Knee Pain and Degeneration: How Pilates Can Help You Keep Moving

If you’ve been told you have “degenerative” changes in your knees, it’s easy to feel discouraged. Words like arthritis, wear and tear, or bone-on-bone can make it sound like your knees are fragile—or that movement is risky.

The truth is far less scary.

Degenerative changes in the knee are very common, especially as we age. They don’t automatically mean pain, and they don’t mean you need to stop moving. In fact, the right kind of movement is often one of the best things you can do for your knees.

What “Degenerative” Really Means

Degeneration simply means that your knees have changed over time. Just like skin gets wrinkles or hair turns gray, joints adapt as the years go by. Many people have arthritis or meniscus changes on imaging and feel just fine. Others feel knee pain without anything dramatic showing up on an X-ray or MRI. Pain isn’t just about what your knee looks like—it’s about how it’s being used.

Why Degenerative Knees Sometimes Hurt

Knee pain often shows up when the knee is doing more than its fair share of the work.

This can happen when:

• The hips aren’t helping enough

• The feet and ankles aren’t absorbing load well

• Muscles around the knee are weak or tired

• Stiffness limits how forces are spread through the leg

When this happens, the knee can feel cranky—especially with stairs, hills, squatting, or getting up from a chair.

Common Myths About Degenerative Knee Pain

Let’s clear a few things up:

• “Pain means I’m damaging my knee.” Not necessarily. Pain is often a signal to adjust, not to stop.

• “I should avoid bending my knee.” Gentle, well-supported knee bending is usually helpful, not harmful.

• “Exercise will wear my knee out faster.” Thoughtful movement often helps joints tolerate daily life better.

• “Pilates isn’t safe if I have arthritis.”Pilates can be very supportive—when it’s taught with awareness and modifications.

  
  

How Pilates Can Support Degenerative Knees

Pilates isn’t about pushing through pain or forcing flexibility. It’s about learning how to move in a way that’s kinder to your joints.

A smart Pilates approach focuses on:

• Sharing the work between hips, knees, and feet

• Building strength where you need support most

• Moving with control instead of momentum

• Adjusting on “bad knee days” without giving up completely

When the body works more evenly, the knees don’t have to work so hard.

What Usually Helps (and Feels Good)

People with degenerative knee changes often do well with:

• Strengthening the hips and back of the legs

• Gentle knee bending within a comfortable range

• Foot and ankle work to improve balance and support

• Slower, more intentional movement

It’s not about doing more—it’s about doing better.

A Quick Word About Being Careful

Not every exercise is right for every knee, every day. Deep bends, fast transitions, or repetitive movements can be irritating if they’re introduced too quickly or without enough support.

That doesn’t mean those movements are “bad.” It just means your body may need a different path—or more time—to get there.

Dealing With Flare-Ups

If your knees have good days and bad days, you’re not alone. Flare-ups don’t mean you’ve failed or made things worse.

They’re often a sign that your knees need:

• A little less load

• A little more support

• Or simply a change in focus for the day

Pilates can always be adapted to meet you where you are.

The Bigger Goal: Keep Moving With Confidence

The goal with degenerative knee pain isn’t to make your knees “perfect.” It’s to help you:

• Move more comfortably

• Feel stronger and more stable

• Do daily activities with less worry

• Stay active long-term

  
  

Degeneration doesn’t mean your body is broken. With the right guidance, it can still be strong, capable, and resilient.