Knee Arthritis: Building Strength, Function & Resilience Through Smart Exercise

Knee arthritis can be frustrating—it can limit your ability to walk, climb stairs, or even stand up from a chair without discomfort. But while arthritis changes the structure of the knee joint, the way your knee feels and functions depends heavily on strength, stability, and movement confidence.

One of the most effective things you can do is start building strength in the right way, and that sometimes begins in the pool.

Hydrotherapy: The Perfect First Step

Hydrotherapy (exercise in warm water) can be an excellent way to start your arthritis rehab journey. Thanks to buoyancy, you can significantly reduce the load through your knees while still moving and strengthening. This allows you to:

• Improve mobility without aggravating symptoms

• Begin functional movements like squats or step-ups in a supported environment

• Increase cardiovascular fitness without high-impact stress

However, the goal isn’t to stay in the pool forever. For the greatest improvement, you need to transition into shallower water, increasing the load gradually, and ultimately return to land-based exercises. This progression helps prepare your knees for real-life challenges.

Two Functional Exercises That Make a Big Difference

When it comes to knee arthritis, building functional strength—strength that helps with daily activities—is key. Two of the best exercises are:

1. Step-Ups

• Start with a low step height and use support if needed.

• Gradually increase step height or add resistance for progressive overload.

• Step-ups mimic stair climbing, an essential movement for independence.

2. Sit-to-Stands

• Begin with a higher chair to reduce the range of motion.

• Progress by lowering the chair height, then adding weights.

• Sit-to-stands build power for getting out of chairs, cars, and toilets—vital for everyday living.

Progressive overload is crucial. This means gradually making exercises more challenging as your body adapts. This is where a physiotherapist can ensure you’re working hard enough to improve but not so hard that you flare up your symptoms.

When Exercise May Not Be Enough

For many people with knee arthritis, structured physiotherapy and progressive strengthening lead to better function and reduced pain. But there are times when the arthritis is too severe—for example, when pain is constant and mobility is significantly restricted despite months of targeted rehab.

In these cases, surgery (such as a knee replacement) may need to be considered. Even then, going into surgery with stronger muscles can significantly improve your recovery outcomes.

The Bottom Line

Knee arthritis doesn’t have to mean giving up the things you love. By starting with supportive exercise like hydrotherapy, transitioning to land-based functional movements, and applying progressive overload, you can build resilience in your knees.

And remember—strength is protective. Whether your goal is to walk further, play with the grandkids, or delay surgery, the right exercise plan makes all the difference.

References:

• Fransen M, McConnell S, Harmer AR, et al. (2015). Exercise for osteoarthritis of the knee: a Cochrane systematic review. British Journal of Sports Medicine, 49(24), 1554–1557.

• Brosseau L, et al. (2012). Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis. Physiotherapy Canada, 64(3), 208–235.

• Hinman RS, et al. (2007). Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Physical Therapy, 87(1), 32–43.