“My knee hurts too much to exercise”
By Matheus de Paiva, Exercise coach, BSc Physical Therapy, MSc Rehabilitation Science. Updated 2026-10-03.
Exercise is the first-line treatment for knee osteoarthritis. It reduces pain and improves function about as much as common pain medication, with fewer side effects. The key is starting at a level your knee tolerates.
What the research shows
A Cochrane review of 54 trials found that exercise reduced knee pain and improved physical function in people with knee osteoarthritis, and the benefits lasted months after treatment.
Clinical guidelines worldwide recommend exercise and education as the core treatment for knee osteoarthritis, before medication or surgery.
How to start with a sore knee
- Some pain during exercise is acceptable if it stays mild, around 2 to 3 out of 10
- Pain should settle within 24 hours
- Start with partial movements, like sit-to-stand from a higher chair
- Build up range and load over weeks
Common questions
Will exercise wear out my knee faster?
No research shows that well-dosed exercise speeds up knee osteoarthritis. Stronger muscles around the knee usually reduce pain.
Sources
- Fransen et al. 2015, exercise for osteoarthritis of the knee (Cochrane)
- Bannuru et al. 2019, OARSI guidelines for knee, hip and polyarticular osteoarthritis
These guides are general education and do not replace advice from your doctor or health team. True Pace does not diagnose or treat medical conditions.