Walking, cycling and swimming may be among the best exercises to ease knee pain, according to a study of patients with osteoarthritis. The condition occurs when the protective cartilage on the ends of bones wears away, causing pain, swelling and impaired movement.
An estimated 10 million people in the UK have osteoarthritis, with 5.4 people seeing their knees affected. Researchers in the US and China looked at data from 217 trials looking at common exercise therapies, published between 1990 and 2024.
Aerobic exercise — such as walking, cycling or swimming — consistently proved the most successful exercise-based treatment.
There was also evidence that mind-body exercise such as yoga boosted short-term function.
This includes any continuous, rhythmic activity using large muscle groups that increases your heart rate, breathing and oxygen intake.
It strengthens the heart and lungs, improves circulation and helps the body use oxygen more effectively.
Writing in The BMJ, the authors suggested aerobic exercise “as a first line intervention for knee osteoarthritis management, particularly when the aim is to improve functional capacity and reduce pain”.
They said: “In patients with knee osteoarthritis, aerobic exercise is likely the most beneficial exercise modality for improving pain, function, gait performance, and quality of life, with moderate certainty.”
The study was led by researchers at Johns Hopkins University School of Medicine in the US and Zhejiang University School of Medicine in Hangzhou, China.
If aerobic exercise is not possible, they added that “alternative forms of structured physical activity may still be beneficial.”
The average age at which symptoms of osteoarthritis begin is 55. It is more common among women.
Almost 30% of people aged over 45 show signs of knee osteoarthritis on x-rays and around half of those have severe symptoms.
Rates of osteoarthritis are expected to rise due to an ageing population and rising prevalence of obesity.