Walking, cycling, and swimming are best exercises for knee osteoarthritis
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- Reviewed by Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Exercise is the mainstay of treatment for knee osteoarthritis. By strengthening muscles and increasing range of motion in the knee joint, exercise can help ease pain and improve function. But what kind of exercise is best? In a study published online Oct. 15, 2025, by BMJ, researchers analyzed results from 217 randomized controlled trials to answer this question. The trials, which were conducted between 1990 and 2024 and included a total of 15,684 participants, compared different types of exercise — aerobic, flexibility, mind-body, neuromotor (which incorporates balance, coordination, gait, and agility), strengthening, and mixed programs.
Aerobic exercise came out on top for relieving pain and improving general function, gait (a person’s walking pattern), and quality of life. Lower-impact aerobic exercises (walking, bicycling, and swimming) tend to be the best options for people with knee osteoarthritis.
Other forms of exercise also showed value. Mind-body workouts contributed to functional improvement in the short term (four weeks). Strengthening and mixed exercise programs improved function at 12 weeks. Neuromotor exercise improved gait in the short term. Flexibility exercises helped relieve pain in the long term. The researchers noted that the strength of evidence was of moderate certainty. They called for further studies with longer follow-ups.
Image: © kali9/Getty Images
About the Author
Lynne Christensen, Staff Writer
About the Reviewer
Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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