August 06, 2021 7 min read

Knees are Complicated

The knee is one of the most complex structures and one of the most stressed joints in the body. It is the largest joint that is vital for movement, and vulnerable to injury. The  knee is the most commonly injured joint by adolescent athletes, with an estimated 2.5 million sports-related injuries annually.  

Our knees absorb a lot of shock. Simple everyday activities and regular exercise such as walking, running, going up and down the stairs that you do not even notice you are doing add shock and pressure to the knee joint. And what makes it worse is that for every kilogram that you weigh, your knees receive 4 x the amount of stress. So, ensuring that you are the healthiest, leanest version of yourself is crucial to maintain the knee joint.

Working out is both beneficial and consequential to our knees. Running, for example, impacts the knee joints, and yet it is important to reduce the weight you put on your knees. However, low impact exercise like water fitness is a great way to workout without the consequence on the body. Swapping at least a high-impact workout for a water-based exercise at least once a week can remove the impact from the knees and help strengthen the knees, prevent knee pain and injury.

Australia and Knee injuries

Knee pain or trauma can be caused by a range of different factors. According to the  Medical Journal of Australia, Australia has the highest reported rates of anterior cruciate ligament (ACL) injury in the world. This rate has increased 70% in ages under 25s over the last 15 years. From 2000 to 2015, almost 200,000 primary ACL reconstructions were performed in Australia, and it presently costs the hospital industry an estimated $142 million a year. ACL Rupture is one of the common injury in sports such as AFL, rugby, basketball, running, track and field, and netball. The increase in ACL injuries is linked to a combination of longer sporting seasons, more intense training, and a stronger level of competition.

Some other common knee injuries include tears in the ligament, tendon, cartilage, and patellofemoral pain syndrome. There are also many arthritic-related causes of knee pain; including osteoarthritis, gout, bad knees, rheumatoid arthritis, or septic arthritis. 

Prevention tips for knee injuries

Many causes of knee pain and injury can be prevented and in the case of arthritic conditions, deterioration slowed. Knee injuries can be prevented if you readdress how much impact you place on them and take good care of them. You can prevent injuries and reduce deterioration of the knee joint by using exercises to strengthen knees and shifting to low-impact activities options like water cycling or water therapy as early as possible when symptoms of stiffness, restricted mobility, or swelling arise. Knee pain, stiffness, restricted mobility, or swelling are all signs you need to relook at the impact on your knees and remove the pressure as quickly as possible. 

Exercises to Strengthen Knees & Prevent Knee Injuries or Knee Deterioration

Knee surgery is an option but prevention is better than needing a cure. Rather than resort to surgery as a solution, we must do what we can to prevent knee injuries and reduce deterioration of the knee joint. Regardless of your fitness level, introducing water exercise or aquatic exercises as a regular daily activity is an excellent way to prevent knee injuries and slow deterioration of the knee joint. The water’s buoyant nature reduces impact and pain in joints and makes high-intensity exercise possible without the pain and joint damage. At the same time, the  hydrostatic pressure  from the water helps reduce inflammation that makes knee joints painful and the warm water stretches the muscles increasing the range of motion and flexibility. This makes water a great way to exercise and reduce the weight load and shock on the knees as well as a great cross-training option for athletes or manual workers like builders who add additional weight to the knees suffering faster deterioration. 

Water exercises are also an excellent way for people with  osteoarthritis  of the knee to reduce impact, alleviate joint pain, release stiff joints, reduce inflammation, build strength and relax the muscles.

Here are some of the most effective exercises to strengthen knees & prevent knee injuries or joint deterioration: 

1. Start Water Cycling

Have you ever tried cycling in water?

Water Cycling, also known as Aqua Cycling, is an enjoyable low-impact water exercise that involves cycling in water on a Hydrorider AquaBike. Cycling underwater helps reduce the impact on the knees while aiding joint mobility and strengthening the knees and its support structures. Water cycling is perfect for anyone with muscular, joint, or weight problems and suitable for those want to exercise without knee pain or further joint damage.

So how does water cycling improve and strengthen the knees?

Water cycling improves the range of motion, builds muscle strength, relieves joint pain and stiffness, and inflammation. The water's buoyancy and support of the AquaBike structure removes impact from the knee. Similarly, in pool exercises, water movement and warmth enhance the blood flow. The rotation of the bike enables circulation and removes stiffness. The structure of an AquaBike provides alignment and rotation momentum ensuring a maximum range of motion. The hydrostatic pressure from the water also reduces inflammation that makes joints painful. Cycling in water not only strengthens the injured or weak knee but also the supporting joints including the other knee, hips and ankles, and muscles glutes, and quads preventing further injury of these support structures with the additional compensation load from the knee injury.

Once you get started you are sure to fall in love with this fun and addictive sport.

2. Begin Water Cycling in a recumbent position or in deep water

Water cycling in a low cycling position of the back of the AquaBike reduces impact even further as 90% of the body is submerged and buoyant in the water. This recumbent style position enables a range of motion even in severe cases of inflammation, limited mobility, or post-trauma or surgery. AquaBike structure enables rotation alignment and the speed increases the benefits of the Hydrostatic pressure. Please do not try this position on your roadie or exercise bike at home. 

Another cycling position that allows a low impact but high-intensity workout in the water is the standing position in deep water, shoulder height, with bike handlebar support. The Hydrorider Aquabike handlebars can be adjusted horizontally and vertically to suit any stage of rehabilitation and any body type. In this position, you are standing and rotating in the water with water and handle-bar support. It may seem that you are using more of your lower body in this position, but this position also works harder on the upper body, abdominal muscles and core muscles more than knees and legs building these muscles to better support the knees as they recover. In this position no pressure should not be placed on the knees; rather, it should be on the handlebar, arms and utilise the core.

Variations of cycling position can help improve the physical functioning of support structures as well as the knee joint itself. The water's buoyancy helps decompress joints, by providing a weightless feeling during the activity. Also, the warmth of the water relaxes the muscles which reduce stiffness and pain and enables recovery.

3. Add a Resistance Band to target specific supporting muscles

Damaged muscles, ligaments, and tendons are some of the most common symptoms of a knee injury or casualties of surgery. A resistance band is used to target certain muscles to aid rotation, release tightness in the surrounding area of the knees and help strengthen the knees and their support structures.

The Hydrorider RiderBand® is an Aquatic resistance band that has 10 holes providing a range of exercise options for all body types and limb lengths. It improves strength and flexibility. Using a Riderband you will be able to specific muscle groups to strengthen not just the knees but also the supporting structures, quads, glutes, hips and ankles.

Water Fitness Equipment to Strengthen Knees

There is now a range of water fitness equipment available that can help you to strengthen the knees.


An Aqua Bike is a bicycle specially made for an Aquatic environment called a Hydrorider. There are a few models available: 

The  Hydrorider Pro-Fix Aquabike is the most popular Aquabike and is ideal for individuals at home as well as water therapists, physios, and exercise physiologists as it grows with you from light resistance to the heaviest possible and in a fluid motion with the jerkiness of knob changes.

For those coming back from an injury for a short period or with a degenerative condition, the  Hydrorider Easyline Aquabike is a good option. It is an entry-level option to get you started that is light and easy to move yet steady in the pool.

Are you a sports fanatic? Or are you an athlete yourself? The  Hydrorider Professional AquaBike is a good model for cross-training athletes as it allows additional targeted resistance levels. 

Some features that make the Hydrorider a powerful option for Knee Injuries include: 

  • Four Paddle Flywheel for fluid smooth resistance that is not jarring on the knees.
  • Fully adjustable seat to customize to your individual height and leg length so you can cycle in the right position for your body, protecting the knee joint.
  • Complete handlebar adjustments, so the bike will be customized to fit your individual height and limb length and varying rehabilitation stages.
  • Wide wheels for easy transport and require no heavy lifting and do not add weight to the knees while moving.

Why is an Aquabike a great choice to strengthen knees?

The AquaBike is a great way to strengthen the knees. It is one of the best pieces of equipment to aid in overall knee health as it:

  • Enables a range of impact levels and positions in the water for all stages of rotation recovery and impact introduction
  • Enables an aligned controlled rotation
  • Enables increased water speed and hydrostatic pressure to fast track the benefits of hydrostatic pressure and reduce inflammation faster than any other water workout

Aquatic Resistance Band

Hydrorider RiderBand is a great way to introduce load to strengthen the knees and strengthen the knees and support structures for the knees.

Why is an Aquatic Resistance Band aka RiderBand a great choice to strengthen knees?

  • Enables adding load to the limbs without weight-bearing
  • Allows to introduce load to targeted muscle groups as required
  • With 10 different hole options provides a variety of exercise options
  • Adjustable for all body types and limb lengths
  • Specially made for an aquatic environment, chlorine resistant, quick-dry and long lasting.


Note: Please seek medical advice before exercising & always train under the advice your medical specialist.

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