- Scientists reveal one exercise type that may ease knee pain from arthritis.
- In a recent study, researchers found that aerobic exercise outperformed other types of exercise in easing knee arthritis symptoms.
- Here, physical therapists break down the findings.
If you struggle with joint pain from arthritis, especially knee pain, moving might feel like the last thing you want to do. In reality, regular exercise and movement may be just what you need to get some relief. But not just any workout will do. It turns out that one type of exercise in particular may be the most effective at combating knee arthritis symptoms.
Meet the experts: Robyn Culbertson, P.T., D.P.T., board-certified clinical specialist in geriatric physical therapy and spokesperson for the American Physical Therapy Association (APTA); Karena Wu, D.P.T., owner of ActiveCare Physical Therapy.
The revelation comes from a recent study published in The BMJ, which set out to determine which types of movement offer the best pain relief for people with knee osteoarthritis, a chronic condition that affects nearly 30% of people over 45 years old, according to the researchers. The systematic review and meta-analysis included over 200 randomized controlled trials conducted between 1990 and 2024, with over 15,000 total participants who had symptomatic knee osteoarthritis.
The researchers examined the outcomes of six different exercise types for the participants’ pain level, gait performance, physical function, and quality of life: aerobic exercise, flexibility exercise, strengthening exercise, mind-body exercise, neuromotor exercise, and a mixed exercise protocol. Outcomes were measured at a short-term four-week mark, a mid-term 12-week mark, and a longer-term 24-week mark. Across all measures the researchers studied, aerobic exercise consistently ranked as the most effective exercise type for improving knee arthritis symptoms.
What does that actually mean for your workout routine? Ahead, physical therapists break it down.
Why are the findings significant?
The idea that regular exercise plays a role in arthritis pain relief isn’t revolutionary in and of itself. “This study confirms what we already know: regular physical activity can help improve movement and function and reduce joint pain for people with arthritis,” explains Robyn Culbertson, P.T., D.P.T., a board-certified clinical specialist in geriatric physical therapy and spokesperson for the American Physical Therapy Association (APTA). When done with proper form, “repetitive motion helps to nourish the joint surfaces, assist with range of motion, muscle activation, and restoration of gait, function, and quality of life,” adds Karena Wu, D.P.T., owner of ActiveCare Physical Therapy.
The significance of this particular study is two-fold. First, it narrows down the type of movement that consistently produces the best outcomes for people with knee arthritis. “This is important information for those suffering from knee arthritis (much like myself) because there are so many exercises to choose from (e.g., strength, flexibility, stability),” says Wu. As for what makes aerobic exercise so effective, it can “affect multiple metrics of pain, function, gait, and quality of life. Most other therapies or modalities affected [fewer] metrics.”
Second, the study’s large data set—15,684 participants, to be exact—gives its results more credibility. “It provides a big-picture view of the research on exercise modalities for knee osteoarthritis,” Culbertson explains. “Systematic reviews and meta-analyses [like this one] offer some of the highest levels of evidence in research studies.”
It’s worth noting that while aerobic exercise consistently outperformed the other types the researchers examined, other kinds of movement were also effective. “Mind-body exercise, neuromotor exercise, strengthening, and mixed exercise are also beneficial, with flexibility showing large improvements in pain at long-term follow-up,” Culbertson points out.
Does aerobic exercise have other benefits?
You don’t have to have arthritis to reap the benefits of incorporating more aerobic exercise into your routine. “Aerobic exercise emphasizes cardiovascular health, so the heart as a muscle gets a workout, as do the blood vessels,” Wu explains. “This will also benefit the respiratory system, as the lungs have to participate in the continuous exchange of gases.”
Aerobic exercise can also support “bone health and weight loss, which can, in turn, help with symptoms of knee OA,” adds Culbertson. “Endorphins released by exercise can help with mood and quality of life, which can also improve pain.”
What does this mean for you?
If aerobic exercise isn’t already a regular part of your routine, you may want to lace up your sneakers. But Wu cautions against going too hard too fast. “Exercise is a necessary component of arthritis management; however, working within your limits is important,” she says. “Always start low and assess how your body responds. Gradual reintroduction of movement and forces is key to restoring function, reducing pain, and returning to [a better] quality of life.”
Despite the study’s findings, Culbertson also warns not to fully sacrifice variety in your exercise routine in favor of just aerobic exercise. “Strengthening is a key component of knee health, and the recommendations in the study shouldn’t make those with knee OA who want to do more high-impact activities like running or HIIT feel limited,” she says. “It’s important to listen to your body. P.T.s can meet you where you are to ensure safety while doing the things you love.”
After all, the most important metric is what feels good for you, regardless of what the study’s results suggest. “It’s important to talk to your doctor or physical therapist about an exercise program that is best for you, based on your specific symptoms and conditions,” Culbertson maintains. “Rehab for knee OA isn’t a one-size-fits-all approach. Other considerations for modifications may include a recent knee injury or surgery, cardiovascular compromise, or another pre-existing condition that may affect your ability to participate in aerobic exercise.”
The bottom line
The results of the study are promising for people suffering from knee arthritis pain, but they aren’t without their limitations. Colbertson points out that while the total participant pool for the meta-analysis was large, several of the individual randomized controlled trials included in the study had much smaller sample sizes, “which can affect results.”
Further research is also needed to determine whether the results hold up in the long term. “Knee osteoarthritis is chronic and progressive. Therefore, long-term outcomes would be particularly important for evaluating the benefits of an exercise,” Colbertson explains.
Still, the results highlight just how much consistent movement can improve quality of life. “Regular exercise can help with many things,” Colbertson says. “Reducing stiffness, [supporting] joint health, preventing falls, avoiding surgery, and helping you stay active to do the things you enjoy as you age.” Pain relief is just another potential pro to add to that list.
Read the full article here
