Yoga vs. Strength Training for Knee Osteoarthritis: Which Is Better?
Is yoga as effective as strength training for people with knee osteoarthritis? A 2025 randomized clinical trial compared the two approaches and found that both resulted in similar reductions in knee pain – along with improvements in leg strength. Let's take a closer look at what the researchers found and what it means for yoga practitioners and teachers!
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I have a very cool study to share with you today – I think you’ll find it especially interesting and relevant to what we do in our evidence-based yoga community!
This study compared yoga with strength training for people with knee osteoarthritis (OA), and the results were pretty encouraging for those of us who like having movement options. 😃
Strengthening exercise is widely recommended as a first-line treatment for knee OA. But most previous studies on yoga have compared yoga with things like usual care, education, or no intervention.
In this study, the researchers gave yoga a tougher test: they compared it directly with strength training, a similarly active treatment that we know from research tends to help with knee OA.
This study was published in JAMA Network Open, a respected, peer-reviewed medical journal published by the American Medical Association.
What Did the Yoga vs. Strength Training Study Examine?
The study included 117 adults with symptomatic (painful) knee OA whose average age was about 62. Participants were randomly assigned to yoga or strengthening exercise.
For 12 weeks, both groups completed two supervised one-hour sessions and one one-hour home session each week. They then continued with three home sessions per week for another 12 weeks.
Does Yoga Reduce Knee Osteoarthritis Pain?
In this study, both yoga and strength training resulted in about the same decrease in pain
The study’s main outcome was knee pain at 12 weeks, measured on a scale from 0 to 100.
Pain decreased by:
17.7 points in the yoga group
16.7 points in the strengthening group
That’s a difference of only about 1 point in favor of yoga on a 100-point scale.
The researchers had determined ahead of time that a 15-point difference between groups would be the minimum considered clinically meaningful. The approximately 1-point difference fell far below that threshold and was not statistically significant, meaning the researchers couldn’t confidently conclude that yoga reduced pain more than strengthening exercise.
In other words, both yoga and strength training performed about the same for knee pain after 12 weeks.
Can Yoga Improve Leg Strength in People With Knee Osteoarthritis?
In this study, both groups increased the strength of their leg muscles!
At 12 weeks, leg strength increased by:
17.8 kg in the yoga group
21.2 kg in the strengthening group
The average increase was slightly larger in the strengthening group, but the difference between groups was not statistically significant. In other words, the researchers couldn’t be confident that strength training increased leg strength more than yoga did.
Does this mean yoga is just as good as progressive strength training for building strength? Not so fast! 😛
These participants weren’t currently strength training when they entered the study, so they were technically “untrained”. When people are relatively untrained, many activities can provide enough new load to increase strength. Yoga poses involve load, too, right?
But once we adapt to the bodyweight loads a yoga practice provides, strength gains plateau. Progressive strength training is specifically designed to continually increase the challenge by increasing the weight, repetitions, sets, range of motion, exercise difficulty, or other variables. So, over time, a structured strength training program would be more effective for ongoing strength gains.
Why Might Strength Increase Without New Muscle Adaptations?
Here’s another awesome and geeky explanation for the strength increases seen in this study – and I personally think this is super compelling to consider!
Because participants began the study with knee pain, that pain may have limited how much force they were willing or able to produce during their initial strength test. If they had less pain and felt more confident pushing and exerting force by the end of the study, they may have been able to express more of the strength they had – potentially contributing to their higher strength test scores, independently of any actual neuromuscular adaptations.
Their higher scores could therefore reflect some combination of actual strength adaptations, less pain-related inhibition, greater confidence, and familiarity with the test. The study can’t tell us how much each factor contributed. But isn’t it interesting to think about, yoga geeks?
Did Yoga Have Any Advantages Over Strength Training?
Yoga also showed some promising advantages on several secondary outcomes. It performed better than strengthening for:
WOMAC pain, physical function, and stiffness
Participants’ overall assessment of their symptoms
Health-related quality of life
Fast-paced walking speed
Depression at 12 weeks, although this difference wasn’t maintained at 24 weeks
We can’t be highly confident in these findings because the researchers tested many secondary outcomes, increasing the possibility that some differences appeared by chance. The authors therefore described them as exploratory.
The yoga group also completed more of its prescribed home practices during weeks 13 through 24: about 70% compared with 60% in the strength training group. So adherence in the yoga group was higher 👏, and that greater consistency could have contributed to some of the later differences.
How Might Yoga and Strength Training Help Knee Arthritis Pain?
The researchers suggested that strengthening could help by increasing strength around the knee, while yoga might work through a combination of physical postures, flexibility, breathing, mindfulness, stress reduction, and body awareness.
But we don’t really know exactly why either intervention reduced pain. (This research can’t tell us that!)
We know from other research on strength training for pain that people can experience pain reduction by the end of a study without actually increasing their strength levels. This suggests that strength training’s benefits for pain aren’t necessarily caused by stronger muscles alone.
Strength training and yoga could both help people become more comfortable loading their knees, feel less worried about movement, and experience their bodies as capable and adaptable.
Yoga may emphasize breathing and body awareness more explicitly, while strength training may emphasize producing force and progressively increasing physical capacity. But their underlying effects may overlap quite a bit.
Can These Findings Apply to Any Yoga Class?
Here’s an important limitation to conclusions we might be tempted to draw. :)
This was not a study of general yoga. The yoga program was specifically designed for people with knee osteoarthritis, and it involved three one-hour practices per week, totaling three hours of yoga every week.
We therefore can’t assume that occasionally attending a general yoga class would produce the same results.
We also can’t generalize these findings to osteoarthritis in other joints, or to persistent pain conditions more broadly. This study specifically examined adults with symptomatic knee OA.
Yoga or Strength Training for Knee Osteoarthritis: Which Should You Choose?
But I still think the overall message of this research is optimistic: people with knee OA may have more than one useful movement modality option!
Some people enjoy strength training. Some people enjoy yoga. Some may benefit from a combination of both. And the activity that someone enjoys, feels comfortable exploring, and will continue to do consistently is probably the most useful option for that person!
More options mean more opportunities to help people feel capable and confident in their bodies. And that sounds like very good news to me! 💛
Frequently Asked Questions About Yoga for Knee Osteoarthritis
Is yoga good for knee osteoarthritis?
Research suggests that yoga can help reduce pain and improve physical function in people with knee osteoarthritis. In this 2025 randomized clinical trial, participants who followed a yoga program designed specifically for knee OA experienced meaningful improvements in knee pain over 12 weeks.
Is yoga or strength training better for knee osteoarthritis?
In this study, yoga and strengthening exercise produced very similar reductions in knee pain after 12 weeks. Both approaches appear to be useful options, although this single study doesn't establish that they're equally effective for everyone.
Can yoga strengthen the muscles around the knee?
Yes! Yoga poses can place meaningful demands on the muscles that support and move the knee. In this study, participants in both the yoga and strengthening groups improved their measured leg strength. However, progressive resistance training offers more opportunities to continually increase loading and develop strength over time.
How often should you practice yoga for knee osteoarthritis?
In this study, participants practiced yoga three times per week for approximately one hour per session. That's important context! We can't assume that practicing yoga less frequently, or occasionally attending a general yoga class, would produce the same results.
Should you avoid yoga poses that bend your knees if you have osteoarthritis?
Not necessarily! Knee bending and loading aren't inherently harmful for people with knee osteoarthritis. What matters is finding movements and loading levels that are appropriate for the individual. A healthcare professional can help someone with symptomatic knee OA determine how to approach exercise based on their needs and symptoms.
This post is for educational purposes and is not medical advice. Anyone experiencing knee pain or managing knee osteoarthritis should seek individualized guidance from an appropriate healthcare professional.
Reference:
Abafita, Bedru J., et al. "Yoga or strengthening exercise for knee osteoarthritis: a randomized clinical trial." JAMA Network Open 8.4 (2025): e253698.
Related Articles:
-Osteoarthritis & Movement: Facts vs. Fiction – by Special Guest Contributor Magnus Ringberg, MSc Sport Science, BSc Physiotherapy
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