Conditions / Musculoskeletal
Knee osteoarthritis
Degenerative joint change at the knee. Structured land-based exercise is a core treatment, not a risk.
Prescribe
- Strength training at least twice weekly, 2-3 sets of 8-12 repetitions
- Start around 50-60 percent of maximal strength and progress gradually
- Prioritise quadriceps, hip abductors and hip extensors
- Aquatic exercise is a recommended option for knee OA specifically
- Expect at least 12 sessions before judging the pain response
Avoid, and why
- Judging a session by immediate soreness - use the two-hour pain rule instead
- High-force eccentrics early, which may temporarily increase joint pain
- Stopping training because of soreness - reduce load or impact rather than stopping
How the generator handles this
| Max exercise complexity | 3 |
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| Patterns excluded | None |
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| Balance work added | No |
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| Clearance required first | No |
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Exercises automatically excluded:
Walking lunge
Sources
- Arthritis Society Canada (2024). Physical Activity Guide.
Source
Source of the two-hour pain rule: if joints hurt more than usual and take more than two hours to settle after activity, modify the activity. Modify, not stop.
- Bannuru et al., Osteoarthritis and Cartilage (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.
Source
Structured land-based exercise and education are CORE treatments for knee, hip and polyarticular OA. Aquatic exercise is recommended for knee OA but not for hip or polyarticular OA.