Pain guide · Knee pain

Knee pain when walking: where it hurts, arthritis, the kneecap, shoes, sticks and how to build back

Knee pain when you walk is common, and walking rarely harms the knee: it shows up a sore spot. From mid-life a common cause is arthritis, which tends to ache more the further you go and on hills and stairs; in younger and active people it is more often pain around the kneecap. Where it hurts, and when in the walk it starts, are the best clues, and most of these causes get better with a gradual build-up and exercise.

This guide starts with the signs that need help today, from a 999 call or accident and emergency (A&E) to National Health Service (NHS) 111 or a general practitioner (GP), including a knee that locks, gives way or swells straight after a twist. It then maps the causes by where it hurts, explains what the trials of walking, shoes, insoles, braces and walking sticks show, turns the knee pain rule into a rule for your walks, and gives a three-stage plan that ends with your usual walks, hills and distance.

3-stage exercise plan When to get help 50 sourcesUpdated 24 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

You cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape.
You hurt your knee and cannot take 4 steps, or you are 55 or over and hurt it in a fall: get it checked the same day for a broken bone.
The knee locks, gives way or clicks painfully. Painless clicking is normal.
Your knee swelled up straight away after a twisting injury: get advice from NHS 111.
Get advice from NHS 111 now: a hot, red or swollen knee with sudden severe pain, a very high temperature, or feeling hot, cold or shivery. This can be a joint infection.
Same day: a pop or tearing feeling at the front of the knee after a fall, stumble, jump or landing, then you can't straighten the knee or lift the straight leg off the bed, there's a dent above or below the kneecap, or the kneecap sits higher or lower than on the other side. Go to A&E or an urgent treatment centre, or get help from NHS 111. A torn quadriceps or patellar tendon does best when it's repaired soon.
Throbbing pain and swelling in one calf or thigh with red, blue or darkened skin or swollen veins, or sudden worse pain and swelling around a lump at the back of the knee (a possible clot or a burst Baker's cyst).
Leg pain or swelling with breathlessness or chest pain: call 999 or go to A&E, and do not drive yourself. It can be a blood clot that has reached the lungs.
Back or leg symptoms with numbness around the genitals or bottom, new trouble controlling your bladder or bowels, or severe or worsening weakness or numbness in both legs.

See a doctor or physiotherapist if

Knee pain that has not improved within a few weeks of looking after it at home. Many areas offer NHS physiotherapy without a GP referral.
Your knee is hot, swollen or tender, especially if you can't remember injuring it: contact your GP practice, or NHS 111 if it's closed. A hot knee with a very high temperature is urgent (above).
Your knee gives way when you walk, or you've had a fall: use a rail or a stick, and get it checked by a GP or physiotherapist. Asking about a walking aid and a falls check is our suggestion.
Walking has been getting harder over weeks or months with swelling in several joints, or morning stiffness that lasts more than 30 minutes: see a GP. It can be an inflammatory arthritis such as rheumatoid arthritis rather than wear and tear.
Knee pain with night sweats or weight loss, night pain that stops you sleeping, a change in your walking or balance, or heaviness in your legs: see a GP. A hot, swollen knee with a high temperature is urgent (above).
Leg pain, usually in the calf but sometimes the thigh or buttock, that keeps coming on when you walk and goes after a few minutes' rest: see a GP. It can be peripheral arterial disease (narrowed leg arteries).
Numbness, tingling or weakness that travels down the leg from the back. That points to a nerve (sciatica) rather than the knee.
Sudden, severe and persistent knee pain, often on the inner side, that came on with little or no injury, especially if you're over 60: see a GP rather than assuming it's arthritis. Early X-rays are usually normal, and a magnetic resonance imaging (MRI) scan may be needed.
A child or young person with knee or leg pain in only 1 leg or 1 joint, pain in the morning or when walking, a limp, swelling, a rash or unusual bruising, a high temperature, unusual tiredness, or not eating or losing weight: see a GP. These aren't the pattern of growing pains, and unexplained bone pain in a child or young person may need a very urgent X-ray.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Around or behind the kneecap, hard to point to, worse on stairs, squatting and after sitting with your knees bent

Kneecap (patellofemoral) pain, often called runner's knee, though it happens in people who don't run.

Read: Runner's knee →A stiff, achy knee from your mid-40s, worse the further you walk and on hills and stairs

Stiff for under 30 minutes in the morning or after sitting: knee arthritis.

Read: Knee arthritis →The joint line on the inner or outer side, with catching, locking or swelling later that day

A possible meniscus tear, after a twist or coming on gradually from mid-life: get it assessed.

Read: Meniscus tear →The inner shin a few centimetres below the joint, worse on stairs and getting up from a chair

Pes anserine pain.

Read: Pes anserine pain →The outside of the knee, building during a walk and often worse downhill

Iliotibial (IT) band syndrome.

Read: IT band syndrome →One point just below the kneecap, worse with stairs, hills and squats

Patellar tendon pain (jumper's knee).

Read: Jumper's knee →Under and either side of the tendon below the kneecap, worst as the knee straightens fully

Fat pad pain.

Read: Fat pad impingement →A tender band on the inner edge of the kneecap that clicks or catches

A medial plica.

Read: Plica syndrome →A soft lump behind the knee, worse after walking and tight to bend

Often a Baker's cyst. One swollen, throbbing calf below it needs a same-day check for a clot.

Read: Baker's cyst →The knee gave way after a twist, with a pop and swelling within hours

A possible ligament injury, such as the anterior cruciate ligament (ACL): get it assessed.

Read: ACL injury →Pain in the groin, thigh or buttock as well, or a stiff hip that makes socks and car seats hard

The hip can be felt in the knee. Our hip pain when walking guide maps it.

Read: Hip pain when walking →Pain down the leg below the knee with tingling or numbness, often with back pain

A nerve from the back (sciatica).

Read: Sciatica →An ache in the calf, thigh or buttock after walking a set distance that goes within a few minutes of standing still

Possibly narrowed leg arteries (claudication): see a GP. Our calf pain when walking guide explains.

Read: Calf pain when walking →Pain bending, kneeling or getting up from a chair more than on walks

Our knee pain when bending guide.

Read: Knee pain when bending →Knee pain mostly on stairs

Our knee pain on stairs guide.

Read: Knee pain on stairs →A child or teenager with knee or thigh pain and a limp, the knee looking normal

It can be the hip (a slipped upper femoral epiphysis): get help the same day.

Read: SUFE (slipped hip growth plate) →After a knee replacement

Your team's plan comes first; our knee replacement guide covers recovery.

Read: Knee replacement →

A hot, red, swollen knee, or one calf swollen and throbbing

Possibly an infection, gout or a clot: get help the same day, as the warning signs say.

Understand it

Walking shows up a sore knee; it rarely harms oneEmerging evidence

In 5 people with measuring implants in their knees, the peak force through the knee was about 261% of body weight walking on the flat, 316% going up stairs and 346% coming down. A walk adds thousands of these loads, which is probably why a sensitive knee often aches more the further you go (our explanation). In 4,673 people with or at risk of knee arthritis, using stairs was the first activity to become painful as knee pain began, followed by walking.

Knee pain is common: a review of UK data found that about a quarter of people over 55 have a persistent episode of knee pain in a year, and about 1 in 10 have painful, disabling knee arthritis. Arthritis UK says knee pain isn't usually a sign of anything serious.

Sources 1, 2, 3, 4

Arthritis and kneecap pain: the two common long-term causesStrong evidence

From mid-life, arthritis is a common cause. The National Institute for Health and Care Excellence (NICE) diagnoses it without a scan in people 45 and over with activity-related joint pain and no morning stiffness, or stiffness that lasts no more than 30 minutes. The NHS says arthritic knees may be most painful "when you walk, particularly when walking up or down hills or stairs", may give way or be hard to straighten, and hurt and stiffen more when you haven't moved them for a while.

In younger and active people, an ache around or behind the kneecap is more often kneecap (patellofemoral) pain. NHS inform describes pain beneath or around the kneecap, especially on stairs, kneeling and squatting, and after sitting for a while; a clinical guideline says it worsens with squatting, long sits, stairs, jumping or running, and can come back and persist for years.

Sources 5, 6, 7, 8

The meniscus, a Baker's cyst and a knee that gives wayEmerging evidence

A torn meniscus or ligament can make the knee feel unstable, give way or be hard to straighten, the NHS says. In middle age, meniscus tears are often worn (degenerative) rather than from an injury, and they are common on scans of knees that don't hurt. A Baker's cyst, a fluid-filled lump at the back of the knee, can cause pain, tightness and difficulty bending, and the NHS says "Your symptoms may be worse after walking".

In 2,351 adults with a median age of 63.5, 11.8% had had their knee buckle at least once in the past 3 months, and 12.6% of them fell when it did. Buckling went with knee pain and weak thigh muscles, and over half of those it happened to had no arthritis on an X-ray. In 1,842 adults aged 55 to 84, buckling predicted repeated falls, fear of falling and poor confidence in their balance 2 years later.

Sources 9, 10, 11, 12, 13, 14

Pain felt in the knee from somewhere elseMixed evidence

The hip can be felt in the knee, though two small studies disagree about how often, so groin, thigh or buttock pain as well, or a stiff hip, is worth mentioning to your GP.

A nerve from the back (sciatica) causes pain, tingling or numbness down the back of the leg, often into the foot. Narrowed leg arteries (peripheral arterial disease) cause "a painful ache in their legs when they walk, which usually disappears after a few minutes' rest", the NHS says.

Sources 15, 16, 17, 18

When an X-ray or scan helpsStrong evidence

Rarely at first. NICE says don't routinely use imaging to diagnose arthritis unless something doesn't fit, such as a recent injury, long morning stiffness, a rapid worsening or a hot, swollen joint. In a population study of 991 people aged 50 to 90, meniscus tears showed on magnetic resonance imaging (MRI) in 19% to 56%, depending on age and sex, and 61% of people with a tear had had no knee pain, aching or stiffness in the past month.

UK guidance suggests an MRI when meniscus symptoms haven't settled after 3 months of non-surgical treatment, and urgent assessment for a knee that locks. Leg pain on walking that could be the arteries is checked by comparing the blood pressure at your ankle and your arm (the ankle brachial pressure index).

Sources 5, 11, 19, 20

How it usually goesEmerging evidence

NHS inform says new knee problems should begin to settle within 6 weeks, and the Chartered Society of Physiotherapy (CSP) says most muscle and joint problems get better within 6 to 8 weeks.

In 1,753 people with knee arthritis followed for 6 years, none of five patterns of pain got substantially worse. The NHS says arthritis "doesn't necessarily get any worse over time and it can sometimes gradually improve", and Arthritis UK says only about 1 in 10 people with knee arthritis go on to have a knee replacement. With kneecap pain, a 12-week programme got 85% of 40 young women back to their sport without pain a year later, though there was no untreated group. No one can promise a date.

Sources 21, 22, 23, 24, 25, 26

What helps, and how strong the evidence is

Walking for exercise went with less knee pain, not moreEmerging evidence

In 1,212 people aged 50 or over with knee arthritis, those who walked for exercise were less likely to develop new frequent knee pain (odds ratio 0.6) and had slightly less narrowing of the joint space (0.8). That is a link in an observational study, not proof. Across 9 trials, exercise that loads the knee didn't appear to harm cartilage, on low-quality evidence.

In 439 adults aged 60 or over with knee arthritis, 18 months of an aerobic or a resistance programme lowered disability by 10% and 8% and knee pain by 12% and 8%, against health education, with no difference in X-ray scores. The NHS says exercise or a job that puts frequent, excessive strain on your joints can raise the risk of arthritis, and still recommends at least 150 minutes a week of moderate activity such as fast walking.

Sources 27, 28, 29, 24

Exercise is the main treatmentStrong evidence

NICE makes therapeutic exercise, and weight management if appropriate, the core treatments for knee arthritis, and says joint pain may rise when you start but regular exercise still helps. Across 217 trials (15,684 people) with knee arthritis, aerobic exercise ranked most likely to be the best type for pain, function, walking and quality of life, on moderate-certainty evidence that came mostly from indirect comparisons; strengthening and mixed exercise also improved function. Only 18% of the trials reported on safety.

For kneecap pain, international consensus statements recommend exercise, with hip and knee exercises together rather than knee exercises alone. NHS inform's knee arthritis exercises start with 2 to 3 repetitions at a time and build up to 2 sets of 15.

Sources 5, 30, 31, 32, 33

Shoes and insoles: a comfortable, supportive pair is enough for mostEmerging evidence

In 164 people with arthritis on the inner side of the knee, stable, supportive shoes eased walking pain more than flat, flexible shoes over 6 months (by 1.1 points out of 10), with fewer side effects; no one stayed in their usual shoes for comparison. In another 164, shoes designed to take load off the inner knee did no better than ordinary walking shoes. Wedged insoles did no better than flat ones over 12 months in 200 people, and a Cochrane review found no difference between wedged and neutral insoles. These trials were all in people with arthritis on the inner side of the knee, so applying them to other knee pain when walking is our reading.

The NHS suggests footwear with shock-absorbing soles, NHS inform supportive footwear with cushioned soles and no high heels, and Arthritis UK shoes with thick soles and room for your toes, with a broad heel no higher than about 3 cm and a thick, non-slip sole. NICE says don't routinely offer insoles.

Sources 34, 35, 36, 37, 5, 38, 39, 25, 40

Braces and supports: unproven, so not the planMixed evidence

A Cochrane review found the evidence on knee braces inconclusive. NICE says don't routinely offer braces, tape, splints or supports unless the joint is unstable or loads abnormally and exercise alone isn't enough. Arthritis UK says some people find knee supports or braces help. A simple support on a long walk is fine if it helps you, alongside the exercises rather than instead of them (our suggestion).

Sources 37, 5, 25

A walking stick, in the hand opposite the sore kneeEmerging evidence

In 64 people with knee arthritis, using a cane every day for 2 months eased pain a little and improved function; walking took more energy in the first month, but that settled by the second. NICE says consider walking aids, and Arthritis UK says a walking stick can reduce pain and improve quality of life.

The NHS says hold it on the opposite side of your body to your affected leg, so that it takes some of your weight, and an NHS trust's leaflet sets the handle at wrist height. You can borrow some sticks from the NHS.

Sources 41, 5, 25, 38, 42, 43

A knee that gives way can be trainedEmerging evidence

In 159 people with knee arthritis and an unstable knee, 12 weeks of supervised strengthening and practising daily activities reduced instability, pain and activity limitation by about 20% to 40%, and the gains lasted to 6 months; adding specific stabilisation drills made no difference. There was no group without exercise. Buckling goes with weak thigh muscles, which is what the plan trains.

Sources 44, 13

Medicines, injections and surgeryStrong evidence

For knee arthritis, NICE says offer a painkilling gel (a topical non-steroidal anti-inflammatory) and consider tablets if that isn't effective or suitable; consider a steroid injection into the joint to support exercise, explaining that it gives only short-term relief (2 to 10 weeks); and don't offer hyaluronan injections, glucosamine, strong opioids, or keyhole washout or debridement. A knee replacement is considered when symptoms substantially affect your quality of life and other treatment hasn't worked or isn't suitable.

Sources 5, 38

How much pain is OK while you exercise?

0 to 2 is safe, up to 5 is acceptable, and your walks follow the same ruleEmerging evidence

This guide uses the knee hub's rule, the arthritis version. Rate your knee pain from 0 to 10 during and after exercise. In the pain-monitoring model used in knee trials, 0 to 2 counts as safe, up to 5 as acceptable and above 5 as too much. Aim for 0 to 3 most of the time.

By the next morning your knee should be back to its usual level. If it is not, drop back one step next time (fewer sets, a shallower range, a lower step), not to nothing. Over the weeks pain should hold steady or ease; that last check is our suggestion rather than a tested rule.

Some knee programmes say you should feel no pain at all. The trials allowed some, and a meta-analysis found exercising into some pain did no worse than pain-free exercise. NICE says joint pain may rise when you start exercising with arthritis, and that regular exercise still helps in the long run. NHS inform's knee arthritis exercises use a similar limit: keep your pain within 0 to 5 out of 10.

Sharp, catching or giving-way pain, or new swelling, is a reason to stop and get it checked.

On your walks (our suggestion, built on the same rule and Arthritis UK's advice): walk at a distance and pace where knee pain stays at 5 out of 10 or below and is back to your usual level by the next morning; if it isn't, make the next walk shorter, flatter or slower, not none. Change one thing at a time, and rest before the knee becomes too painful. In the pain-monitoring programme for severe hip and knee arthritis, people's median pain after sessions was 2 out of 10.

Calf, thigh or buttock pain on walking that goes after a few minutes standing still isn't a knee pain rule matter: see a GP.

Sources 26, 45, 46, 5, 33, 25, 47

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: keep walking, shorter and flatter, and wake the thigh up

About the first 2 weeks: walks within the pain rule (shorter, flatter, split in two, with a stick in the hand opposite the sore knee if you limp, as the written steps below say), NHS inform's knee exercises with its pacing, and heel slides before your first steps if the knee is stiff. After a fresh twist with swelling, or a knee that locks, get checked first; with a meniscus tear, a Baker's cyst or a new knee replacement, that guide's plan comes first. Doses are NHS inform's or a named guide's; the rest are editorial.

Quad set (static quads) demonstrated on the 3D figure

3D demoQuad set (static quads)Beginner · No equipment

Hold 10 s: 2 to 3 at a time, building to 8, 2 to 3 times a day · NHS inform's knee exercise, with its pacing, as in our knee pain on stairs guide

Harder: Straight-leg raise

Straight-leg raise demonstrated on the 3D figure

3D demoStraight-leg raiseBeginner · No equipment

Hold 5 s at the top: 2 to 3 at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's knee exercise, with its pacing

Easier: Quad set (static quads) · Harder: Leg extension

Supine heel slide demonstrated on the 3D figure

3D demoSupine heel slideBeginner · No equipment

10 slow reps each side, once or twice a day · The move page's dose, an editorial starting point. Doing them before you get up when the knee is stiff is our suggestion. After surgery, stay within the range your team allows, as the move page says

Harder: Hip windshield wipers

Seated knee extension (chair) demonstrated on the 3D figure

3D demoSeated knee extension (chair)Beginner · A bench or box + Something with weight

3 sets of 10 to 15 each leg, 2 to 3 days a week · The move page's dose, an editorial starting point. Work from 90° to about 45° only if the kneecap hurts, as the move page says

Easier: Quad set (static quads) · Harder: Leg extension

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 to 3 at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's knee arthritis exercise, with its pacing

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

About 10 minutes on the flat at a comfortable pace, once or twice a day, within the pain rule · Editorial, as on our exercise for arthritis page and in our hip pain when walking guide. Walking outdoors counts the same

Harder: Treadmill jogging

Move on when: 15 to 20 minutes of walking on the flat stays within the pain rule, and the knee is back to usual by the next morning (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: standing strength, balance and longer walks

About weeks 2 to 6, strength 2 or 3 days a week: the knee hub's second stage, with walks a few minutes longer each week, one change at a time (editorial).

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

3 sets of 8 to 12, higher seat to start · As in our knee pain guide. Lean slightly forward and stand up slowly using your legs, as the NHS describes

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Sit squat (partial squat) demonstrated on the 3D figure

3D demoSit squat (partial squat)Beginner · No equipment

Lower until your bottom just touches a chair behind you: 2 to 3 at a time, building to sets of 8 · NHS inform's sit squat, with its pacing. To about 45° of knee bend at first if the kneecap hurts

Harder: Bodyweight squat

3D demoStep-upBeginner · A step

Lead with the sore leg onto a low step (the bottom stair), building to 3 sets of 10 each leg · NHS inform's step-up leads with the affected leg; the 3 sets of 10 is our runner's knee guide's

Easier: Low step-up · Harder: Dumbbell step-up

Side-lying leg raise demonstrated on the 3D figure

3D demoSide-lying leg raiseBeginner · No equipment

3 sets of 12 each side · As in our knee pain guide. Use a smaller range if the outside of the hip is already sore, as the move page says

Easier: Lateral band walk · Harder: Lateral band walk, band at the feet

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

A few seconds, building to 20 to 30 s, a hand near a support · NHS inform's balance exercise goes up to 20 s; 30 s is our knee pain guide's. After a recent fall, stay within reach of something solid, as the move page says

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

3D demoTreadmill walkingBeginner · Cardio machine

Build towards 20 to 30 minutes on most days, adding a few minutes every 2 or 3 walks · Editorial, as in our knee arthritis guide's second stage

Harder: Treadmill jogging

Move on when: 30 minutes of walking on the flat stays within the pain rule, and 10 step-ups on each leg are controlled (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Your usual walks come back: distance, hills and rough ground

From about week 6, strength 2 days a week and walking most days: single-leg strength and the controlled lowering that downhills and stairs need, while your usual walks come back by the written steps below.

Patrick step-down demonstrated on the 3D figure

3D demoPatrick step-downIntermediate · A step

3 sets of 8 to 10 each leg, from a low step · As in our knee pain and stairs guides. It practises the lowering that downhills and stairs need (our reasoning)

Easier: Bodyweight squat · Harder: Skater squat

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

3 sets of 8 each leg, holding a support at first · As in our knee pain and knee arthritis guides. Pad the back knee and shorten the range rather than pushing through knee pain, as the move page says

Easier: Bodyweight squat · Harder: Reverse lunge

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

3 sets of 8 to 12 · As in our knee pain guide

Easier: Bodyweight squat · Harder: Barbell front squat

Lateral band walk demonstrated on the 3D figure

3D demoLateral band walkBeginner · A band

3 sets of 12 steps each way · As in our knee arthritis guide

Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet

Single-leg calf raise from a step demonstrated on the 3D figure

3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall

3 sets of 10 each leg · As in our knee pain guide. Keep a hand on a rail, as the move page says

Easier: Slow calf raise · Harder: Single-leg pogo hops

3D demoTreadmill walkingBeginner · Cardio machine

Build towards 150 minutes a week of brisk walking, adding one of distance, pace, hills or rough ground at a time · The NHS's 150 minutes a week of moderate activity; the build is editorial

Harder: Treadmill jogging

Move on when: Our suggestion: your usual walks, hills and distances leave the knee back to its usual level by the next morning. Keep two strength days a week for the long term; if a walk flares the knee, go back to the last walk that was fine, not to none.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

How to walk for now (written steps)

Our 3D figure can't show these changes. They come from NHS inform, the NHS, Arthritis UK and a shoe trial; where a step is our suggestion, it says so. No trial has tested a walking distance, pace or route for knee pain.

1. In the first days of a flare, avoid long periods on your feet and move the knee gently for 10 to 20 seconds every hour; after 48 hours, try to use your leg more (NHS inform).
2. Pace your activities through the day and avoid sitting in one position for long (NHS inform); break harder jobs into chunks and rest before the knee becomes too painful (Arthritis UK).
3. Split a long walk into two, and start with about 10 minutes on the flat at a comfortable pace (our suggestion). Speed up only once the distance is comfortable: a brisk walk is when you can still talk but can't sing (the NHS).
4. Shoes: comfortable and supportive, with cushioned, shock-absorbing soles, room for your toes, a broad heel no higher than about 3 cm and a non-slip sole, and no high heels (the NHS, NHS inform and Arthritis UK). In a trial in people with arthritis, stable, supportive shoes eased walking pain more than flat, flexible ones.
5. Stairs: lead with your good leg going up and your sore leg coming down, and use the handrail (NHS inform).
6. Hills: flat routes first, gentle slopes next, long downhills last (our suggestion). Arthritic knees are often most painful on hills and stairs (the NHS).
7. Calf, thigh or buttock ache that comes on as you walk and goes after a few minutes standing still: see a GP before building up further.

Sources 21, 39, 25, 6, 38, 40, 34, 48

Using a walking stick (written steps)

These come from the NHS, NICE and an NHS trust's physiotherapy leaflet.

1. Hold the stick in the hand opposite the sore knee, so it takes some of your weight (the NHS).
2. Put the stick forward a stride length and a little out to the side, step forward with your sore leg, push some weight onto the stick, then step through with your good leg (the trust's leaflet).
3. Set the height so the handle is at wrist height, wear supportive flat shoes, and replace worn or split rubber feet; a stick lasts about 2 years (the leaflet).
4. You can borrow some sticks from the NHS through a GP, physiotherapist, occupational therapist or hospital staff, or buy one for about £15 to £50. Ask for advice on the right height, and see a physiotherapist before using a stick on steps (the NHS).
5. Put it away when you can walk your usual distance without limping and within the pain rule, and keep it for long or rough walks if it helps (our suggestion). NICE says consider walking aids.

Sources 38, 42, 43, 5

Your usual walks, hills and distance come back (written steps)

No trial has tested how to build walking back after knee pain. These steps are our suggestion, built on the NHS's and Arthritis UK's advice.

1. Add a few minutes every 2 or 3 walks on the flat, one change at a time, towards 30 minutes.
2. Then pace: walk a little faster once the distance is comfortable. A brisk walk is about 3 miles an hour (the NHS).
3. Then hills: short, gentle slopes first and long downhills last, with shorter steps going down. Walking poles can be useful going up or downhill, Arthritis UK's physiotherapist says.
4. Rough ground last: grass and firm paths before uneven trails, once your single-leg balance is steady.
5. If mornings are stiff, a lunchtime walk may suit you better (Arthritis UK's physiotherapist). Build up before a holiday, a charity walk or a new step target rather than jumping straight in.
6. Aim towards the NHS's 150 minutes a week of moderate activity, and keep two strength days a week for the long term.
7. If a walk flares the knee, go back to the last walk that was fine, not to none. If it isn't improving within 6 weeks, or it's getting worse, see a GP or physiotherapist (NHS inform); in many areas you can refer yourself to physiotherapy (the NHS).

Sources 48, 47, 21, 9

Positions to swap, and why

Habit or position	Why it matters	Instead
Stopping walking altogether until the knee stops hurting	NHS inform says try to use your leg more after the first 48 hours, and in knee arthritis, walking for exercise went with less new knee pain, not more.	Shorter, flatter walks within the pain rule.Try: Treadmill walking
One long walk, or a long day on your feet, while it's sore	NHS inform says avoid long periods on your feet in the first days, and Arthritis UK says rest before the knee becomes too painful.	Two or three shorter walks, with sitting breaks.
Long downhills, steep hills and rough ground early on	Arthritic knees are often most painful on hills and stairs, and going down stairs loaded the knee most of the daily activities measured.	Flat routes first and gentle slopes next; step-downs in stage 3 train the lowering.Try: Patrick step-down
High heels, or worn, thin-soled shoes	NHS inform advises supportive footwear with cushioned soles and no high heels, and Arthritis UK thick soles with room for your toes.	Your most comfortable supportive walking shoes.
Special knee shoes or wedged insoles as the fix	Unloading shoes did no better than ordinary walking shoes and wedged insoles no better than flat ones, and NICE says don't routinely offer insoles.	Ordinary supportive shoes, and the strength work.Try: Sit to stand from a chair
A brace instead of the exercises	The evidence for braces is inconclusive, and NICE doesn't routinely offer them unless the knee is unstable and exercise alone isn't enough.	The strength work, with a simple support on long walks if it helps you.Try: Quad set (static quads)
Limping on without a stick, or holding it on the same side as the sore knee	NICE says consider walking aids, and the NHS says hold a stick on the opposite side to the affected leg so it takes some of your weight.	A stick in the opposite hand, with the handle at wrist height.
Walking on through a knee that keeps giving way	Buckling went with falls and poor confidence in balance, and NHS inform says contact your GP if your knee gives way.	Get it checked, and build strength and balance.Try: Single-leg stand
Jump squats or jogging to test the knee	The move page calls the jump squat the wrong starting point for irritable knees.	Step-ups within the pain rule.Try: Step-up
Sitting still for a long time, then setting straight off	Arthritic knees hurt and stiffen more when you haven't moved them for a while, and NHS inform says avoid sitting in one position for long.	A few heel slides before you stand, then an easy first few minutes.Try: Supine heel slide

Routines to follow

Low-impact leg workout (no jumping)

A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.

20 minBeginner7 movesA bench or box, A step

Arthritis exercise routine: a joint-friendly circuit

A 30-minute joint-friendly circuit built like the GLA:D and ESCAPE-pain programmes: a gentle warm-up, chair, step and band strength moves, balance, then stretches.

30 minBeginner14 movesA bench or box, A step

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Strength and balance exercises for seniors

A 40-minute strength and balance session for over-65s, built from the Otago home programme and NHS exercises, using a chair, a counter and a step.

40 minBeginner18 movesA bench or box, Something with weight

Knee strengthening workout: from first steps to full range

A 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.

25 minBeginner13 movesA bench or box, A wall

Interval walking workout: 3 minutes fast, 3 minutes easy

A 40-minute walk alternating 3 minutes fast and 3 minutes easy, five times over: the interval walking tested in Japanese trials, built up from three rounds.

40 minBeginner3 movesCardio machine, A wall

More moves for this area

Questions people ask

Why does my knee hurt when I walk?

Usually because walking shows up a sore spot rather than causing one: pain around or behind the kneecap, a stiff, achy arthritic knee from mid-life, or the meniscus at the joint line are the common causes. Each step on the flat loads the knee about two and a half times your body weight, so a sensitive knee often aches more the further you go. Where it hurts is the best clue, and the map on this page sends each cause to its own guide.

Is walking good for knee pain, or should I rest it?

Keep walking, adjusted. In people with knee arthritis, those who walked for exercise were less likely to develop new frequent knee pain, and NHS inform says that after the first 48 hours you should try to use your leg more. Make walks shorter and flatter at first, and keep the pain at 5 out of 10 or less, back to normal by the next morning.

Why does my knee hurt when I walk if it isn't swollen?

Many common causes, such as pain around the kneecap and arthritis, cause pain with no swelling or only mild swelling. No swelling is reassuring, but a knee that locks, gives way or is very painful still needs advice. Swelling straight after a twist, or a hot, swollen knee with a high temperature, needs help the same day.

Why does my knee hurt walking downhill or down stairs?

Going down loads the knee most: about three and a half times body weight down stairs against two and a half on the flat, measured in people with knee implants. The NHS says arthritic knees are often most painful on hills and stairs, and kneecap pain is typically worse on stairs. Take shorter steps, use a rail or walking poles, and build the lowering strength in the plan.

Why does my knee hurt when I start walking after sitting?

Stiffness that eases as you get going is typical of arthritis, which the NHS says hurts and stiffens more when you haven't moved the joint for a while. Kneecap pain is often worse after sitting with your knees bent, such as driving or at the cinema. A few heel slides before you stand up can help (our suggestion).

What does pain on the inside, outside or back of my knee when walking mean?

Pain at the joint line on either side, with catching or swelling, can be a meniscus, and a stiff, achy knee from mid-life is often arthritis. Pain on the inner shin just below the joint is often pes anserine pain, and pain on the outside that builds on longer and downhill walks is often the iliotibial band, as our knee pain and stairs guides describe. A lump behind the knee that is worse after walking can be a Baker's cyst, but one swollen, throbbing calf below it needs a same-day check for a clot.

What are the best shoes for knee pain when walking?

Comfortable, supportive shoes with cushioned, shock-absorbing soles and room for your toes, and no high heels, are the health services' advice. In trials in people with arthritis, stable, supportive shoes eased walking pain more than flat, flexible ones, and special unloading shoes did no better than ordinary walking shoes. Arthritis UK suggests a broad heel no higher than about 3 cm and a thick, non-slip sole.

Do knee supports or braces help with walking?

The evidence is inconclusive, and NICE says don't routinely offer them unless the knee is unstable or loads abnormally and exercise alone isn't enough. Some people find a support helps. If one makes a long walk easier, use it alongside the exercises rather than instead of them.

Should I use a walking stick for knee pain?

If you limp or your knee hurts on longer walks, a stick can help: NICE says consider walking aids, and daily cane use eased pain a little over 2 months in a trial. Hold it in the hand opposite the sore knee, with the handle at wrist height. You can borrow one through the NHS or buy one for about £15 to £50, and ask a physiotherapist before using it on stairs.

Why does my knee give way when I walk?

It's common: 11.8% of adults in one study had an episode of knee buckling in 3 months, linked with knee pain and weak thigh muscles, and over half of them had no arthritis on an X-ray. Strengthening and practising daily activities reduced instability in people with knee arthritis. Get a knee that gives way checked by a GP or physiotherapist, and get advice from NHS 111 now if it also locks, or swelled straight after a twist.

Why does my knee ache after walking a lot?

A long walk adds thousands of loads on the knee, so a sensitive knee often aches afterwards. If it's back to its usual level by the next morning, that's within the pain rule; if not, make the next walk shorter or flatter, not none. Build distance up gradually, as Arthritis UK's physiotherapist advises.

When should I see a doctor about knee pain when walking?

See a GP or physiotherapist if it hasn't improved within a few weeks, or within 6 weeks of following self-help advice, or it's getting worse; the CSP says seek advice sooner if it isn't settling over 2 to 3 weeks and is stopping your normal activities. In many areas you can refer yourself to physiotherapy. Get advice from NHS 111 now if you can't put weight on it, it's badly swollen or misshapen, it locks or gives way, or it's hot and red with a high temperature.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.