Is High-Intensity Exercise Better for Knee Arthritis?


Knee Arthritis

There’s a common misperception that exercise is bad for the knees and that high-impact exercise increases the risk of knee osteoarthritis, the most common form of age-related joint disease. Osteoarthritis is a degenerative type of arthritis, although recent research suggests that, in some cases, it has an inflammatory component. Osteoarthritis is more common later in life as various factors wear away the cartilage that cushions the tips of the bones within a joint. Surprisingly, some people have significant osteoarthritis and are relatively symptom-free while others experience pain and stiffness most days.

What about the common belief that high-impact exercise and knee arthritis? Some people believe that high-impact exercise causes damage to joints and may increase the risk of developing osteoarthritis. However, research also shows that staying physically active improves quadriceps strength and that can lower the risk of developing osteoarthritis of the knee. Plus, exercise helps with weight control. That’s important since carrying excess weight places added stress on the knee joints. In fact, experts believe that losing weight is one of the best ways to take the load off your knees and ease arthritis symptoms.

Exercise for Knee Arthritis

What if you already have knee arthritis? Exercise can help. In one study in which older individuals strength trained, researchers found that those who strengthened their quadriceps through resistance training experienced less progression of osteoarthritis of the knee over time. As osteoarthritis advances, the joint space gradually becomes narrower. But those who strength trained slowed the rate of joint narrowing by 26%.

We know that resistance training is helpful because it helps strengthen the quadriceps muscles that support and stabilize the knees. But what about aerobic exercise and what type is best? Traditionally, physicians have recommended moderate-intensity exercise of a low-impact nature. However, a new study suggests that high-intensity exercise may be better for arthritic knees.

How did researchers come to this conclusion? They pored over research from the past on therapies for knee arthritis. This was followed by a randomized trial comparing moderate-intensity exercise to high-intensity interval training. For the study, researchers recruited 27 patients with osteoarthritis of the knee. The participants cycled at home for 25 minutes 4 times weekly for 8 weeks. The only difference was the intensity with which they worked out. One group cycled at a moderate intensity while the other picked up the pace and worked out at a high intensity.

The results? Both groups reported improvements in quality of life, but the group that did high-intensity training experienced the greatest improvements in how well their knees functioned. Of note is the fact that the frequency of training matters. The study showed that training only once per week offered no benefits. So, consistent exercise and, possibly, more intense exercise is optimal for boosting knee function in people with osteoarthritis of the knee. The study subjects exercised intensely, but they did it in a low-impact manner. In this case, they cycled. High-impact exercise could be harmful to people with severe knee arthritis. Whether your knees can handle high-impact exercise will depend on how severe your arthritis is and the recommendations of your doctor.

Strength Training for Knee Arthritis

If anything, total body strength training is even more important for healthy knees. Strengthening the quadriceps muscles helps stabilize an arthritic knee and the muscle you develop absorbs some of the shock that hits your knees each time you take a step. However, you should take extra precautions when training with knee arthritis.

Choose your exercises carefully and limit the number and volume of exercises you do that require bending of the knees, such as squats and lunges. Don’t use a weight that’s so heavy that it causes discomfort. Also, don’t be afraid to modify an exercise that feels uncomfortable or that you can’t use good form on. For example, if you experience pain when you do a deep squat, only go down as low as feels comfortable. Step-ups, particularly stepping onto a high platform, places a lot of stress on the knees. So, limit them or don’t do them at all. Monitor how you feel after a strength workout to see how you need to modify your routine the next time.

Tips for Exercising with Knee Arthritis

For most people with knee arthritis exercise is safe and beneficial. Still, talk to your physician first if you have a lot of joint pain. If they don’t recommend high-impact workouts, you can still work out at a high intensity without pounding your joints excessively. Cycling, brisk walking, strength training, kettlebells, and some step workouts involve minimal impact.

If your physician says it’s okay to do some high-impact exercise, work out on a soft surface whenever possible and wear shoes with good support. Also, don’t do high impact exercise every day. Give your knees a break by only doing high-impact exercise once or twice per week. You might also consider wearing a knee brace for added knee support.

Most importantly, listen to your body and what it’s telling you. If you experience knee pain, stop and reevaluate. You might discover that certain exercises aggravate the pain. If that’s the case, find a substitute. Also, always be aware of the form you’re using. You might find that lightening the weight and doing higher volume works best for you.  It’s important for everyone, but even more vital if you have an arthritic knee. Be sure to do a dynamic warm-up and cooldown followed by stretching each time you work out.

The Bottom Line

Preliminarily, it looks like high intensity could improve knee functionality more than moderate-intensity workouts. However, this was a small study. But there’s no doubt that we all need to work our muscles against resistance to strengthen the muscles that support our joints. Don’t be afraid to modify how you train to keep your workouts knee and joint-friendly.



·        Internal Medicine News. “Strength Training May Stave Off Knee Osteoarthritis”

·        Family Practice News. August 2019. “Knee Osteoarthritis: What’s Hot in Research on Exercise Interventions”

·        Practical Pain Management. “Knee Osteoarthritis Impacted By Quadricep Strength”

·        Internal Medicine News. “Strength Training May Stave Off Knee Osteoarthritis”


Related Articles By Cathe:

How to Modify Exercises if You Have Knee Pain Due to Arthritis

When Your Knees “Crack” and “Pop” What Does It Mean?

How Plyometric Exercises Can Benefit Your Fitness Routine

Knee Noises: Should You Be Concerned if Your Knees Crackle or Pop When You Exercise?

Are Women at Higher Risk for Knee Problems?

What Impact Does Strength Training Have on Arthritis?

Are the Joint Aches You’re Experiencing Due to Arthritis?

The Effect of High Impact Exercise on Knee Health

Why Are My Knees Hurting? 5 Common Causes of Knee Pain in Active People


Related Cathe Friedrich Workout DVDs:

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