Range of motion exercises for knee osteoarthritis

Knee pain has it’s way of creeping in and hijacking your life. Whether you’re working through a flare-up or your knee pain and mobility is a constant issue, it’s important to know that there are things you can do today to improve your situation.

Knee pain and range of motion (ROM) are intimately linked and by focusing on improving knee movement, you can actively cutdown on your pain. Devoting a short amount of time each day to bettering knee range of motion will payoff in dividends. And you may have guessed it…this “short amount of time each day” means exercises aimed at improving mobility, flexibility, and strengthening key supporting muscles!

To design an easy-to-follow at-home exercise program aimed at improving your ROM and cutting down knee pain, we spoke with physical therapist Arash Maghsoodi (PT, DPT, CSCS). Dr. Maghsoodi is a member of the popular physical therapy trio, The PreHab Guys and is a strength and conditioning specialist. His holistic approach to improving knee function and pain means retraining and strengthening the muscles that influence and support your knee.

Looking Elsewhere: Reducing Knee Pain & Improving Range of Motion

Arash, physical therapist, explains that “knee pain is influenced from both the hip, foot and ankle. A lack of strength and stability in the foot and ankle can place stress on the knee. It comes down to making sure the foot, ankle and hip in optimal alignment which will offload excessive stress on the knee.” Arash adds that even just “improving the strength of your hip muscles has shown to reduce stress and improve knee pain.”

“Tightness of surrounding muscles including the calves, hamstrings and quads can also lead to knee pain”,, explains Arash. He adds that “making sure that the calves, hamstrings and quads have adequate flexibility will help offload the knee structures.”

In other words, by looking at the larger picture and turning to the parts of your body (like your ankles, hip, foot etc.) that influence the knee, you can build-up a support system for your troubled knee joint by taking away some of the pressure (literally and figuratively).

Read on as we share ‘ROM basics and knee pain 101’ before breaking-down a custom exercise routine for you to do at home.

ROM Basics and Knee Pain 101

1. Knee Pain Often Starts with a Torn Meniscus

Knee pain often starts with an injury like a torn meniscus (one of the most common knee injuries). You may not even realize you’ve torn your meniscus (your knees cartilage). Continual breakdown or loss of this cartilage will eventually lead to osteoarthritis and bone spurs of the knee.

Torn your meniscus but feel no pain? Often times an MRI may show a tear or other pathologies, but you may not feel any pain or have any mobility issues. These are known as asymptomatic meniscal tears. You can let pain be your guide when seeking treatment or working with a physical therapist, but preventative care is a great investment!

2. What Exactly Does “Range of Motion” (ROM) Mean?

Range of motion refers to the full movement of your joint (in this case knee). Your knee ROM will include: flexion (bending), extension (straightening), adduction (movement towards middle of the body), abduction (movement away from middle of the body), and rotations (inward and outward) must be worked towards. Your knee ROM is measured with a “goniometer”. The knee is a hinge joint and primarily only moves in one plane of movement, flexion and extension.

A completely straight knee joint will measure 0° and a fully bent knee will have a flexion of at 135° degrees. These are the benchmark “normal” ROM measures. If you’ve had a knee replacement, your physician may look for a knee flexion in the 125-135 degree range once you’re fully recovered.

Learn more about knee ROM milestones to hit after a knee replacement, knee arthroscopy or knee arthroplasty.

The caveat to your knee range of motion measurement: it’s got to be pain-free. If you’re knee can bend to 130 degrees but you’re in excruciating pain, this is not a true ROM flexion measure.

Arash includes a caveat to patient’s ROM measure saying “a true range of motion is how far they can bend/ extend pain-free.” In other words, if your knee can bend to 130 degrees but you’re in excruciating pain, this is not your true ROM flexion measure.

3. Got Knee Pain? Physical Therapy is For Everyone!

Whether you’ve had a knee replacement due to severe osteoarthritis, are preparing for a knee surgery, are recovering from a painful injury, trying to minimize ongoing knee pain, or looking to avoid injury, there are knee ROM exercises you should be doing. Seeing a physical therapist to customize and tailor these PreHab or ReHab exercises is often a necessary step. Continuing with an at-home preventative or recovery program is necessary for regaining back range of motion and setting yourself up for your “new normal”.

When should I see a physical therapist? Dr. Maghsoodi explains, “if you have knee pain you should seek medical advice. It is always recommended to attempt conservative care such as physical therapy prior to seeking a more invasive option.”

Dr. Maghsoodi illustrates, “Your body is like a bank account. The more you put in, the more you can take out. The more you strengthen, the higher capacity you have to perform activities pain-free.” Amen!

4. What’s if Physical Therapy/ Exercises Don’t Help My Knee Pain?

If after 6 weeks of consistent physical therapy, you’re not getting better, more invasive procedures may be recommended. Physical therapy is considered non-invasive, conservative care. If there’s a lack or progress and you have a diagnosed structural issue, then your physical therapist may refer or recommend you to an orthopedic surgeon. Generally, surgery is reserved as a last resort for those who have a quality of life that is suffering, a structural issue that surgery can resolve, and aren’t high-risk.

When could it be time for a knee replacement? As a rule of thumb, your primary care physician and orthopedic surgeon will want you to exhaust most non-invasive treatments (like injections, physical therapy etc.) before they proceed with an arthroscopy or arthroplasty (AKA a replacement).

A Stability & Mobility Exercise Program for ROM and Knee Pain

With a goal of regaining knee range of motion, Arash highlights the two key ways to improve knee range of motion, pain and movement: stability and mobility.

If you’re prone to knee pain and are looking for a preventative program, then run through this program 2-3 times a week. If you’re experiencing a flare-up or have chronic knee pain, we recommend doing the program daily (the mobility portion 2-3 times). Use the set and rep numbers beside each exercise as a guide, tailoring it for you.

Why Improve Stability?

The first group of exercises will focus on building up stability. In order to work on stability, you need to take both a “passive” and “active” approach. Passive stability targets your cartilage, ligaments, and joints. Active stability will include exercises that engage the surrounding muscles. Arash explains, “With knee osteoarthritis, we want to offload the pain generators (like bone spurs which is created from being bone on bone in your knee) by increasing active stability. This will help to reduce symptoms. By increasing active stability you will offload passive structures. The way to do this is by training surrounding muscles of the knee by increasing their strength and endurance.” He adds that by strengthening the surrounding muscles (like the hip, foot, quads, hamstrings, etc.) you create “active shock absorption” for the knee vs. putting stress on passive structures such as the knee cartilage and bone.”

Why Improve Mobility?

Now, the second group of exercises in your “ROM and Knee Pain” program will target mobility. These exercises will help you regain motion, without putting your knee under too much stress and pain. Mobility exercises tend to be performed more frequently, whereas stability exercises do not need to be performed as much.

Watch this short video on “knee cap mobilization” for a better understanding of how knee mobility works and why it’s so important.

Your Stability Exercises

To be performed once a day during a flare-up, or 2-3 times a week for preventative maintenance.

1. Long Arc Quad (LAQ)

15 reps x 2, 1 time a day

2. Step Up Exercise

10 reps x 3, 1 time a day

3. Sidelying Clams

10 reps x 3, 1 time a day

4. Side Lunges

10 reps x 3, 1 time a day

5. Standing Heel Raises  

10 reps x 3, 1 time a day

6. Mini Squats

10 reps x 3, 1 time a day

Your Mobility Exercises

To be performed 2 or more times a day during a flare-up, or multiple times a week for preventative maintenance.

1. Heel Slides

10 reps x 2, 2 times a day

1. Hamstring Stretch

30 second hold x 2, 2 times a day

1. Knee Cap Mobilization

10 reps (in each direction), 2 times a day

1. Supine Hip Flexor Stretch

30 seconds x 2, 2 times a day

Are you experiencing knee pain? Do you have reduced range of motion? See if you qualify for PeerWell Health, your virtual care program for knee pain.

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