Knee Arthritis Gym Workout: Safe, Joint-Friendly Plan
- Michael Dilworth
- Dec 12, 2025
- 6 min read
You walk into the gym, look at the treadmills and leg machines, and your knees start talking before you even move. Maybe the last time you tried a “leg day,” your knees ached for three days. Maybe you’ve been told you have arthritis, and now every step feels like a question: “Am I helping myself or wearing things out?”
I’m Coach Michael, a spinal-fusion survivor and personal trainer. I work with adults 35 and up who often have knee pain, back issues, spinal fusions, and a very real fear of getting hurt. If you’ve been searching for a knee arthritis gym workout that doesn’t feel like a gamble, this post is for you.
Quick note before we dive in: this is educational, not medical advice. I’m a personal trainer/corrective exercise specialist, not a doctor. If you’ve had knee surgery, injections, a spinal fusion, or other serious medical conditions, please talk with your doctor or surgeon before starting or changing an exercise program, especially if pain is severe or getting worse.
Walking Into the Gym With Sore Knees and a Lot of Doubt
You’re not lazy. You’re cautious—and for good reason.
Going down stairs makes you grab the rail
Getting up from a low chair feels like a mini workout
You’d love to walk more, but you’re scared of paying for it later
On top of that, the fitness world sends mixed messages: “Never run again,” “Just do yoga,” “Heavy squats fix everything.” It’s no wonder people with knee arthritis feel stuck, frustrated, and confused.
The good news: we don’t have to guess. A big 2025 study looked at different exercise types for knee osteoarthritis and gives us a solid roadmap for what to prioritize in a knee-friendly, spine-friendly program. [1]
What the Research Says About Exercise and Knee Arthritis
Researchers analyzed 217 trials with over 15,000 people who had knee osteoarthritis. They compared different exercise types—cardio, strength, stretching, balance, mind–body work—and checked which ones helped most with pain, function, walking, and quality of life. [1]
Why low-impact cardio is the foundation
The clear standout was low-impact aerobic exercise:
Walking
Cycling
Pool walking or similar
Compared to doing very little, these forms of cardio improved:
Knee pain
Everyday function (getting around, using stairs)
Walking ability
Overall quality of life [1]
So when I build a knee arthritis gym workout, I start with this: steady, low-impact movement.
How strength and balance make your knees feel safer
The same study also showed strong benefits from:
Strength training – especially for function and daily tasks
Balance and neuromotor training – for better walking control
Mind–body exercise (like Tai Chi) – for function and confidence [1]
Put simply:
Cardio helps your joints feel better and move more
Strength work gives your knees “muscle armor”
Balance and mindful movement help you trust your body again
That’s exactly how this gym session is structured.
A Knee Arthritis Gym Workout You Can Actually Do
This is a sample 40–50 minute gym workout designed for someone with knee arthritis who may also be protective of their back. You can adjust time, sets, and difficulty based on your fitness and how your knees respond.
Always move in a pain-aware way: a bit of discomfort is okay, but sharp, stabbing pain or big flare-ups are not the goal.
Warm-up (5–8 minutes)
Goal: Gently warm tissues, wake up the knees and hips, and settle into movement.
5 minutes easy treadmill walk
Flat incline or very slight incline
Pace: comfortable, you could talk in full sentences
2–3 minutes of gentle joint prep
Standing heel raises holding a rail: 1–2 sets of 8–10 reps
Gentle knee bends holding onto a rail or bench (mini-squats): 1–2 sets of 8–10 reps within a comfortable range
If walking is tough, swap the treadmill for a stationary bike or recumbent bike at easy resistance.
Main Block 1 – Low-Impact Cardio (10–15 minutes)
This comes straight from what the study supports: low-impact aerobic work as your base. [1]
Option A – Treadmill
10–15 minutes at a pace that feels “moderate” (you’re working, but not gasping)
Keep incline low to control knee load
Option B – Bike (upright or recumbent)
10–15 minutes at low-to-moderate resistance, smooth pedaling
If you’re just starting, it’s okay to break this into 2–3 shorter blocks (e.g., 2 x 6 minutes).
Main Block 2 – Strength for “Knee Armor” (12–15 minutes)
Choose 3 exercises. Do 2–3 sets of 8–12 controlled reps each, resting 45–75 seconds between sets.
Sit-to-Stand from Bench or Box
Feet about hip-width, knees tracking over middle toes
Lean slightly forward from the hips, stand up, then sit back slowly
Use a higher bench if the knees complain; you can also lightly touch a rail or hold a dowel for support
Leg Press (Short, Comfortable Range)
Seat adjusted so knees start bent but not jammed (avoid deep flexion)
Press through mid-foot and heel, extending legs to a soft lock, then return under control
Choose a weight that feels like a 6–7/10 effort by the last reps, not a max strain
Supported Step-Up (Low Step)
Use a 4–6 inch step with a rail or handle for balance
Step up with the more comfortable leg first, then bring the other foot up
Step down slowly, keeping control, alternating lead leg if tolerated
Optional swap or add-ons (especially for hip and calf strength):
Standing Hip Abduction with Cable or Band
Light resistance, 8–12 reps per leg, holding onto a rail
Seated or Standing Calf Raises
Bodyweight or light load, 8–12 reps
We’re not chasing “burn” for its own sake. We’re teaching your muscles to support the joint so your knees aren’t doing all the work.
Main Block 3 – Balance and Control (5–8 minutes)
Short, simple drills to improve stability and confidence:
Rail-Supported Tandem Walk
Walk along a rail or counter placing one foot directly in front of the other, heel to toe
2–3 passes of 10–15 steps, light fingertip support as needed
Step-Up Hold
Step one foot onto a low step and pause for 2–3 seconds with all your weight balanced
Step down with control
6–8 slow reps per leg
Tai Chi-Style Weight Shifts (Optional)
Stand with feet wider than hip-width
Slowly shift weight side-to-side, letting knees bend slightly, arms flowing gently
1–2 minutes of continuous, slow movement
This block echoes what the research suggests about balance and mind–body work improving function and walking ability. [1]
Cool-down (5–10 minutes)
3–5 minutes easy walk on treadmill or around the gym, slower than your main cardio block
Gentle stretches for calves, quads, and hips
Hold 20–30 seconds, no bouncing, within a comfortable stretch—not pain
As you cool down, check in with yourself:
How do my knees feel right now?
Did anything feel unsafe or sharp?
What felt surprisingly okay?
This helps you adjust next time.
How to Adjust This Knee Arthritis Gym Workout for Your Body
Everyone’s knees and history are a little different, especially if you’ve also had back surgery or a spinal fusion. Here are some ways to tweak this plan:
If pain spikes during an exercise:
Shorten the range (shallower squat, lower step)
Slow the movement down
Reduce weight or resistance
If your back feels threatened:
Keep a tall, neutral spine (no deep forward bending with load)
Use more supported positions (machines, rails, benches)
Skip any move that forces twisting or sudden changes of direction
If this feels easy after a few weeks:
Add 2–3 minutes to the cardio block
Add a third set to your strength moves
Slightly increase leg press weight or step height, staying in a comfortable range
The big idea from the research is that consistent, low-impact exercise plus strength and balance helps—you don’t need extreme workouts to make progress. [1]
Action Steps: Start Small, Stay Consistent, Get Support
Here’s a quick checklist you can use this week:
Where to start
Pick 2–3 days this week to try a shortened version of this session (even 25–30 minutes is a win).
Commit to just showing up and starting the warm-up, even if you’re nervous.
During the workout
Keep pain at a “tolerable” level, not “white-knuckle it.”
Use rails, benches, and machines without shame—they’re tools, not crutches
Over the next month
Gradually nudge up time on the treadmill or bike.
Add a little strength when your body proves it can handle the base.
You’re not broken. Your knees are just asking for support, not punishment.
You Don’t Have to Navigate Knee Pain Alone
If this still feels overwhelming, you’re not alone. It’s completely normal to feel scared, stuck, or unsure where to start, especially if past workouts left you more sore than strong.
You deserve a plan that respects your knees, your back, and your real life. If you’d like help building a knee-friendly workout around your arthritis, back issues, or spinal fusion, I’d be glad to coach you through it. Book a consultation with me and let’s build a safe, realistic plan that helps you move with more confidence—one careful walk, one controlled set, one balanced step at a time.
References
[1] Yan L, Li D, Xing D, et al. Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis. BMJ. 2025;391:e085242. DOI:10.1136/bmj-2024-085242. (PubMed) Read My Summary