Cardio doesn’t have to mean pounding the pavement and punishing your joints. Low-impact aerobic training can elevate your heart rate while being gentle on your knees, hips, and ankles. That makes it an ideal choice for anyone recovering from an injury, dealing with arthritis, or simply looking to protect their joint health over time.
According to Megha Abraham, MD, an assistant professor and sports medicine physician at UTHealth Houston, low-impact cardio is “a great way to get exercise in and stay active without putting a ton of stress on your joints, especially if you’re someone that has pre-existing medical conditions or injuries.” The key distinction, experts say, is that low-impact doesn’t mean low intensity. You can push yourself as hard as you like while avoiding the repetitive pounding that often leads to wear and tear. Here are the five best low-impact cardio options recommended by physicians, physical therapists, and exercise physiologists.
Treadmill With Incline
Even the best treadmills reduce impact compared to running on roads or trails, but running at a flat level is still not exactly low-impact. Adding an incline changes the equation. Milica McDowell, PT, MSPT, DPT, associate vice president of education at US Physical Therapy and author of WALK, says the incline shifts the position of your ankles, hips, knees, and spine. “For anybody who has difficulty managing load on a flat surface, taking them to an incline is going to feel much more gentle.”
The incline also reduces the downward force your body has to absorb. Alex Rothstein, EdD, MS, CSCS, exercise physiologist and assistant professor of exercise science at New York Institute of Technology, explains that you step up rather than jump and land. “You’re not really jumping up and landing down on the treadmill,” he says. “You’re kind of stepping up. There’s still some impact, but it’s not nearly as strong.”
Elliptical
The elliptical is the go-to for most people when they think of low-impact cardio. McDowell notes it was originally brought to market as a gentler alternative to the treadmill. Because your feet stay on the pedals, there’s only a fraction of the impact you’d experience from running. Plus, moving the handlebars engages your upper body, which can boost calorie burn. “By incorporating the upper extremities (a.k.a. your arms) you’re also going to burn more calories,” she says.
To get the most out of the elliptical, Rothstein suggests choosing a machine that allows for your natural stride. Fixed-stride models may not fit your body well. “The ones that are fixed might not fit your natural hip, knee, and ankle motion very well, and we always want to do any type of repetitive exercise in our natural pattern,” he says.
Swimming
Swimming has the highest entry barrier of these options, since it requires access to a pool. But for anyone dealing with injuries or severe arthritis, it’s often the best choice. Abraham recommends swimming and water aerobics in those situations. “There is still a little bit of impact, depending on how hard you’re swimming, but overall that’s going to be your lowest-impact option,” she says.
The main drawback, according to Rothstein, is that swimming doesn’t offer the same direct real-world application as running or biking. “Swimming is a great low-impact exercise, but it only has what we call concentric muscle contraction,” he says. “Because you never have to physically slow down your limbs—the water does that for you—there’s virtually no eccentric muscle contraction, which is something that we rely on in daily life and just about any activity.” He further notes that swimming is valuable for cardiovascular health and joint mobility, but it doesn’t fully prepare the body for everyday demands. “Swimming is very good for the body as a cardiovascular application, and for moving the joints through various ranges of motion, but it doesn’t really train the muscle and nervous system for the real world,” he says.
Spin Bike
Spin bikes provide all the cardiovascular benefits of cycling without the repetitive pounding. Abraham sees them as an excellent option for people with knee or hip issues. “It’s very joint friendly, and you can control the intensity, so you can still have your HIIT workouts and things like that,” she says.
For the most effective workout, clip in with proper spin shoes to get a smooth, circular pedaling motion that includes pulling up as well as pushing down. A spin bike also lets you hone in on your effort and really go all out. Rothstein points out that cycling can become almost addictive. “Riding a bike is one of those things that when people get into it, they become obsessed,” he says.
Air Bike
Known by several names, including Assault Bike, Echo Bike, and Airdyne, the air bike doesn’t often top anyone’s favorite cardio list. But the so-called devil’s tricycle may be one of the best low-impact options for combining joint safety with full-body intensity. McDowell admits her recommendation is not popular. “This is an unpopular opinion, because everybody hates it,” she says.
The air bike blends elements of the elliptical and the exercise bike, offering both seated support and upper body movement. McDowell explains that when you’re seated, you take weight off your joints, and the handlebars add an upper-body challenge. “You’re upgrading the cardio demand and challenging your upper body because of the handlebars,” she says. The resistance increases with your effort, so it’s only as tough as you make it.
No matter which option you choose, the key is finding a form of low-impact cardio that fits your needs and keeps you moving. As Abraham notes, low-impact doesn’t have to mean low intensity, so you can still maintain a challenging workout while protecting your joints. Whether you hit the treadmill at an incline, hop on the elliptical, take a dip in the pool, or battle the air bike, you’ll be doing your heart and your joints a favor.
