Mediterranean diet. It emphasizes nutrient-dense foods like fresh fruits, vegetables, whole grains, lean proteins like fish and poultry, nuts, seeds, and healthy fats like olive oil. It can help reduce inflammation and OA symptoms.

The Mediterranean diet and other whole-food diets can supply your body with antioxidants, vitamins, minerals, and omega-3 fatty acids. These nutrients support cartilage and bone health, help maintain body weight, protect joint function, and potentially slow the progression of osteoarthritis.

A balanced diet emphasizing whole, unprocessed foods may also improve energy levels.

3. Consider Taking a Supplement

Dietary supplements can be a valuable addition to your OA management plan. Research findings on the effect of supplements on OA are mixed, though some evidence suggests certain supplements may help relieve common OA symptoms and support joint health.

Supplements that may help with OA include:

• Glucosamine and chondroitin: Glucosamine and chondroitin are cartilage components that may protect and repair joint tissues. While some studies showed only mild symptom relief after taking the two, others suggest the combination may rival nonsteroidal anti-inflammatory drugs (NSAIDs) in lowering pain, stiffness, and swelling in knee OA. 
• Vitamin D: Vitamin D helps strengthen bones. Vitamin D supplements may improve joint pain in people with vitamin D deficiency. In people who are not deficient, vitamin D supplements likely won't relieve OA pain. 
• S-adenosyl-methionine (SAM-e): SAM-e is a natural compound with pain-relieving and anti-inflammatory effects. Some research suggests it may be as effective as NSAIDs for managing OA symptoms, though other studies have shown no benefit. 
• Curcumin: This is the most abundant compound in turmeric. Some evidence suggests curcumin may be as effective as Advil (ibuprofen) for relieving knee OA pain. 
• Willow bark: Willow bark contains compounds similar to aspirin, so people have historically used it for pain and inflammation. While its effectiveness for OA is unclear due to mixed research results, some people find it helpful for managing symptoms. 
• Undenatured type II collagen (UC-II): UC-II is a form of type II collagen, the structural protein found in cartilage. Evidence suggests that UC-II may reduce OA symptoms like pain and stiffness and improve joint function.

Before trying any supplement, talk with a healthcare provider. Some supplements can interact with medications you may be taking. A provider can let you know if the supplement will be safe and effective for you. 

4. Manage Weight

Maintaining the weight you and your healthcare provider decided was optimal for you is one of the best ways to manage osteoarthritis and improve overall joint health. Excess weight adds stress to your joints, particularly weight-bearing joints like the knees, hips, ankles, and spine—which can worsen osteoarthritis symptoms.

Losing even a small amount of weight can help osteoarthritis in the following ways:

• Reduces pressure on joints: For every pound you lose, there is a fourfold reduction in pressure on the knees. Losing 10 pounds removes 40 pounds of pressure from your knees.
• Eases pain: Research shows that weight loss leads to arthritis pain relief. One study found that losing 10–20% of body weight can significantly improve pain, joint function, and quality of life among people with knee OA.
• Reduces inflammation: Fat tissue produces pro-inflammatory chemicals that can worsen arthritis symptoms. Weight loss lowers these fat stores, decreasing systemic (body-wide) inflammation.
• Slows cartilage breakdown: Losing weight can protect joint cartilage. Research suggests that losing weight may reduce cartilage breakdown, slowing the progression of OA.

Weight loss and maintenance take time and perseverance, but they're one of the most effective ways to improve arthritis symptoms. If you have extra body weight, talk to a healthcare provider about losing weight—it could make a substantial difference in your OA management.

5. Prioritise Sleep

Around 70% of people with OA experience sleep disturbances, such as waking up throughout the night or having trouble falling asleep. Pain can interfere with a good night's sleep, and poor sleep can also intensify pain.

Research shows that sleep disturbances can raise pain sensitivity and worsen pain signals beyond what is typical for any joint damage you have. Over time, poor sleep can lead to or worsen depression, increase disability, and reduce your ability to manage daily activities, compromising your independence and overall quality of life.

Prioritizing sleep can improve pain management and mood and help you cope with the challenges of OA. For consistent, high-quality sleep, you can:

• Maintain a consistent bedtime and wake-up time
• Engage in calming bedtime activities, such as reading, meditation, or taking a warm bath 
• Avoid caffeine, alcohol, and large meals in the evening
• Keep your bedroom dark, quiet, and at a cool temperature
• Avoid screen use at least 30 minutes before bed
• Exercise regularly and eat a healthy, balanced diet
• Practice relaxation techniques like deep breathing or progressive muscle relaxation before sleep

6. Practice Pain Management Techniques

Managing pain is a key part of life when living with osteoarthritis. Pain management techniques for osteoarthritis include:

• Heat therapy: Heating pads, compresses, and warm baths or showers can reduce joint pain and stiffness and increase range of motion. 
• Meditation: This mind-body practice helps lower stress and inflammatory chemicals in the body. Regular meditation, such as mindfulness meditation or breathing exercises, can help relieve OA pain. It can also retrain the brain to lower its response to pain, offering long-term benefits. 
• Stretching: Gentle stretches can improve flexibility and range of motion. It can also relieve tension in the muscles surrounding your joints. Stretching promotes blood flow to your joints, easing stiffness and reducing pain. Incorporate stretches targeting the muscles around your affected joints, such as hamstring stretches for knee OA or hip flexor stretches for hip OA.
• TENS therapy: Transcutaneous electrical nerve stimulation (TENS) therapy uses a small, battery-powered device to deliver low-voltage electrical currents to the skin. These currents stimulate nerves in the affected area, interrupting pain signals before they reach the brain. TENS therapy also encourages the release of endorphins, the body's natural pain-relieving chemicals. TENS therapy may help relieve joint pain in the knees, hips, or back, making it a useful tool for OA pain management.

7. Use Assistive Devices

When OA pain is intense, assistive devices can provide relief and help make daily tasks easier on your joints. Whether you need mobility support, tools to reduce strain during household tasks, or aids to make working or driving less painful, there are many options to consider:

• Dressing aids: Items like zipper pulls, button fasteners, and long-handled shoehorns can help you get dressed while minimizing pain. 
• Kitchen aids: Reachers (long-handed gripping tools) can help get items stored above or below you. Built-up handles and grips on utensils provide a more comfortable hold. Electric can openers and fixed jar openers offer quick, effortless access to canned and jarred goods. 
• Bathroom aids: Tub bars and handrails can make getting in and out of the bath or shower safer. Faucet levers or tap turners can help if you have difficulty gripping. Raised toilet seats make it easier to sit down and stand up, reducing stress on your hips and knees.
• Office aids: Adjustable-height chairs and desks encourage comfortable posture. Large-button phones and hands-free headsets make communication easier. 
• Car aids: Devices like wide key holders or gas cap openers can make turning the car's ignition or fuelling much easier. 

8. Get Emotional and Social Support 

Between fear of movement due to pain, difficulty staying active, and feelings of anxiety or depression, osteoarthritis can make it hard to stay connected with others, increasing the risk of isolation. When managing a chronic condition like OA, social connections aren't just comforting—they're essential.

Research shows that people with chronic conditions and strong social support enjoy a better quality of life and experience fewer physical and mental effects of stress. Support can take many forms, such as a spouse helping with household chores, friends checking in regularly, or support groups providing advice and resources that make daily life easier. 

To build a support network, you can:

• Reach out to a friend or family member for a chat or to meet up
• Join an in-person or virtual group centred on an interest, such as a book club or hobby, or a support group for people living with OA 
• Take a class through a local community program to connect with others who share your interests
• Schedule regular activities with friends, like having lunch or walking together

When To Call a Healthcare Provider

While self-care can help manage osteoarthritis symptoms, it is also important to follow your treatment plan and maintain regular appointments with your healthcare provider.

If you have OA, contact your healthcare provider if you develop:

• Severe or worsening joint pain 
• Sudden inability to move or bear weight on the affected joint
• New or worsening symptoms after starting a new exercise or treatment 
• Difficulty sleeping due to pain 

A Quick Review

If you have osteoarthritis, self-care strategies can help you manage symptoms, maintain independence, and improve your quality of life. Self-care strategies can include regular exercise, a joint-friendly diet, and assistive devices.

Contact your healthcare provider if your symptoms worsen or prevent you from engaging in daily activities. They may suggest additional self-care strategies or changes to your treatment plan to help improve your quality of life. 

https://www.health.com/osteoarthritis-self-care-8773980