If you have arthritis, you’ve probably been told to “stay active.” That advice is useless unless someone tells you which exercises won’t make your knees feel worse the next morning.

This article does that. The balance exercises here are specifically chosen for seniors dealing with osteoarthritis, rheumatoid arthritis, or general joint pain. They challenge your balance without grinding your joints, and they’re sequenced so you can build confidence without flaring up.

Before we get into the exercises, a quick word: arthritis pain is a signal, not an obstacle. Pain that gets worse during exercise means stop. Pain that fades within an hour after exercise is usually fine. If you can’t tell the difference yet, you’ll learn. And working with a trainer who understands exercise with osteoarthritis makes that learning curve a lot shorter.

Why Balance Training Matters More When You Have Arthritis

There’s a cruel irony with arthritis. The joints that hurt are the same ones you need for balance. So most seniors with arthritis move less, which weakens those joints further, which makes balance worse, which raises fall risk, which makes them move even less.

The way out isn’t avoiding movement. It’s choosing movements that train balance without irritating the affected joints. Here’s what that looks like in practice.

Exercise 1: Seated Single-Leg Hold

What it works: Quad strength, hip flexor activation, core engagement Joints it spares: Knees, ankles, lower back

Sit in a sturdy chair. Straighten your right leg in front of you so it’s parallel to the floor (or as close as you can get without pain). Hold for 5 seconds. Lower with control. 10 reps per side.

This builds the quad strength that’s essential for catching yourself, without putting weight through painful knees. If your knee pain is mostly in the front (which is common with knee arthritis), keep the leg slightly bent at the top. Don’t fully lock it out.

Exercise 2: Heel and Toe Raises (Holding a Counter)

What it works: Calf strength, ankle stability, the tiny stabilizers in your feet Joints it spares: Knees, hips, back

Stand at a kitchen counter, hands lightly resting on it. Rise up onto your toes, hold for 2 seconds, lower with control. That’s one rep. Do 12.

Then reverse it: rock back onto your heels (lifting your toes off the floor), hold 2 seconds, lower. 12 reps.

These two movements wake up the muscles around your ankles, which are critical for the micro-adjustments that prevent falls. Almost no load goes through the knees.

Exercise 3: Side-Lying Leg Lifts (Hip Strengthener)

What it works: Hip abductors, lateral stability Joints it spares: Knees, ankles

This one is done on the floor or a bed. Lie on your left side with your legs straight, stacked on top of each other. Slowly lift your right leg about 12 inches, hold 2 seconds, lower. 10 reps. Switch sides.

If getting up and down from the floor is an issue, you can do a version of this standing, holding a chair. But the floor version is gentler on the supporting joints.

Why this matters: weak hip abductors are one of the biggest reasons seniors with knee or hip arthritis fall sideways. Strengthening them takes pressure off the affected joints during daily walking.

For more on how strength training protects arthritic joints rather than damaging them, our article on strength training with arthritis is worth a read.

Exercise 4: Counter-Supported Single Leg Stand

What it works: True balance, all four balance systems Joints it spares: Most arthritis isn’t aggravated by static standing

Stand at a sturdy counter. Hold lightly with both hands. Shift your weight onto your right foot and lift your left foot 4 to 6 inches. Hold 10 seconds. Switch.

Build up to 30 seconds per leg. Once that’s easy, try one hand on the counter. Then no hands.

If you have hip arthritis, you may notice this is harder on one side than the other. That’s normal. Train both, but don’t push the painful side into discomfort. Slow progress on the bad side beats no progress at all.

Exercise 5: Seated Marching with Arms

What it works: Coordination, core engagement, cardiovascular system, neural patterning Joints it spares: Knees, hips, ankles (mostly)

Sit tall. Lift your right knee as you bring your left elbow toward it (rotation through the core). Lower. Switch sides. 20 reps total.

This trains the cross-body coordination that balance and walking require. It’s surprisingly effective for the nervous system without loading any joint significantly.

Exercise 6: Modified Tandem Stance

What it works: Static balance under challenge Joints it spares: Customizable based on what hurts

Stand at a wall. Place your right foot slightly in front of your left foot (not full heel-to-toe, just half a step forward). Hold 15 seconds. Switch which foot is forward.

The “half tandem” version is much gentler on arthritic ankles and knees than the full heel-to-toe stance. As your stability improves and your joints settle, you can progress to fuller heel-to-toe positioning.

Exercise 7: Pool Walking (If You Have Access)

What it works: Full balance system, leg strength Joints it spares: All of them (buoyancy unloads about 70% of body weight)

Walk forward, backward, and sideways in chest-deep water. 5 minutes of each direction is plenty to start.

The water provides resistance and support at the same time. For seniors with severe arthritis, this is sometimes the only way to challenge balance without aggravating joints.

If pool access is an option, water therapy for joint pain covers what to do once you’re in the water.

What to Do If a Specific Joint Is the Problem

Knee Arthritis

Avoid: deep squats, single-leg standing with the painful leg as the support leg for long periods, anything with sudden direction changes

Lean into: seated work, counter-supported standing, heel and toe raises, hip strengthening (strong hips reduce knee load)

Specific resource: exercise modifications for knee osteoarthritis has the full breakdown.

Hip Arthritis

Avoid: deep lunges, exercises that grind the hip joint (most lateral leg raises with high range), high-impact anything

Lean into: side-lying leg work, swimming and pool walking, seated marching, balance work that keeps the hip in a neutral position

Ankle and Foot Arthritis

Avoid: balance work on unstable surfaces (foam pads, BOSU balls) until you’ve built up to it, prolonged single-leg standing on the affected side

Lean into: heel and toe raises (these can actually help by strengthening the muscles around the painful joint), seated work, swimming

Lower Back Arthritis

Avoid: trunk twists with load, exercises that require holding your breath, anything that increases pain in the back during the movement

Lean into: gentle seated marching, weight shifts, counter-supported balance, core work that emphasizes stabilization over flexion

For seniors with multiple joint issues, low-impact exercises for osteoarthritis covers options that work across the board.

How to Sequence These Exercises Through the Week

Monday:

Seated marching with arms (1 set of 20)
Seated single-leg holds (10 per side)
Heel and toe raises (12 each)

Wednesday:

Counter-supported single leg stand (3 holds per side)
Side-lying leg lifts (10 per side)
Modified tandem stance (15 seconds per side, 2 rounds)

Friday:

All seven exercises, one set each (about 20 minutes total)

Weekends: Walk if your joints allow it. Pool work if you have access.

Recovery Tools That Actually Help

Arthritis pain often gets worse with overuse, but it also gets worse with underuse. The trick is recovery between sessions. Here’s what helps:

Sleep. Inflammation drops during quality sleep. Get 7 to 8 hours.
Gentle stretching. Tight muscles around an arthritic joint make pain worse. Our article on gentle stretching routines for arthritis that actually work walks through what to do.
Heat before exercise, ice after. Heat loosens stiff joints. Ice reduces post-exercise inflammation.
Red light therapy. Research suggests it reduces inflammation in arthritic joints. We offer this at our studio. Red light therapy 101 covers how it works.
Infrared sauna. Heat penetrates deeper than a hot shower, and many of our arthritic clients use it specifically for joint relief.

When to Stop and See Someone

Stop these exercises and consult a professional if you experience:

Sharp, sudden pain (different from your normal arthritis discomfort)
Significant swelling in a joint after exercise
Pain that lasts more than 24 hours after a session
A new clicking, popping, or locking sensation
Numbness or tingling in any limb

This isn’t about being cautious. It’s about being smart. An assessment from a senior-fitness specialist can identify whether something has changed in your joints or whether you just need a program adjustment. How to find a personal trainer for older adults in the Asheville area walks through how to vet a trainer.

The Truth About Training With Arthritis

Seniors with arthritis who train consistently report less pain, not more. The research backs that up. Movement is medicine, but only when it’s the right kind of movement in the right doses.

You don’t have to figure out the right movements and doses on your own. Our senior fitness programs at PEAKFIT Studio are built for clients who are dealing with exactly what you’re dealing with. We assess what hurts, what works, and what’s safe. Then we build around it.

Book a free consultation if you want a real plan instead of a generic one. We’re in Arden, 15 minutes from downtown Asheville and 20 minutes from Hendersonville.

For a deeper look at the bigger picture, arthritis-friendly exercise programs covers how to stay active without joint pain in much more detail than this article can.

Train strong. Live long. Thrive always.