Ten slow chair stands for a sore knee, and the honest odds

Move it monday

There is a soft green armchair in our front room, and last March I could not get out of it without both hands.

It is Carol's chair, by rights. I sit in it to read when she is out. That day I had spent two hours on my knees in her garden beds, and my right knee had gone stiff as an old gate hinge. I pushed on the arms, rocked twice, and came up with a grunt. Carol was in the door. She did not say a word… and she did not need to.

So I did what I always do… I went and read. It turns out there is a test for this. The CDC, the US agency that tracks the nation's health, uses it to check fall risk in older folks. You sit in a plain chair with your arms crossed on your chest. Then you stand up and sit down as many times as you can in 30 seconds.

For a man aged 65 to 69, the CDC says fewer than 12 is below average. The bar for a woman that age is 11. I got 9. I sat and looked at that number the way I once looked at a bad quarter. It was not a crisis. But it was a trend I did not like.

Why a chair tells you about your knees

Put your hand on the front of your thigh. The big muscle under it is the quadriceps, or quads for short. It is four muscles that join in one tendon over the kneecap. Their job is to straighten the knee. And each time you rise from a chair, climb a stair, or step off a curb, they take the load.

In knee osteoarthritis, the most common kind of arthritis, the cartilage wears thin. Cartilage is the smooth, slick pad on the ends of the bones. As it thins, the knee gets sore and stiff. So we use it less, and the quads get weak. Weak quads leave more strain on the joint. In other words, it can turn into a loop that feeds itself.

That is why so many plans for a sore knee start with the thigh. NICE, the body that writes health rules for doctors in Britain, set this out in its 2022 advice. It says all people with arthritis should be offered exercise, and that this should include work to make the muscles round the joint strong. The chair stand does just that. It needs no gym, no gear, and a few minutes.

The move: the slow chair stand

Use a firm chair with no wheels. Push it back against a wall so it cannot slide. A kitchen chair is just right. Sit near the front edge. Set your feet flat, about as wide as your hips, and a bit back from your knees.

Cross your arms on your chest, or rest your hands on your thighs. Lean forward a little, nose over toes. Then push down through your heels and stand up tall. Take about two seconds to rise.

Now the part that counts. Sit back down slowly, over a count of four, as if the seat were a long way off. Do not drop the last few inches. That slow trip down is where the quads do their hardest work. Touch the seat lightly, then rise again.

Here's the thing I got wrong for a week. Keep your knees in line with your toes. If they cave in toward each other, slow down and ease them out. Do 8 to 10 slow stands, rest a minute, and do a second set if you feel up to it. Once a day is plenty to start.

It may ache a bit at first. NICE says to expect that. Its advice is that joint pain can go up when you start, and that sticking with it is where the gain lies. A mild ache that fades by the next day is fine. Sharp pain, or a knee that puffs up, is not. Stop, and do less.

Both halves of the evidence

Now the honest part. In December 2024, Cochrane put out a new review of exercise for knee arthritis. Cochrane is a group that gathers all the good trials on one question and weighs them up as a set. This one pooled 139 trials with 12,468 people. That is about as big a pile of proof as you will find on a sore knee.

Exercise helped. Pain in these trials is scored from 0 to 100. Next to people who did nothing new, those who did exercise were about 13 points better. Set against a fake treatment, the gap shrank to about 9. Most people need a drop of about 12 before they feel it in daily life. Or put another way, the gain is real, but it sits right at the edge of what you would notice.

There is a catch in the trials, too. In nearly all of them, people knew they were doing exercise. That can tilt the results, since hope alone can make pain feel a bit less. The team, led by Belinda Lawford at the University of Melbourne, was frank about it. They still called exercise a first choice for a sore knee. But they told doctors not to oversell it. I respect that… it is rare to see a team mark down its own field.

Bear in mind what an average hides. Some people in those trials did well, and some got next to nothing. And exercise is cheap, it is safe, and it is good for the heart and the rest of you. Few pills can say all that… and none come with a free test you can do in a kitchen chair.

So I keep at it. I did my ten slow stands most mornings this summer. Last week I took the 30-second test again and got 12. I do not know if that will hold. Nor can I say how much is the chair and how much is the walks I take with Carol. We'll see. But I get out of her green chair now with my arms crossed… and she has stopped standing in the door to watch.

Here is to getting up without your hands,
Walt

The Health Brief is for education only. It is not medical advice. Always check with your own doctor about your own situation.