Knee Pain? Start Walking!

Walking Group Boulder Foothills

What Seems Counterintuitive Actually Works!

It started as a mild ache in the front of Sarah’s knee. Though barely noticeable at first, the pain got worse over the next few weeks. Like so many people with knee pain, Sarah decided she should stop running because maybe that’s what was causing the problem. She also began avoiding stairs, and then hikes became difficult so Sarah eventually stopped them as well. This tale is all too common for thousands of people with knee pain. And if you saw an x-ray of your damaged knee, you might be even more convinced to avoid activity! Here’s the thing: not moving is moving in the wrong direction. Your pain will not improve. Results of a quality study that assessed the effect of exercise on knee pain found that walking more than 6000 steps per day actually decreased the likelihood that knee osteoarthritis would cause pain and limit function. And doing more is even better. The same group of researchers found that, after two years, for every 1000 additional steps subjects logged, functional limitations were reduced an impressive 16 to 18 percent. Okay, so walking more means less knee pain. But what if walking hurts too much? Then it’s time to get some help. Multiple studies on knee arthritis show that therapy made a significant difference in pain and function if the treatment program:

  • was individualized (versus a class)
  • happened three times a week
  • focused on aerobic fitness and quadriceps strength

Many people who love to run and walk give it up because of knee pain. In fact, there’s a wide-spread misconception that exercise wears joints out. Such an ingrained belief can put a wrench in your plans; if you expect more pain from exercise, it’s likely to happen. It’s called the “nocebo” effect. This misconception flies in the face of findings from well-controlled studies. You are not like the fan belt or a piston in your car. You are meant to use your joints and they will respond by getting stronger. You might have to start with a short walk, or you may need to walk with poles (see sidebar), or even walk on an anti-gravity treadmill. Starting is the key. Don’t let pain, or fear of pain limit your activity level. With the right treatment and the right guidance, you can be on the trails again.


Have you ever been stumped by a problem and then during exercise you get that “ah ha!” moment as you figure out the answer? There’s a good explanation for that. A book called “Brain Rules,” by Dr. John Medina, lists 12 ways to improve your brainpower, all based on research in the field of neuroscience. And Medina calls exercise the magic bullet for improving brain function. Studies have shown that the incidence of Alzheimer’s decreased 50 percent for people who exercise. Even for people with dementia, clarity improved once they started exercising. Exercise enhanced standardized test scores for children, and those same test scores plummeted just as quickly after kids stopped moving. Being active helps combat depression and anxiety. In some cases, people can decrease or eliminate medication after starting a regular aerobic exercise program. Why? A person who exercises develops a rich supply of blood vessels throughout the body, including the brain, and having more oxygen-rich blood destroys free radicals. Less garbage in the brain translates into mental sharpness. Physical activity creates the chemical BDNF, or brain-derived neurotropic factor, which Medina calls Miracle Grow for the brain. It’s a protein that helps support the survival of existing neurons and encourages the growth of new ones. Moving just 30 minutes twice a week produces BDNF and makes more neurons that are resistant to damage and stress. So keep exercising. It’s your magic bullet.

Jane Milliff is co-founder and director of ALTA Physical Therapy and Pilates in Boulder.