Exercise for arthritis in knees: what helps and how to start
Exercise is the most strongly recommended non-drug treatment for knee arthritis, and strength training belongs in the plan. Start light, keep joint pain from climbing, and build up over weeks.
Book a free Baseline SessionLifting weights with arthritic knees
People with sore knees hear one piece of advice more than any other: rest them. One woman in her mid 40s described going from five workouts a week to one because of joint pain and slow recovery. The research points the other way.
The 2019 guideline from the American College of Rheumatology and the Arthritis Foundation strongly recommends exercise for osteoarthritis of the knee, hip, and hand. Walking, strengthening, neuromuscular training, and water exercise all count, with none ranked above the others. The guideline also notes exercise is associated with better outcomes when supervised.
Lifting weights helps arthritis, with honest limits. The 2024 Cochrane review of 139 trials and about 12,500 people found exercise improves knee osteoarthritis pain and function in the short term, though the average gains were small. A 2019 analysis comparing exercise types found aerobic and mind-body exercise relieved pain the most, and strengthening gave moderate benefits across several measures. A sensible plan pairs strength work with walking or cycling.
The CDC advises adults with arthritis to aim for 150 minutes of moderate activity a week plus two days of muscle strengthening, and to choose weights or bands which don't cause joint pain. Talk with your doctor before you start for advice specific to your joints.
Joint pain after working out has a simple test. The Arthritis Foundation's two-hour rule: if you have more joint pain two hours after exercising than before you started, you overdid the session. Ease up next time. If the pain lasts beyond a few days, see your doctor.
The Foundation's strength test gives you a starting load. Use light weights, lift slowly, and aim for two sets of 10 with good form. If the 10th rep is a struggle, stay at the weight. If you finish both sets with plenty left, go up next session.
How we do this at Sessions. Your free Baseline Session includes a movement assessment, so we see how your knees move before choosing a single exercise. You leave with a written plan you keep whether you join or not. Our coaches are not doctors or physical therapists. Bring any guidance from yours, and we build the program inside those limits.
In the studio, two coaches are on the floor every session, six people per coach, and every member runs their own written program. Your coach watches form on every set and swaps an exercise when a joint complains. Every weight is logged, so the load climbs at a pace your knees handle, and a sore week gets a lighter session planned from the log. Start with a free Baseline Session.
Three rules for lifting with arthritis
- Pain-free loadPick weights and bands which cause no joint pain during the set, per CDC guidance.
- The two-hour checkMore joint pain two hours after training than before means ease up next session.
- Two strength days a weekStrength work on two or more days, plus walking or other moderate activity across the week.
Common questions
What is the best exercise for arthritis in the knees?
No single exercise wins. The ACR and Arthritis Foundation guideline lists walking, strengthening, neuromuscular training, and water exercise without ranking one above the others. A practical mix is leg strengthening two days a week plus walking or cycling, in line with CDC guidance.
Does lifting weights help arthritis?
Research supports exercise, strengthening included, for knee osteoarthritis pain and function. The 2024 Cochrane review found small average improvements over the short term. In the earlier 2015 Cochrane review, no study reported a serious adverse event from exercise.
Is joint pain after working out normal?
Some soreness happens. The Arthritis Foundation's rule: if your joints hurt more two hours after exercise than before you started, you did too much, so ease up next time. Pain lasting beyond a few days is a reason to see your doctor.
How often should I strength train with arthritis?
The CDC recommends muscle-strengthening activity on at least two days a week for adults with arthritis, plus 150 minutes of moderate aerobic activity. Choose weights or bands which don't cause joint pain and build up slowly.
Should I see a doctor before starting?
The CDC advises talking with a health care provider before beginning physical activity for personalized recommendations. With a new diagnosis or a recent joint injury, get cleared first, then bring the guidance to your coach.
Sources: ACR/Arthritis Foundation OA guideline, 2019 · Cochrane 2024: Exercise for knee osteoarthritis · Goh et al., Sports Medicine 2019 · CDC: Physical activity and arthritis · Arthritis Foundation: How hard should you work out?