It can be hard to know how much to exercise when you have knee pain. The 4 exercises below are part of the progressive resistive strengthening program for ENACT’s BOOST study, and are known to decrease pain and improve function for those with knee pain due to knee osteoarthritis.

Click on each exercise for detailed instructions:
Exercise 1 – The Squat
Exercise 2 – The Clam Shell/Leg-raise
Exercise 3 – Knee Extension
Exercise 4 – Knee Flexion

What is Progressive Resistive Training?: Progressive Resistive Training is muscle strength training that is based on 2 principles: 1) proper intensity and 2) gradual muscle overload. The 1st principle for improving strength, using a proper level of intensity, is to feel muscle fatigue in 10 repetitions when using good form (see below for more on finding the right intensity). Adding more repetitions (especially greater than 15) will improve muscular endurance rather than continuing to improve muscle strength.  As the muscle adapts to the intensity of your exercise by becoming stronger, your muscle strength will not improve further unless you apply the 2nd the principle of gradual muscle overload.  To do this, you must continue to increase the difficulty of the exercises by adding more weight or resistance for continued strength gains.

With each of the 4 exercises, we have provided progressions to help you achieve the proper intensity for strength gains, both when you first start the exercises and over time.

Know your lingo – Repetitions (“reps”) and Sets: In the BOOST program, a repetition is a single, complete move.  Ten repetitions makes one set. Take a short rest (30 seconds) in between sets and complete two sets of each exercise at a time. If you can do 15 or more repetitions easily, you are improving your muscular endurance more than strength so increase the intensity, but as suggested in the progressions.

Finding the Right Intensity: At the right intensity, you should find the weight moderately difficult to lift the first time, but well within your ability. By the 6th or 7th repetition, it should seem heavier. Ideally, you should be able to perform the 10th repetition in good form but feel that if you didn’t stop and rest your muscles, you couldn’t continue. This is a level 4 on the intensity scale. Start out slowly and build up to a level 4 over the first 2 weeks using the progressions provided with each exercise.  Worried about pain?  Click here to learn more about good pain vs. bad pain

Before you begin: Wear loose, comfortable clothing to stay cool and supportive footwear. Keep water nearby and drink some before, during, and after your workout. Warm up by doing 5-10 minutes of aerobic exercise (for example, walking or stair-climbing) outside or around the house. After exercising, cool down by stretching the same muscles you just worked out. This stretching guide from the Arthritis Foundation is a good resource for people who aren’t sure what stretches to try.

Want more?  Visit our Get Active page for more exercise resources