ReviewedReviewed. The exercises, repetition counts, hold times, and order of the exercises on this sheet have been checked by Dr. Mahendira against the clinic's printed handout.
SMH Osteoarthritis Clinic · Knee osteoarthritis · Corticosteroid injection (Depo-Medrol (methylprednisolone acetate))
Reviewed by Dr. Mahendira against the clinic handout.
Your injection
A long-acting corticosteroid injected directly into the knee joint to reduce inflammation and relieve pain. It is not a pain reliever. It works by calming the immune response that drives swelling in the joint.
After your injection
What to expect
- Mild soreness or increased pain at the injection site is normal for 24 to 48 hours (a steroid flare).
- The Depo-Medrol usually begins working within 2 to 5 days. Full effect may take up to 2 weeks.
- The knee may appear slightly more swollen or feel warm initially. This is common.
First 24 hours
- Rest the knee. Avoid running, jumping, prolonged standing, and heavy lifting.
- Apply ice wrapped in a cloth for 15 to 20 minutes every 2 to 3 hours to reduce swelling.
- Keep the injection site clean and dry. A small bandage may be removed after a few hours.
- Take acetaminophen (Tylenol) as needed. Avoid NSAIDs for 24 hours unless directed.
Days 2 to 7
- Gradually resume light walking and daily activities as comfort allows.
- Continue to avoid high-impact activities (running, jumping, heavy squats).
- Begin gentle range of motion and strengthening exercises.
- Use a knee sleeve or brace during activity if it provides comfort.
Important reminders
Limit injections to 3 to 4 per year per joint. Repeated corticosteroid injections may accelerate cartilage loss over time. People with diabetes should monitor blood sugar closely for 3 to 5 days.
Your exercises
Begin gently after about 48 hours if you are comfortable. Move slowly and stay within a mild, pain-free range. The counts below are a guide for how much to do.
1Quad sets (isometric)
Most important
Sit or lie with your leg straight. Tighten the muscle on top of your thigh by pressing the back of your knee into the floor. Hold 5 seconds, relax.
3 sets of 10 reps, 2 to 3x daily
You should see your kneecap move slightly upward.
Lie on your back with one knee bent and the other leg straight. Tighten your quad, then lift the straight leg to the height of the opposite knee. Hold 3 seconds, lower slowly.
2 sets of 10 reps, 2x daily
Keep your core engaged and back flat.
Lie on your back with both legs straight. Slowly slide your heel toward your buttock, bending the knee as far as comfortable, then slide back out.
2 sets of 10 reps, 2x daily
Use a towel under your heel to reduce friction.
Stand holding a chair for balance. Slowly bend one knee, bringing your heel toward your buttock. Hold 3 seconds, then lower slowly. Keep thighs parallel.
2 sets of 10 reps each leg, 2x daily
Avoid arching your lower back.
Sit in a sturdy chair with feet flat. Slowly straighten one knee until the leg is extended. Hold 3 to 5 seconds, then lower slowly. Control the motion throughout.
2 sets of 10 reps, 2x daily
Add a light ankle weight after week 3 if pain-free.
Stand holding a chair for balance. Rise onto your toes, hold 3 seconds, then lower slowly. Strengthens the calf muscles that support knee stability.
2 sets of 12 reps, 2x daily
Keep weight even across both feet.
7Mini wall squat
Start after week 2
Stand with your back against a wall, feet shoulder-width apart and about 12 inches from the wall. Slowly slide down to a partial squat, no more than 45 degrees. Hold 5 to 10 seconds, slide up.
2 sets of 8 reps, 1 to 2x daily
Start after week 2. Do not squat past 45 degrees.
Exercise guidelines
- Stop any exercise that causes sharp or increasing pain in the knee.
- Mild discomfort is fine. Sharp pain is not. Use the 0 to 3 rule: stay at 3 out of 10 or below.
- Apply ice for about 15 minutes to the knee after exercising if it feels warm or swollen.
- Progress slowly. Increase reps before adding resistance or depth.
Protecting the area every day
- Maintain a healthy weight. Every pound lost removes roughly 4 pounds of stress from the knee joint.
- Wear supportive, cushioned footwear. Avoid high heels and worn-out shoes that alter knee alignment.
- Use a cane or walking stick on the opposite side if needed to offload the affected knee.
- Avoid prolonged kneeling, squatting, or sitting cross-legged. These positions increase joint pressure.
- Take the stairs one step at a time. Lead with the stronger leg going up and the affected leg going down.
- Break up long periods of sitting. Stand and gently move every 20 to 30 minutes to prevent stiffness.
- Apply ice for 10 to 15 minutes after activity if the knee feels warm or achy. Use a cloth barrier.
- Consider a knee sleeve or brace for additional support during walking or exercise.
Low-impact activity
Swimming, cycling, water aerobics, and elliptical training are excellent for knee osteoarthritis. They build strength and endurance while minimizing joint impact. Aim for 150 minutes of activity per week.
Tracking your progress
Tick a box each day you complete your exercises, and circle how the area feels.
| | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|
| Week 1 | | | | | | | |
|---|
| Week 2 | | | | | | | |
|---|
| Week 3 | | | | | | | |
|---|
| Week 4 | | | | | | | |
|---|
Pain level today (circle one)012345678910
0 = none10 = worst
!When to call your doctor. Contact the clinic or seek care if you notice any of the following: Increasing pain, swelling, or redness at the knee lasting more than 48 to 72 hours after injection; Fever above 38C (100.4F), which may indicate joint infection (septic arthritis). Seek care urgently; Inability to bear weight on the leg, or a sensation of the knee giving way; Skin changes near the injection site: lightening, thinning, or a dimple in the skin; Symptoms of high blood sugar in people with diabetes: excessive thirst, frequent urination, blurred vision; New swelling, warmth, or locking of the knee joint that was not present before; No improvement in pain or function after 2 weeks.
This is general information, not medical advice. Your exercises and recovery depend on your own situation, and your clinician will guide you.
Back to the knee osteoarthritis guide
