Should I Exercise with Knee Pain?

Adam Rivadeneyra, M.D.

Knee pain is a common complaint that can affect people of all ages. When knee pain strikes, it can raise the concern on whether one should continue to exercise, or if exercising could cause more knee damage or pain. We asked Dr. Adam Rivadeneyra, a sports medicine physician at Hoag Orthopedic Institute, to debunk the myths surrounding exercising with knee pain.

Q: Why is it important for people with knee pain to continue exercising? How can the right exercises help alleviate pain or progression of pathologies?

A: Depending on the cause of a person's knee pain, increased exercise may help it improve. If there isn't significant structural injury, a focused exercise or physical therapy plan will likely help.

Q: What are the primary causes of knee pain?

A: "Runner's Knee" is one of the most common causes of knee pain. It's typically related to poor biomechanics, which can be improved with the help of a skilled physical therapist. Osteoarthritis (wear and tear) is another common cause, and one of the best treatment options is increased exercise and movement to help with pain relief and improve function.

Q: What considerations should people with knee pain make when crafting their workouts? What experts should people refer to when exercising with knee pain? At what point is evaluation warranted?

A: Any knee pain that results in significant swelling, or "water on the knee," should be evaluated by a physician, preferably a physician with experience in orthopedics or sports medicine. Falls, loud "pops" that make your knee feel unstable, redness around the knee, swelling or severe pain that limits your activity should be evaluated prior to changing your workouts or exercise plan.

Q: What are some of your favorite lower-body exercises for those with knee pain, and why?

A: Assuming no major injury exists, a progressive walking program is always a great way to start. Stationary biking, swimming, tai chi, Pilates, yoga, and water aerobics are good for lower impact exercises. For strengthening exercises, I prefer "closed chain" exercises where your feet are firmly engaged on the floor or other stable objects like a leg press machine. Using weights, kettle bells, resistance bands, and your own body weight are a great way to build functional strength in your hips and core to help alleviate knee pain. The most important thing is to remain strong through the hips and core to build a more stable base for all lower body activity.

About Dr. Adam Rivadeneyra

Dr. Adam Rivadeneyra is a board-certified primary care sports medicine physician at Hoag Orthopedic Institute specializing in non-surgical orthopedics. His practice includes acute and chronic musculoskeletal injuries, diagnostic and interventional ultrasound for orthopedic issues, and comprehensive medical care for elite athletes. He has a passion for patient education and enjoys an individualized approach to care based on the patient's health history. Dr. Rivadeneyra participates in frequent activities for continuing medical education.