Knee osteoarthritis is a leading cause of pain and stiffness as we get older, and exercise is recommended just about everywhere as a first-line treatment. But the evidence is enormous and sometimes contradictory, so this study did something ambitious: it reviewed the reviews.
An umbrella review pulls together many systematic reviews to see the big picture. This one gathered 116 systematic reviews and meta-analyses on therapeutic exercise for knee osteoarthritis, looking at pain, function and quality of life.
Knee osteoarthritis is common, and people are often told simply to exercise. Seeing what the whole body of evidence says helps us give clear, honest guidance.
A wide range of exercise approaches for the knee, including strengthening, aerobic and other programs, delivered across the many included reviews.
Rather than testing patients directly, this study summarised the conclusions of 116 existing reviews, giving a birds-eye view of the field.
The overall message was positive, with an honest note about evidence quality.
Most reviews reported that exercise improved knee pain in people with osteoarthritis.
A large share of reviews found improvements in physical function.
Some reviews also reported gains in quality of life.
No one style of exercise stood out as best for everyone, so tailoring matters.
The weight of evidence says exercise helps reduce pain and improve function and quality of life in knee osteoarthritis. There is no single magic exercise, so the best program is one that suits you and that you will actually keep doing.
This strongly supports exercise as a cornerstone of managing knee osteoarthritis, and it takes the pressure off finding one perfect routine. Because no single type won out, we can focus on what fits your goals, your knee and your life, which is exactly how good rehab should work.
Hands-on treatment can help ease pain and stiffness so that exercise feels more doable, but the research is clear that staying active is the main game. Building strength and keeping the knee moving is genuinely disease-appropriate care, not something to fear.
Directly supports individualised exercise programs as a first-line treatment for knee osteoarthritis.
Backs hands-on care to ease pain and stiffness so exercise feels more achievable.
Reinforces soft-tissue work around the knee and hip as support alongside exercise.
Confirms that staying active and building strength is central to managing knee osteoarthritis.
The authors were honest that many of the included reviews were of low or critically low methodological quality, so the overall certainty of the evidence is limited. That does not overturn the positive message, but it does mean we should hold it with appropriate humility and keep individualising care.
Drawing on 116 reviews, this umbrella review found exercise helps reduce pain and improve function and quality of life in knee osteoarthritis, with no single best type. For sore knees, it is powerful encouragement to keep moving with a program that suits you.
Impact of therapeutic exercises on pain-related outcomes in patients with knee osteoarthritis: an umbrella review of 116 systematic reviews. Viderman D, and colleagues. Frontiers in Pain Research, 2026. Please confirm the full citation at the source before publishing.
