If knee arthritis were a growth stock, you’d want to own a few shares.

Fifty percent of adults in the U.S. will develop knee osteoarthritis, which happens when the cartilage in the joint wears away and the bones rub more closely against one another. Once you have it, you can expect to live with it for 26 years, on average.

While the damage can’t be reversed, new research offers promising ways to mitigate the pain and perhaps even slow the disease’s progress by targeting what drives it — things like body weight and mechanical load. Three recent studies exemplify the trend.

Consider weight loss drugs: Excess body weight has long been linked with increased knee arthritis risk. People with obesity have higher rates of knee arthritis, get diagnosed younger, and experience more pain and physical limitations. “Just telling people ‘go lose weight’ is not going to work,” said Elena Losina, PhD, a biostatistician and professor of orthopedic surgery at Harvard Medical School.

Exercise is the most commonly recommended treatment for knee arthritis, and walking is the most commonly recommended type of exercise. But the repetitive stress of walking — never mind running, basketball, or tennis — can sometimes worsen knee pain. Arthritis typically begins in the medial compartment of the knee — the part closest to the other knee.

Medial arthritis is three times more common than lateral arthritis, on the outer part of the knee. That’s because, when you walk, 70% of the compressive force lands on the medial compartment. Physical therapist Kim Bennell, PhD, has been studying musculoskeletal injuries for three decades. In recent years, she and her research team at the University of Melbourne in Australia have increasingly focused on exercise, as it’s the most effective nonpharmaceutical, nonsurgical arthritis treatment.

One continual challenge: too many barriers to exercise for the people they were trying to help.

Some live in remote areas without access to facilities or coaching. And some who live in cities and suburbs either don’t have transportation, aren’t mobile enough to get to a facility, or can’t afford to join a gym or pay a trainer.

“So we decided to design and test unsupervised programs that we could offer free,” said Bennell, a professor at the university’s Centre for Health, Exercise, and Sports.

Her team’s most recent study featured an online tai chi program designed for adults with knee arthritis. Participants were given access to a series of 45-minute tai chi videos, led by one of the study’s co-authors, and instructed to do three 45-minute sessions per week.

After 12 weeks, 73% of the participants reported a clinically meaningful reduction in knee pain while walking, along with improvements in physical and mental well-being.