Strengthening the thigh and hip muscles is the most recommended long-term treatment for knee osteoarthritis in every major guideline (NICE, ACR, OARSI). Strong muscles take load off the joint. Start gently, do the exercises most days, and expect results after 6 to 8 weeks.
The 7 exercises
| Exercise | How | Sets |
|---|---|---|
| Straight leg raise | Lie on your back, one knee bent. Tighten the thigh of the straight leg and lift it to the height of the other knee. Hold 3 seconds. | 2 x 10 each leg |
| Quad set | Sit with legs straight. Press the back of the knee into the floor, hold 5 seconds. | 2 x 10 |
| Bridge | Lie on your back, knees bent. Lift hips until body is straight. Hold 3 seconds. | 2 x 10 |
| Side-lying leg lift | Lie on your side, lift the top leg up and slightly back. | 2 x 10 each side |
| Wall sit | Back against a wall, slide down to a comfortable bend. Hold 10 to 30 seconds. | 3 to 5 holds |
| Step-up | Step onto a low step, then down. Hold a rail. | 2 x 10 each leg |
| Sit to stand | Stand up from a chair without using your hands, sit down slowly. | 2 x 10 |
How much pain is OK
Mild discomfort during exercise is normal. A useful rule used by physiotherapists: pain up to about 5 out of 10 that settles within a day is acceptable. If pain is worse the next morning, do fewer repetitions.
Low-impact cardio
Cycling, swimming, water walking and walking on flat ground keep the joint moving without heavy impact. Thirty minutes most days is a good target.
A physiotherapist can tailor a program if you are unsure where to start.