Your knees ache on the stairs, feel stiff when you get out of a chair or complain at the end of a long walk. After 50, knee pain becomes more common, and it is natural to wonder whether to do less. In fact, staying strong and active is one of the best things you can do to keep your knees comfortable.

Why knees can ache after 50

As we get older, the cartilage and other tissues in the knee naturally change. Knee osteoarthritis becomes more common, especially after 50. It involves changes to the cartilage and bone, as well as low-grade inflammation inside the joint, which is why knees can feel achy, stiff and sometimes swollen.

Muscle strength also declines with age if it is not kept up. The muscles at the front of your thigh act like shock absorbers for your knees, so when they are weaker, the knee itself takes more of the load.

None of this means your knees are wearing out. Knees respond well to movement and strength at any age. Pain often varies from day to day, and a sorer day does not mean your knee has worn further.

Why movement helps

Cartilage has no direct blood supply. It relies on movement to circulate the fluid that keeps it nourished. That is why knees often feel stiff after sitting and loosen once you get going.

Exercise is one of the most effective treatments for knee pain. In large education and exercise programmes for people with knee osteoarthritis, knee pain reduced by around a third on average, and many people used less pain relief afterwards.

Building knee strength

Something to try two or three times a week:

• Sit to stand. Rise from a chair without using your hands, then lower yourself slowly.
• Step-ups. Step up onto the bottom stair and down again, holding the banister.
• Heel raises. Rise onto your toes, pause, then lower slowly.
• Bridges. Lie on your back with your knees bent, lift your hips, then lower slowly.

If you would like to follow along, VIDA has short videos of sit to stands, heel raises and bridges you can use at your own pace. Start with a few repetitions and build up gradually.

A mild ache during exercise that settles by the next day is usually fine. On days when your knee is louder, gentler movement still counts.

Managing stairs

Stairs ask more of your knees than walking on the flat. Some things that can help:

• Take stairs one at a time if they feel difficult.
• Lead with your stronger leg going up and your sorer leg going down.
• Hold the banister for support.
• Keep using stairs where you can, as they help build strength.

Walking

Walking is one of the best things you can do for your knees. Some ideas:

• Spread walks across the day rather than doing one long one.
• Choose supportive, cushioned shoes.
• Start on flatter routes and add gentle hills as your knees get stronger.
• Try walking poles for extra support on longer walks.

Swimming, cycling and water exercise are good options on days your knees prefer less load.

The role of body weight

Every step puts more than your body weight through your knees. In one study of adults with knee joint changes, each kilogram of weight lost took around four kilograms of load off the knee with every step. If you are carrying extra weight, even small changes can make your knees feel easier.

Managing stiffness

Knees often feel stiffest after sitting. Some things that can help:

• Straighten and bend your knees a few times before you stand up.
• Get up and move every half hour or so if you sit for long periods.
• Use warmth on a stiff knee before activity, or a wrapped cold pack if it feels warm or swollen.

Your VIDA pain check-in can help you notice how your knees change as you build strength and activity.

What to take away

• Knee changes are common after 50, and knees respond well to movement.
• Exercise is one of the most effective treatments for knee pain.
• Strengthen your legs two or three times a week.
• Keep using stairs and walking, building up gradually.
• Even small changes in body weight can ease the load on your knees.

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