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People who regularly bike or cycle have lower odds of developing knee pain or arthritis in the knee joints as they age, a new study suggests.

Biking isn’t just a good low-impact cardio workout. A new study suggests that it might also help prevent knee pain and arthritis.

By middle age, people who participated in cycling or biking at any point in their lives were 17 percent less likely to experience knee pain and 21 percent less likely to develop symptomatic arthritis in the knee joint, according to study results published in Medicine & Science in Sports & Exercise.

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“The natural history of osteoarthritis is very long, making it difficult to track the different exercises you’ll do throughout your life, as well as their impact on joint health,” said the lead study author, Grace Lo, MD, an associate professor of immunology, allergy, and rheumatology at Baylor College of Medicine in Houston, in a statement.

Osteoarthritis, the most common form of arthritis, can develop in one or both knees as you age, causing symptoms such as pain, swelling, and stiffness in the knee joint, according to Cleveland Clinic. While some people have few symptoms, others can experience swelling and pain that makes it difficult to do daily activities like gardening or cleaning, or to continue to work.

Low-Impact Exercise for Knee Osteoarthritis

There’s no cure for arthritis of the knee joints, but doctors often advise people to pursue low-impact exercise like cycling, swimming, or walking — and to avoid high-impact activities like running or tennis — to help manage their symptoms, according to Cleveland Clinic. Up until now, however, it hasn’t been clear which low-impact exercise might be best for promoting healthy knee joints.

For the new study, researchers focused specifically on the potential benefits of cycling. Scientists asked more than 2,500 people whether they biked or cycled over four periods during their lives: 12 to 18 years, 19 to 34 years, 35 to 49 years, and 50 and up.

Then, researchers took X-rays of the participants to look for evidence of arthritis of the knee, also known as radiographic osteoarthritis (ROA). Participants also described any knee pain they experienced, allowing scientists to identify people who had what’s known as symptomatic radiographic osteoarthritis (SOA) — when people have both X-ray evidence of arthritis in the knee joint and symptoms like pain and swelling.

“The study revealed that people who biked at any point in their lives reported less knee pain, ROA, and SOA than those who never biked,” Dr. Lo said in the statement. “Moreover, those who did bike and did so across age periods throughout their lives reported even fewer instances of all three.”

Cycling for Knee Osteoarthritis

This may be because osteoarthritis is associated with loss of muscle mass, muscular function, and physical activity levels, as well as potentially a gain in body fat, says Justin Keogh, PhD, an associate professor and the associate dean of research for the faculty of health sciences and medicine at Bond University in Robina, Queensland.

“Such changes make it more difficult to engage in activities of daily living, and may result in increased loading on the knee joint during activities such as walking, stair climbing, and squatting,” says Dr. Keogh, who wasn’t involved in the new study.

“Cycling and other forms of exercise can reduce the osteoarthritis-related loss of muscle mass, muscular function, and physical activity — thereby resulting in improved symptom management in the long-term,” Keogh adds.

One limitation of the study is that researchers relied on participants to accurately recall and report on their exercise habits going back several decades, making it possible that the results were impacted by faulty memory. It’s also possible that people who regularly rode a bike throughout their lives had other healthy habits that contributed to a lower risk of knee pain or arthritis in the knee joint.

The study also wasn’t designed to determine the ideal frequency, intensity, or duration of cycling sessions for preventing or managing knee osteoarthritis. But study participants experienced benefits from cycling anywhere from two to five times per week, for 20 to 60 minutes per session.

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“This suggests that a variety of cycling exercise prescriptions can still be effective,” Keogh says. “The best frequency, intensity, and duration of cycling may be something that the individual with knee osteoarthritis needs to determine themselves.”

Even if you already have pain related to knee osteoarthritis, it’s not too late to start, says Scott Barbuto, MD, PhD, an assistant professor of physical medicine and rehabilitation at Columbia University Irving Medical Center in New York City, who wasn’t involved in the new study.

“Strengthening the muscles around the joint will help offload the stress and should help with pain from osteoarthritis,” Dr. Barbuto says. “Of course, the exercise will not take away the arthritis that is already there.”