Knee health depends on strength, movement, and managing stress on the joint. While aging can lead to muscle loss and cartilage wear, many knee problems—including pain and early arthritis—can be prevented or delayed with the right habits.
Alexis Colvin, MD
In this Q&A, Alexis Colvin, MD, Mount Sinai Orthopedic Surgeon and Chief Medical Officer for the US Open, discusses how knees lose their resilience with age and how to keep them healthy.
“Keeping your muscles strong is one of the most effective ways to protect your knees as you get older,” explains Dr. Colvin, Professor of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai.
Why is knee strength important?
With everyday activities like walking, the knee can experience forces of one and a half to three times your body weight, and even higher with stairs or running. Your knees depend heavily on the surrounding muscles—especially the quadriceps, hamstrings, and glutes—to absorb force and keep the joint stable. Strong muscles help distribute these forces more evenly and reduce the load placed directly on the cartilage and other parts of the joint.
Why do I need to keep my knees strong as I get older?
Muscle mass and strength tend to gradually decline starting in our 30s, and flexibility can decrease as well. When muscles are weak or unbalanced, it is common to develop occasional knee pain, stiffness, or discomfort as you enter middle age. But if you keep your legs strong you can reduce and even potentially avoid knee pain as you grow older.
Why do my knees hurt now that I’m in my 40s? Is this normal?
Imaging studies show that many people in their 40s and over have early signs of arthritis but don’t have significant symptoms. When they do have pain, it is can be from other issues like muscle weakness or reduced flexibility. In other words, some knee pain or discomfort is often a sign that the muscles and tendons around the knee may need strengthening and/or stretching.
How can I keep my knees strong as I get older?
With exercise, you can prevent muscle loss in your knees. Regular movement also stimulates the production of synovial fluid within the knee joint, which helps maintain cartilage health. A balanced routine that includes strength training, aerobic activity, and flexibility work tends to produce the best results. Research shows that gradual strengthening programs can reduce knee pain and improve function, even in people with early arthritis.
What are some easy ways to make my knees stronger without getting hurt?
- Exercises that can safely build knee strength include sit-to-stand movements (chair squats), step-ups, and wall sits, as well as low-impact activities such as cycling and brisk walking
- Start with simple, controlled movements and focus on consistency rather than intensity
- It is also important to strengthen the hips and core, as they play a key role in controlling knee alignment and reducing abnormal stress across the joint
- Moving slowly with good form and progressing gradually helps minimize injury risk
- Consider working with a physical therapist for guidance on exercises
When should I see a doctor for knee pain?
Knee pain can improve with time, activity, and/or strengthening, but certain symptoms need to be examined. You should consider seeing a doctor if you experience:
- Pain that persists for more than a few weeks despite rest, ice, and anti-inflammatories, or if you experience swelling that does not resolve
- Symptoms such as locking, catching, or a feeling that the knee is giving way, which indicate issues such as meniscal injury or ligament instability
- Pain following a specific injury, particularly one involving twisting or impact (requires prompt evaluation)
- Knee pain limiting your ability to perform daily activities or exercise
Seeing a doctor early can identify treatable conditions and potentially prevent an injury from developing into something worse.
How does my weight affect my knee health?
Maintaining a healthy weight is critical—biomechanical studies show that each additional pound of body weight can translate to roughly three to four pounds of extra force across the knee with each step.
Does knee pain always mean injury?
Not always—many causes of knee pain are related to muscle imbalance and respond well to targeted exercise. Research consistently shows that people can improve strength, reduce pain, and enhance function at virtually any age with the right approach.