Low-Impact Cardio Exercises for People with Knee Pain
Knee pain can make many cardio exercises difficult or even impossible. The impact involved in activities like running, jumping, and hopping can aggravate knee injuries and arthritis. Fortunately, many low-impact cardio options are joint-friendly and allow you to get your heart pumping without harming your knees.
Benefits of Low-Impact Cardio for Knee Pain
Low-impact cardio provides several benefits for those with knee issues:
Reduced pain and inflammation - The lack of impact minimizes stress on the joint, helping decrease soreness, swelling, and stiffness.
Increased flexibility and range of motion - Gentle activity helps lubricate the knee joint and improves mobility.
Strengthened muscles around the knees - Low-impact workouts can boost leg muscle strength to better support and protect knee joints.
Weight loss - Cardio exercise helps burn calories, assisting weight loss to further reduce knee strain.
Improved cardiovascular health - Maintaining an elevated heart rate has cardiovascular benefits like lower blood pressure and cholesterol.
Decreased risk of further injury - Low-impact activities avoid the risk of impacts that could worsen existing knee problems.
Low-Impact Cardio Exercises for Knee Pain
Swimming
Swimming is one of the most joint-friendly cardio options, providing an excellent workout with zero impact. Using different strokes like freestyle, backstroke, and breaststroke works for various muscle groups while keeping your heart rate elevated. Swimming strengthens the legs and improves cardio endurance without knee strain.
Water Aerobics
Water aerobics offers challenging cardio conditioning without stressing the joints. The water provides cushioning and support, while resistance tones the muscles. Kicking, jumping jacks, and other high-knee moves can be done in the water with less knee irritation. Deep water running/jogging is also a good option.
Stationary Cycling
Cycling on a stationary bike, recumbent bike, or spin bike is an easy way to get low-impact cardio. It allows you to build leg strength and endurance while going at your own pace and adjusting resistance as needed. Avoid standing cycling classes which require constant standing and fast movements that could aggravate knees.
Elliptical
Working out on an elliptical machine provides a smooth gliding motion that mimics running without the impact. Adjust incline and resistance for an engaging cardio and lower body workout. Hold onto handlebars which can assist balance and take pressure off knees.
Rowing Machine
Rowing machines offer an effective cardio and strength training exercise that does not stress the knee joints. The smooth repetitive motion works the legs, core, arms, and back. Adjust resistance as desired, but maintain proper form to avoid injury. Rowing engages the legs with no harsh impacts.
Ski Machine
Ski machine workouts simulate the movements of cross-country skiing. Unlike downhill skiing, cross-country has a very low impact. The side-to-side motions target leg muscles while keeping one foot planted, reducing knee strain. Work up to higher resistance cautiously if you have knee injuries.
Low-Impact Aerobics
Low-impact aerobics classes focus on achieving an elevated heart rate through non-jarring movements. Look for low-impact options like Zumba Gold, yoga aerobics, and low-intensity barre classes. Avoid fast-paced, high-intensity step aerobics. Gentle dance moves, marches, and bodyweight squats are knee-friendly alternatives.
Walking
One of the simplest and most accessible low-impact cardio exercises is walking. It provides a gentle activity that burns calories and keeps your heart healthy. Those with knee osteoarthritis often tolerate walking well. Stick to flat terrain and softer surfaces like grass or dirt trails. Wear comfortable, supportive shoes.
Yoga
Yoga provides light strength training plus cardio benefits from flowing sequences. Avoid high-intensity power yoga in favor of gentle, basic hatha and restorative yoga. Poses can improve flexibility and balance, while mindful breathing controls heart rate. Choose modifications to limit knee bending and strain.
Tai Chi
The slow, graceful motions of Tai Chi provide mental and physical benefits. Following along a Tai Chi routine raises heart rate through fluid, dance-like movements. The focus on balance and alignment helps reduce knee pain. Tai Chi’s meditative nature also aids relaxation and reduces stress.
Low-Impact Cardio Tips
Always warm up first with 5-10 minutes of light activity to lubricate joints and prep muscles.
Slowly build up duration and intensity. Start with shorter workouts (10-15 minutes) and gradually increase.
Listen to your body's pain signals. Avoid exercises and movements that cause knee pain.
Try exercising in a pool - the water reduces impact and compression.
Focus on proper exercise form and technique to prevent injury.
Wear comfortable, supportive footwear with cushioning and stabilization.
Combine low-impact cardio with knee-strengthening exercises for additional benefits.
Supplement with upper body cardio like arm cycling or weights to give knees a break.
Monitor pain and swelling. Ice knees after exercising to manage inflammation.
Low-Impact Cardio vs High-Impact Cardio
Additional Low-Impact Cardio Exercises
While swimming, cycling, and the elliptical are some of the most popular low-impact cardio options, many other effective exercises are gentle on the knees. Continuing to vary your workout routine will keep you motivated while protecting your knee joints.
Seated Stationary Bike
A seated stationary bike, sometimes called a semi-recumbent bike, can provide a comfortable cardio workout. The seated position reduces stress on the knees, hips, and back while still providing a solid cycling motion. Pedal smoothly with moderate resistance, avoiding any strain or discomfort in the knees.
Handcycling
Handcycling involves using a hand-powered stationary bike that works the upper body instead of the legs. This allows you to get vigorous cardio exercise while completely protecting the knee joints. It’s a great option if you need to limit or avoid bending the knees. Adaptive handcycle machines are also available.
Upper Body Ergometer
Also known as an arm bike, upper body ergometers offer cardio conditioning by working the arms and shoulders. The hand pedals allow you to get your heart pumping without using your legs at all. Increase resistance gradually for a more challenging workout that isolates the upper body.
Seated Stepper
A seated stepper machine resembles a typical stepper but has a seat and backrest. Step your feet up and down while remaining in a seated position to reduce knee strain. Work both legs evenly at a comfortable pace. Adjustable resistance and height settings accommodate different users.
NuStep Machine
The NuStep works the upper and lower body simultaneously with pushing and pulling motions of the arms and legs. The seated position minimizes impact on the knees while providing a complete cardio and strength workout. Adjust the resistance to control workout intensity on the NuStep.
Seated Elliptical Trainer
For those who find standard elliptical machines too hard on the knees, a seated elliptical trainer is a low-impact alternative. In a seated position, work the legs in an elliptical motion smoothly and comfortably by adjusting resistance and range of motion.
Recumbent Cross Trainer
A recumbent cross trainer combines the features of a recumbent bike and elliptical while keeping you in a reclined, seated position. This reduces strain on the knees while allowing you to pedal forward and backward in an elliptical pattern. Adjust incline and resistance for varied intensity.
Rowing Machine with Seat
Rowing machines with a sliding or rolling seat have a lower impact than standard rowers where your feet are fixed. The moveable seat allows more momentum with each rowing motion. Focus on good form and avoid over-compression of the knees as you row.
Battle Rope Waves
Doing battle rope waves provides an intense full-body cardio workout using just your upper body. Generating waves with thick battle ropes builds cardio endurance and strength with no impact on the knees. Set your own pace but maintain proper technique.
Shadow Boxing
Throwing punches at an imaginary opponent is effective cardio that keeps knee impact to a minimum. Shadowboxing with freestyle or choreographed punch/kick combinations keeps your heart rate up. Focus on speed and technique over power. Box lightly on the toes without heavy stomping.
Kayaking
Paddling a kayak engages the upper body, core, and some lower body muscles with only minimal knee involvement. Being seated with legs stretched out reduces knee strain. Rowing the kayak continuously provides a great cardio workout both on water and with an indoor kayak machine.
Rollerblading
Rollerblading provides an excellent cardio workout like ice skating but with less knee strain. Look for smooth outdoor surfaces without large bumps or cracks. Bend knees only slightly while avoiding deep knee bends. Focus on pushing off with your feet, not landing hard.
Low-Impact Step Aerobics
While traditional step aerobics can be hard on the knees, low-impact options are available. Use a shorter step and avoid hopping on/off it. Instead, keep one foot on the floor at all times. Step up/down slowly and control. Opt for lower-intensity routines.
Seated Cardio Methods
For those with knee injuries that may preclude most exercise, simple movements done from a chair or wheelchair can get the heart pumping. Seated marching, kickboxing, arm raises, and abdominal crunches are options. Use resistance bands to increase workout intensity.
Aquatic Treadmills
Water treadmills allow you to walk, jog, or run on an underwater treadmill usually waist or chest-deep. The water reduces the impact on joints while providing resistance. Hold onto handles for support and use slower speeds. It’s ideal for knee conditions.
Additional Tips for Preventing Knee Pain
Some additional strategies beyond low-impact exercise can help protect the knees during cardio workouts:
Wear knee braces or sleeves to help support and stabilize the joint
Use an ice pack or cold therapy on the knees after exercise
Take anti-inflammatory medication or supplements to reduce swelling
Get knee injections like cortisone or PRP therapy to relieve pain
Consider knee-taping techniques like McConnell or Kinesio tape to improve alignment
Stretch and foam roll thigh, hip, and calf muscles before and after workouts
Strengthen the leg and core muscles with weight training to support knees
Use osteoarthritic medications, supplements, or topical analgesics to ease knee arthritis
Have orthotics fitted to provide arch support and optimize knee alignment
Avoid exercising on hard surfaces like concrete which can worsen the pain
Monitor footwear wear to replace them before they lose support and cushioning
Signs You Need to Modify or Stop Exercise
It’s important to pay attention to warning signs from your knees during exercise. Certain symptoms mean you should alter or cease your workout:
Pain, swelling, or stiffness that lasts more than 1-2 hours after exercising
Limping, instability, or feeling like your knee may “give out”
Hearing clicking, crunching, or popping sounds from the knee joint
Extreme pain, swelling, or redness after exercise
Inability to fully straighten the knee all the way
Worsening pain even with low-impact activities
A sudden increase in pain or swelling for no clear reason
Feeling like your pain medication or braces are no longer working
If you experience any of these symptoms, stop exercising and consult your doctor. You may need to adjust your workouts, try other modalities like ice or medication, or possibly take a complete break from exercising to allow the knees to recover. Don’t try to push through severe knee pain.
When to See a Doctor
Along with the above symptoms, you should see a orthopedic doctor or physical therapist if you experience:
Inability to bear weight on the affected leg
Locking sensation where the knee gets temporarily stuck
Sudden swelling with no preceding injury
Signs of infection like fever, redness, warmth in the knee area
Popping or tearing sensation indicating a ligament injury
Worsening pain or function that is impeding activities
Pain, swelling, or other issues persisting longer than 2 weeks
The knee joint is complex and susceptible to many types of damage and disease. Seeking professional medical advice can help determine the exact cause of your knee pain and guide appropriate treatment to help you remain active.
Frequently Asked Questions
Should I avoid cardio if I have knee pain?
No, you can still do cardio exercises by choosing low-impact options. Work closely with your doctor and physical therapist to find suitable activities that do not exacerbate knee problems. Start slowly and avoid high-intensity workouts.
How often should I do low-impact cardio for knee pain?
Aim for 30-45 minutes of low-impact cardio at least 3-5 days per week. Listen to your body and take rest days as needed. Avoid overexercising or pushing through knee pain, which can worsen injuries.
What exercises should I avoid with knee injuries?
Avoid high-impact exercises like running (especially downhill), jumping, squats, lunges, and step aerobics. Also avoid activities involving quick stopping/starting, pivoting, or crouching which can stress the knees. Minimize stairs if you have knee pain.
Should I work out on rest days if I don’t have knee pain?
No, recovery days are still important when you have knee injuries to allow full healing. Do light stretching or foam rolling on rest days instead of more strenuous workouts. Moderate your exercise so you don’t overdo it.
Can low-impact cardio help avoid knee replacement surgery?
While not fully preventative, low-impact cardio combined with muscle strengthening can potentially delay the need for knee replacement by improving function and managing pain. However, severe joint damage usually still requires surgery at some point.
The Bottom Line
Knee pain and injuries don’t have to stop you from getting in valuable cardio exercise. There are many low-impact cardio options like swimming, cycling, and elliptical workouts that provide cardiovascular benefits without further damaging the knees. Always get medical guidance to find suitable activities based on your specific knee condition. Start slowly, focus on proper form, and listen to your body. Low-impact cardio can improve cardiovascular health while allowing damaged knee joints some much-needed rest and recovery.
