An aching knee or a stiff hip does not have to mean giving up on exercise. With the right starting point and a simple way of reading what your joints are telling you, strength work can become one of the things that helps rather than one of the things you avoid.
Monday's article, Strength Training and Joint Health, explained why strong muscles protect your joints and why resting a painful joint often makes it worse. If you have not read it yet, it is worth starting there. Today's article puts that into practice, with a simple way to judge your discomfort and three exercises that are kind to sore knees and hips.
Reading What Your Joint Is Telling You
Many people with joint pain either stop as soon as they feel anything, or push on regardless. A simple traffic light approach, used widely by clinicians, sits in between. It helps to give the discomfort a score out of 10, where 0 is none and 10 is the worst you can imagine.
Green: Carry On
No discomfort, or a mild ache of around 3 out of 10 or less that does not build as you go and has settled by the next morning. This is acceptable, and often a sign the joint is being asked to do something useful.
Amber: Adjust
Discomfort that climbs above that level during the exercise, or a joint that is noticeably more achy the next day. Make the exercise easier next time: fewer repetitions, a smaller range or less weight.
Red: Stop and Seek Advice
Sharp pain, pain that makes you change the way you move, swelling, or a joint that is clearly worse for several days. Stop that exercise and get it checked before carrying on. If you are not sure who to see, our guide Osteopath, Physiotherapist or Chiropractor? How to Choose explains the differences.
How the joint feels the next morning tells you far more than how it felt in the moment.
Five Ways to Make Exercise Kinder to Your Joints
Use support. Holding the back of a sturdy chair or the worktop lets you work the muscles without worrying about your balance or the joint giving way.
Choose the time of day. If mornings are stiff, exercise later in the day when the joint has eased.
Work in a range that feels comfortable. A smaller movement done well builds strength. You can widen the range as the joint settles.
Swap rather than skip. If one movement aggravates a joint, choose another that works the same muscles in a different position, such as sitting or lying instead of standing.
Plan around flare-ups. On a bad day, do fewer repetitions or the easier version rather than stopping altogether.
If you followed Strength Exercises Everyone Can Start last week, these principles apply to those exercises too.
Three Joint-Friendly Exercises
These three exercises strengthen the muscles that support the knee and hip without putting your full body weight through a sore joint. Aim for ten repetitions of each.
1. Seated Knee Straightening
Helps with: walking downhill, stepping off a kerb, lowering yourself into a chair.
Sit towards the front of a firm chair with your feet flat and your back supported. Slowly straighten one knee until your leg is out in front of you, tighten the muscle at the front of your thigh and hold for three seconds. Lower the foot back to the floor over three seconds. Ten repetitions, then change legs.
Easier: straighten the knee only part of the way, or skip the hold.
To progress: hold for five seconds, or add a light ankle weight.
2. Straight Leg Raise on the Bed
Helps with: standing for longer, getting in and out of the car, climbing the stairs.
Lie on your back on a firm bed with one knee bent and that foot flat. Keep the other leg straight, pull your toes gently towards you and tighten the front of the thigh. Lift the straight leg until it is level with the bent knee, pause, then lower it slowly. Ten repetitions, then change legs.
Easier: tighten the thigh muscle and hold for five seconds without lifting the leg.
To progress: pause for longer at the top, or lower more slowly.
3. Seated Pillow Squeeze
Helps with: a steadier knee when standing up, getting in and out of the car, walking on uneven ground.
Sit towards the front of a firm chair with your feet flat and hip-width apart. Place a firm cushion or folded pillow between your knees. Squeeze your knees together into the cushion as firmly as is comfortable and hold for five seconds, breathing steadily, then relax. You should feel the inner thighs working. Ten repetitions.
Easier: squeeze more gently, or hold for three seconds.
To progress: hold for ten seconds, or squeeze while straightening one knee a little way.
Do the three exercises on two or three days a week, with a day between. One round takes around ten minutes. Our cornerstone guide, Strength Training After 50: Building Capability for Life, explains how to build from here into a full weekly plan.
Apollo Insight
When an exercise hurts, people often blame the exercise and drop it. Much more often, the problem is the dose. The same movement done through a slightly smaller range, a little more slowly or with fewer repetitions is usually fine, and the joint tends to accept more within a few weeks. Changing the dose before changing the exercise keeps you building strength rather than starting again.
This Week's Movement Tip
Controlled Knee Bends
Stand facing the kitchen worktop with both hands resting on the edge, feet hip-width apart. Keeping your heels down and your back upright, bend your knees a short way, taking three seconds as you go, and keep your knees pointing in line with your middle toes. Go only as far as feels comfortable, which may be just a few centimetres to begin with. Pause, then straighten your legs without locking your knees. Ten repetitions. You should feel the front of your thighs working, and the knee should feel no worse the next morning.
Before starting any new exercise programme, please consult your healthcare professional if you have any medical conditions, concerns or existing injuries. If you experience pain or worsening symptoms whilst exercising, stop and seek appropriate medical advice.
How Can Apollo Help You Exercise With Joint Pain?
If you are not sure which exercises are right for your joints, Osteopathy can help you understand what is behind the pain and what is safe to work on, at our Sheringham clinic and in Coltishall and Norwich. Reformer Pilates offers controlled strength work in classes of no more than four, where the springs can take some of the load from a sensitive joint. Explore our services or get in touch to find out more.
How Apollo Health Collective Supports Healthy Ageing
Healthy ageing is about understanding your body, looking after it well and having the right support when you need it.
At Apollo Health Collective, we help people stay active, capable and independent through personalised, evidence-informed care. Our integrated approach brings together different areas of expertise to support movement, recovery and long-term wellbeing.
Our Sheringham clinic offers Osteopathy, Sports Therapy, Sports Massage, Clinical Exercise & Rehabilitation, Reformer Pilates, Podiatry, Biomechanics, and Lifestyle & Wellbeing services. We also offer Osteopathy appointments in Norwich and Coltishall.
Whether you are recovering from an injury, managing ongoing concerns, looking to improve your movement or simply investing in your future health, our team is here to support you.
References
01 Lawford BJ, Hall M, Hinman RS et al. (2024). Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2024(12), CD004376. https://doi.org/10.1002/14651858.CD004376.pub4
02 Smith BE, Hendrick P, Smith TO et al. (2017). Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. British Journal of Sports Medicine, 51(23), 1679-1687. https://doi.org/10.1136/bjsports-2016-097383
03 Skou ST, Roos EM (2017). Good Life with osteoArthritis in Denmark (GLA:D): evidence-based education and supervised neuromuscular exercise delivered by certified physiotherapists nationwide. BMC Musculoskeletal Disorders, 18, 72. https://doi.org/10.1186/s12891-017-1439-y
04 National Institute for Health and Care Excellence (2022). Osteoarthritis in over 16s: diagnosis and management (NG226). https://www.nice.org.uk/guidance/ng226
