Lower Body Strength for Arthritis

Protocol Archive → Hip, Knee & Extremity → Lower Body Strength for Arthritis
Hip, Knee & Extremity
Strengthening
Beginner
Source: Vive Health (YouTube)

Lower Body Strength for Arthritis

Talk to your doctor first. General education, not medical advice.This content is general education, not medical advice, diagnosis or treatment. Get approval from your physician or another qualified healthcare provider before starting any exercise program, especially if you have a medical condition, a recent injury or surgery, are pregnant, or take medication. Stop and seek medical advice if an exercise causes pain, dizziness, chest discomfort or shortness of breath. You choose to exercise at your own risk. Read the full medical disclaimer.

What this class looks like
  • PositionSeated in a chair
  • You'll needChair
A follow-along class: copy the instructor at your own pace and skip anything that hurts.
Play video
Dosage
Follow along
Equipment
Chair
Source
Vive Health (YouTube)

Part of 3 free routines

This exercise is one step in a phased home routine. Follow the whole routine, or print it on one page.

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Plantar Fasciitis, phase 3Hip Osteoarthritis & Bursitis, phase 3Knee Osteoarthritis, phase 3

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Clinical Context

Osteoarthritis affects over 32.5 million adults in the United States, with the knee and hip being the most commonly affected weight-bearing joints. The condition involves progressive degradation of articular cartilage, subchondral bone changes, and synovial inflammation — leading to pain, stiffness, and functional limitations that can significantly impact quality of life.

This exercise program is aimed at people with osteoarthritis, focusing on building joint-supporting muscles while minimizing stress on arthritic surfaces. The exercises emphasize controlled, moderate-range movements that strengthen the quadriceps, hamstrings, and gluteal muscles — the muscular “shock absorbers” that protect articular cartilage from excessive loading.

In the IDEA trial, Messier et al. (2013) found that combining exercise with about 10% weight loss gave the biggest improvements in pain and function in overweight adults with knee osteoarthritis, and that weight loss lowered both knee joint loads and the inflammatory marker IL-6. Exercise on its own still improved walking speed and function, and the benefits last as long as the program continues.

Step-by-Step Instructions

  1. Sit in a sturdy, armless chair with your feet flat on the floor.
  2. Follow the instructor through each exercise at a comfortable pace.
  3. Perform each movement slowly and with control — never use momentum or bounce.
  4. It is normal for arthritic joints to feel stiff at the beginning of exercise. This typically improves within the first 5 minutes.
  5. Use the back of the chair for balance support during any standing exercises.

Key Form Cues

  • Start with warm-up: 2–3 minutes of marching in place or gentle walking helps lubricate the joints before loading them.
  • Pain vs. discomfort: Muscle fatigue and mild joint aching are acceptable. Sharp, stabbing joint pain is not — stop that exercise.
  • Full range when possible: Move through as much range of motion as your joints allow comfortably.

Progression & Regression

Regression

  • Perform all exercises seated
  • Reduce repetitions to 5–8 per exercise
  • Take longer rest breaks between exercises
  • Apply ice to joints for 10 minutes after exercise if swelling occurs

Progression

  • Add light ankle weights (1–2 pounds, increasing by 0.5–1 pound per week)
  • Increase repetitions before increasing weight
  • Add standing exercises with chair support
  • Progress to the Hip & Knee Strength Routine for a more comprehensive program

Precautions

Designed specifically for arthritic joints — inherently joint-friendly.

  • The “2-hour pain rule”: if your joint pain is significantly worse 2 hours after exercising compared to before, you did too much. Reduce intensity at the next session.
  • Avoid exercising during an acute flare-up (hot, swollen, red joint). Wait until the flare subsides, then resume at a lower intensity.
  • Patients with severe bone-on-bone arthritis awaiting joint replacement can still benefit from gentle strengthening but should work within a comfortable range.
  • Stop if: you experience joint locking, giving way, or sudden sharp pain.

Related Exercises

Try next

Strengthening · IntermediateWall Squats for Quadricep StrengthStrengthening · BeginnerClamshells for Glute MediusStretch · BeginnerCalf Stretch for Plantar Fasciitis

Part of the Plantar Fasciitis routine All Hip, Knee & Extremity exercises

References
Messier SP, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis. JAMA. 2013;310(12):1263-1273.
Kolasinski SL, et al. 2019 ACR/AF Guideline for the Management of OA. Arthritis Care Res. 2020;72(2):149-162.
Uthman OA, et al. Exercise for lower limb osteoarthritis: systematic review. BMJ. 2013;347:f5555.

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