Knee Arthritis in Older Adults: Exercises and Pain Relief at Home

Painful, stiff knees are one of the most common complaints in older age. Many seniors find that sitting cross-legged, using an Indian toilet, climbing stairs or getting up from a low chair becomes harder each year. Often the cause is knee osteoarthritis. While it cannot be reversed, there is a lot that can be done to reduce pain and keep the knees working well. Exercise is at the heart of it.

What is knee osteoarthritis?

Osteoarthritis is a condition in which the cartilage covering the ends of the bones gradually changes and thins, and the joint as a whole, including bone, lining and surrounding muscles, adapts. Common features include:

• Pain on walking, stairs or standing up, which often eases with rest
• Morning stiffness that usually settles within half an hour
• Stiffness after sitting for a while
• A crunching or grating feeling in the knee
• Mild swelling, and in some people, knees bowing outwards

X-ray changes do not always match how much pain someone feels. Some people with marked X-ray changes have little pain, while others with mild changes have a lot. That is why treatment focuses on symptoms and function, not just the X-ray.

What actually helps

Current guidelines commonly recommend the following as core treatment for knee osteoarthritis:

• Exercise: Strengthening the thigh and hip muscles and keeping the knee moving
• Staying active: Regular walking and daily activity, paced sensibly
• Weight management: If overweight, even modest weight loss reduces load on the knees
• Education: Understanding that movement is safe and helpful, and learning to manage flare-ups

Physiotherapy may also include manual therapy, taping, heat advice, and electrotherapy such as TENS for short-term pain relief, along with guidance on walking aids and footwear. Medicines and injections, if needed, are decided by your doctor.

Safe home exercises for knee arthritis

These exercises suit most older adults with knee osteoarthritis. Do them once or twice a day. Mild discomfort during exercise is acceptable, but it should settle within an hour or two and should not be worse the next morning.

1. Knee straightening with towel roll

Lie or sit with legs straight and a rolled towel under the knee. Press the back of the knee down into the towel, tightening the front of the thigh. Hold 5 seconds. Do 2 sets of 10 each leg.

2. Straight leg raise

Lie on your back with one knee bent. Tighten the other thigh and lift the straight leg to the height of the bent knee, hold 3 seconds and lower slowly. Do 2 sets of 8 to 10 each leg.

3. Seated knee extension

Sitting on a firm chair, slowly straighten one knee fully, hold 3 to 5 seconds, then lower. Do 2 sets of 10. As this gets easier, add a light ankle weight or a resistance band, as advised by your physiotherapist.

4. Sit-to-stand

From a firm chair with armrests, lean forward and stand up, then sit down slowly. Do 2 sets of 5 to 10. If this is painful, use a higher chair or a cushion to raise the seat.

5. Side-lying hip raise

Lie on your side with the lower knee bent. Keep the top leg straight and lift it slowly towards the ceiling, then lower. Do 2 sets of 10 each side. Strong hip muscles help control the knee during walking.

6. Heel slides

Lying on your back, slide the heel towards your buttock to bend the knee as far as comfortable, then straighten. Do 10 to 15 each leg. This keeps the knee moving and reduces stiffness.

Stop if you feel sharp or severe pain, the knee locks or gives way, or swelling increases noticeably after exercise. Reduce the number of repetitions next time and discuss it with your physiotherapist.

Daily habits that protect your knees

• Keep walking: Short, regular walks are better than one long tiring walk. Use a stick on the opposite side to the painful knee if advised.
• Choose higher seats: Low sofas, floor sitting and squatting put heavy load on painful knees. A raised toilet seat or western commode chair can help.
• Stairs: Go up with the stronger leg first and down with the painful leg first, holding the railing.
• Footwear: Cushioned, supportive shoes rather than flat, thin chappals.
• Heat for stiffness: A warm pack for 10 to 15 minutes before exercise can ease stiffness. Check skin often, especially if you have diabetes.
• Pace yourself: On busy days, such as during festivals, spread tasks out and take sitting breaks.

Managing a flare-up

Even with regular exercise, arthritis pain can flare up after a long day of standing, a family function or a change in weather. A flare-up does not mean the knee is being damaged. During a flare, reduce the number of repetitions rather than stopping exercise completely, and keep gentle movements like heel slides going. Walk shorter distances more often. A cold pack wrapped in a cloth for 10 to 15 minutes can help a warm, swollen knee, while warmth often suits stiffness. Use your walking stick for a few days if it helps. Most flare-ups settle within a few days. If pain stays severe for longer, or the knee becomes hot and very swollen, contact your doctor.

What to expect from physiotherapy

Most people notice gradual improvement in pain, stiffness and walking over several weeks of regular exercise. Arthritis can still flare up from time to time, so learning a flare-up plan is part of treatment. For people with advanced arthritis who are considering knee replacement, building strength beforehand can help recovery afterwards.

When to see a doctor urgently

• A hot, red, very swollen knee, especially with fever
• Sudden severe pain or inability to bear weight, particularly after a fall
• A swollen, painful calf below the knee
• Pain at night that does not ease with rest, along with weight loss or feeling unwell

Physiotherapy at home in Jaipur

LifeWell Physio provides elderly care physiotherapy at home in Jaipur, and for knee-specific problems you can also see our knee pain physiotherapy page. We visit families in Jagatpura and other localities.

Struggling with knee pain? Send a WhatsApp enquiry to LifeWell Physio to arrange a home assessment with Dr. Rohit Kumar.