How to Exercise with Osteoarthritis

If you have joint pain from osteoarthritis, exercise may be able to help.

People sometimes refer to osteoarthritis (OA) as “wear and tear” arthritis. It’s what happens when the cartilage that protects your joints starts to wear away. OA is different than rheumatoid arthritis (RA), where your immune system attacks your joints.

OA tends to happen with age and because of injury or overuse.

Exercise can help ease the symptoms of both RA and OA. We’ll look at how to exercise with arthritis, focusing on osteoarthritis.

How Do I Know If I Have Osteoarthritis?

More than 32 million adults in the U.S. have osteoarthritis, which usually affects weight-bearing joints like the hands, hips, and knees.

Pain is the biggest complaint of people with OA. You may also feel stiffness and swelling in the joint. OA also affects flexibility and range of motion, which can make it difficult to move in certain ways.

At first, you may only feel pain with movement. But as cartilage damage worsens, you may feel pain even at rest.

Orthopaedists and primary care sports medicine physicians often treat people with OA. You may also see a rheumatologist, but that’s not as common with OA.

Your doctor may prescribe physical therapy and certain medications or injections that relieve pain. Some people with OA may eventually need joint replacement surgery. But exercise can also help.

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How Does Exercise Help OA?

Exercise helps with OA because it strengthens the muscles that stabilize your joints. Having stronger, more stable joints can reduce pain and stiffness. It can also increase your strength and endurance and improve your flexibility.

Exercise can also prevent further damage to cartilage. People with OA need to do all they can to preserve the cartilage they have. This is especially true in knees.

In fact, there’s been a great deal of research about the best interventions for people with knee pain from OA.

A 2022 article in the Journal of Orthopedic and Sports Physical Therapy looked at knee pain from OA. It found that exercise therapy ranked as the best treatment for knee osteoarthritis pain. In fact, exercise was better than either NSAIDs (medications like ibuprofen) or opioids for pain management.

What Are the Best Exercises for Osteoarthritis?

It may seem counterintuitive to exercise when you feel pain in your joints, but the right kind of exercise can help.

What is the right kind of exercise for you? First and foremost, it’s exercise that you enjoy and will continue to do regularly. You want to do what feels good and what challenges you.

If you’re not sure what exercise to try, consider taking a class designed specifically for people with OA. (The Arthritis Foundation recommends several.)

There are a few different types of exercises that doctors recommend for people with OA.

  • Range of motion exercises: These are activities that target your flexibility and include stretching and agility training. Examples include yoga, Pilates, and tai chi.
  • Muscle strengthening exercises: These are exercises you do with your own bodyweight, dumbbells, weight machines, or resistance bands. Bicep curls, pushups, squats, and lunges are all muscle strengthening activities.
  • Aerobic exercises: These are exercises that strengthen your heart and help build stamina. It includes activities like bicycling, swimming, the elliptical machine, or jogging. Sports that involve continual movement, like basketball or tennis, also have aerobic components.
  • Aquatic exercises: These are low impact exercises you do in the water, such as water fitness classes.
  • Walking: Walking is one of the simplest activities to do. It’s easy on your joints and can build both strength and stamina.

It can feel difficult to perform exercises like walking if you are overweight and have a very arthritic joint. If you struggle with joint pain during exercise, low-impact workouts may be a better option, according to Fred Heidenreich, MD, orthopaedic surgeon.

“Low-impact activities like bicycling, swimming, or the elliptical machine don’t put as much weight-bearing stress on your knees and joints compared to when you’re doing exercises like a simple walk,” he says.

He recommends swimming or walking in a pool. “The water helps support some of your weight, so it’s easier on your joints.”

How Much Exercise Should I Get if I Have Osteoarthritis?

The general exercise guidelines for adults are:

  • 150 minutes of moderate aerobic activity, such as brisk walking 30 minutes per day, five days a week. Alternatively, you could get 75 minutes each week of high intensity exercise. Taking a 40-minute high-intensity cycling class twice a week would count.
  • Muscle-strengthening exercises twice a week. These are exercises that use resistance to build muscle. Resistance includes your own body weight or weights you lift.

Those are the recommendations per the Centers for Disease Control (CDC) for the minimum amount of activity adults should do. These guidelines can help ward off heart disease and lower your risk for cancer. Remember to ease into exercise and progressively build up your routine, so as to avoid overexertion and possible injury.

Are There Osteoarthritis Exercises to Avoid?

You should always talk to your doctor when deciding on an exercise program. People with advanced osteoarthritis may need to limit or avoid certain types of high-impact activities.

For example, running and jumping on surfaces like pavement can be hard on joints for people with OA. However, if there is an activity you love, your doctor can work with you to figure out modifications.

A few tips to keep in mind:

  • Do what feels good. Muscle soreness is normal, but constant joint pain isn’t. Distinguish between what’s challenging and what is causing severe pain.
  • Give painful joints a rest. If your hands hurt, take a break from exercises that require gripping, like biking or tennis. Or if your knees are hurting, do a lower impact exercise, like swimming or biking.
  • Use ice. Use ice packs or cold packs after exercising, because ice can help reduce inflammation.
  • Try physical therapy. A physical therapist can help you strengthen and stabilize muscles surrounding your joints. Physical therapy can also teach you appropriate exercises to perform after an injury to aid in recovery.

Learn more about exercise for osteoarthritis at UPMC Orthopaedic Care, or call 1-866-987-6784.

Editor's Note: This article was originally published on , and was last reviewed on .

Osteoarthritis. Centers for Disease Control. Link.

Benefits of Exercise for Osteoarthritis. The Arthritis Foundation. Link.

Exercise and Arthritis. American College of Rheumatology. Link.

About UPMC Orthopaedic Care

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