Knee Osteoarthritis Exercise Program

Practical takeaway: By the end of Week 2, you should feel your knee is “more predictable” during your daily movements, not more irritated.

Workouts

How to use the Pain-Response Traffic Light Model (during training): - Green: pain during exercise stays 0-2/10, and it settles within 1-2 hours after. Do the listed work. - Yellow: pain 3/10 or pain that lingers beyond 2 hours. Reduce range, reduce sets, or shorten time. - Red: sharp pain, swelling increase, or pain ≥4/10 that worsens during the session. Stop the exercise and switch to a safer option (pain-free movement) or rest, then contact your clinician if it keeps happening.

Week 1 (Days 1-7)

| Exercise | Sets × Reps | Load | Rest | | --- | --- | --- | --- | | Warm-up: March in Place (chair support if needed) | 1 × 3-5 min | Bodyweight | 30-60 sec | | Quad Set (tighten front thigh, knee stays straight) | 2 × 10 reps (hold 3-5 sec) | Bodyweight | 20-30 sec | | Straight Leg Raise (only if pain allows) | 2 × 6-8 reps | Bodyweight | 60 sec | | Seated Knee Extension (short arc) | 2 × 8 reps | Light ankle weight or none | 60 sec | | Heel Slide (slow bend/straighten) | 2 × 8-10 reps | Bodyweight | 30-45 sec | | Supported Sit-to-Stand (chair, controlled) | 2 × 6-8 reps | Bodyweight | 60-90 sec | | Gentle Calf Raise (hold chair back) | 2 × 8 reps | Bodyweight | 45-60 sec | | Cool-down: Easy Knee Flexion/Extension AROM (range you feel comfortable) | 1 × 5-8 reps | Bodyweight | - | | Cardio: Brisk Walk / Corridor Walk | 1 × 10 min | RPE (effort) 3-4/10 | - |

Schedule for Week 1: - Strength + mobility days (3 days): Day 1, Day 3, Day 5 (use the table above for these days). - Cardio days (2 days): Day 2, Day 4 (do only Cardio and a 3-5 minute easy warm-up march). - Active recovery (2 days): Day 6, Day 7 (only warm-up march 5 minutes + heel slides 1 set of 8-10 + quad sets 1 set of 10).

Week 2 (Days 8-14)

| Exercise | Sets × Reps | Load | Rest | | --- | --- | --- | --- | | Warm-up: March in Place (chair support if needed) | 1 × 4-6 min | Bodyweight | 30-60 sec | | Quad Set (progress hold) | 2 × 10 reps (hold 4-6 sec) | Bodyweight | 20-30 sec | | Straight Leg Raise (if Week 1 was Green/low Yellow) | 2 × 8-10 reps | Bodyweight | 60 sec | | Seated Knee Extension (short arc, add reps) | 2 × 10 reps | Light ankle weight (0.5-1.0 kg each) or none | 60 sec | | Heel Slide (smooth tempo) | 2 × 10-12 reps | Bodyweight | 30-45 sec | | Supported Sit-to-Stand (slower lowering) | 3 × 6-8 reps | Bodyweight | 60-90 sec | | Step-through at home (small step, hold support) | 2 × 8 reps (each side) | Bodyweight | 45-60 sec | | Gentle Calf Raise (add 1 rep) | 2 × 9 reps | Bodyweight | 45-60 sec | | Cool-down: Easy Knee AROM | 1 × 6-10 reps | Bodyweight | - | | Cardio: Brisk Walk / Corridor Walk | 1 × 15 min | RPE 4-5/10 | - |

Schedule for Week 2: - Strength + mobility days (3 days): Day 8, Day 10, Day 12 (use the Week 2 table). - Cardio days (2 days): Day 9, Day 11 (Cardio + 3-5 minute march). - Active recovery (2 days): Day 13, Day 14 (same as Week 1 active recovery, but add 1 extra set of quad sets if pain stays Green).

Progression protocol (simple and strict): - If your knee is Green for the main strengthening exercises on the last strength day of the week, keep form and add only one thing next week: either +1 set to sit-to-stand (up to 3) or +2-5 minutes to cardio (not both at once). - If you are Yellow, do the same week again: reduce range (smaller bend/straightening), keep sets the same, and keep cardio at 10 minutes. - If you hit Red even once for the same exercise, remove that exercise from the next session and swap to heel slides + quad sets + supported sit-to-stand within a pain-free range for that day.

Practical takeaway: Your progress is measured by how your knee responds after - especially within 1-2 hours after training.

Training Notes

Start by watching the first 5 minutes. Pain that changes from sharp to dull, or settles faster after you warm up, is a good sign. Pain that keeps climbing while you’re doing the exercise is a Yellow-to-Red warning - stop and adjust immediately using the traffic light.

For quad sets, keep the knee straight and tighten the front thigh like you’re pressing the back of your knee gently toward the floor. You should feel work in the thigh, not pinching in the knee joint. For heel slides, move slowly and stop at a range where pain stays in the Green zone. Don’t chase full bend in Week 1-2 - your goal is repeatable comfort, not maximum range.

For supported sit-to-stand, the cue is “nose over toes, then stand up smoothly.” Use a stable chair height you can stand from without strain. If standing makes pain spike, reduce the depth by using a slightly higher chair or do the movement with less bend. In Indian homes, many chairs are low; low chairs often cause knee pain because the bend angle increases. Adjust the seat height if possible (a firm cushion can help).

For seated knee extension (short arc), keep your foot path controlled. Use the smallest load you can manage for clean reps. If you’re using an ankle weight, start light - about 0.5-1.0 kg - or use no weight and focus on tempo. If the knee feels unstable or painful at the end of the movement, shorten the arc: you can strengthen safely without reaching the last few degrees.

Gentle cardio should feel like you can talk in short sentences. Use RPE 3-5/10 (effort level). Corridor walking is often enough - especially when weather or space limits outdoor walking. Keep steps shorter rather than faster if your knee complains. And if swelling shows up after cardio, cut the time back by 3-5 minutes for the next session.

Common mistakes in this phase: - Treating pain as a reason to “push harder.” In Week 1-2, pain control comes first, strength comes second. - Doing too much too soon: one extra set here or longer walk there often triggers a flare. - Skipping the daily micro-routine. Quad sets and heel slides done briefly every other day can improve start-up stiffness without overloading the joint.

A quick comprehension check after each session: Ask yourself, “Was my knee Green during the main exercises, and did it settle within 1-2 hours?” If the answer is yes, you’re training correctly. If not, your plan already has the fix - modify range, reduce sets or time, and let the knee calm down before you increase anything.

Practical takeaway: In the next two weeks, your best win is a knee that responds calmly - then you’ll be ready to build more strength in the weeks after.

End of chapter one. 4 more chapters in the full book.