If you have osteoarthritis, it can seem logical to rest when your joints hurt. You may worry that walking, strengthening exercises, or going to the gym will cause further damage to an already painful joint.
However, for most people with osteoarthritis, exercise is not something to avoid. It is actually one of the most important parts of treatment. Current clinical guidelines strongly recommend exercise for people with knee and hip osteoarthritis.
What Is Osteoarthritis?
Osteoarthritis, often shortened to OA, is a common joint condition that can cause pain, stiffness and difficulty with everyday activities. Although it is sometimes described simply as "wear and tear," osteoarthritis is more complex than a joint gradually wearing out.
Symptoms can also vary considerably. Some people have changes visible on an X-ray but very little pain, while others experience significant symptoms that affect walking, stairs, work, sport or other daily activities.
Because of this, treatment should focus not only on the joint itself, but also on improving your strength, movement, confidence and ability to perform the activities that matter to you.
But What If Exercise Hurts?
This is one of the biggest concerns people have when starting rehabilitation.
Some discomfort during or after exercise does not automatically mean that you are damaging your joint. An osteoarthritic joint can be sensitive to activity, particularly when starting a new exercise or increasing the amount you do.
The important part is finding an appropriate type and amount of exercise for you. Rather than avoiding movement completely, exercise can be gradually adjusted and progressed according to your symptoms and physical capacity.
If exercise consistently causes a large increase in pain or swelling, however, the programme may need to be modified. A physiotherapist can help determine an appropriate starting point and gradually increase the challenge as your body adapts.
How Does Exercise Help Osteoarthritis?
Exercise can help in several ways.
- Reducing Pain and Improving Function: Exercise is one of the most extensively researched non-surgical treatments for osteoarthritis. A large 2025 systematic review examining 217 randomised trials involving 15,684 people with knee osteoarthritis found that exercise can improve pain, physical function, walking ability and quality of life.
- Building Strength: Stronger muscles can help you perform everyday tasks more efficiently. For example, strengthening the muscles around the hip and knee can make activities such as walking, climbing stairs and getting out of a chair easier. Exercise programmes may therefore include resistance training as well as aerobic and movement-based exercises. Evidence supports several forms of exercise for knee osteoarthritis rather than one single "best" exercise for everyone.
- Maintaining Mobility and Independence: Pain can understandably cause people to become less active. Over time, however, reduced activity may lead to loss of strength, fitness and confidence in movement. Exercise helps maintain the physical capacity required for work, recreation and everyday life. Current osteoarthritis management recommendations therefore emphasise remaining physically active and building confidence in managing the condition.
What Type of Exercise Is Best?
There is no single exercise programme that suits everyone with osteoarthritis.
Depending on your symptoms and goals, treatment might include:
- Strength exercises, such as squats, sit-to-stands or resistance exercises
- Aerobic exercise, such as walking or cycling
- Balance and movement exercises
- Pool-based exercise, particularly when exercising on land is uncomfortable
- Exercises designed around specific activities you want to return to
Recent evidence suggests that several forms of exercise can be beneficial for knee osteoarthritis, with aerobic exercise showing particularly favourable results across pain, function and quality-of-life outcomes.
Takeaways
Having osteoarthritis does not mean you need to stop using your joints. While completely resting a painful joint can seem sensible, avoiding activity for long periods may reduce strength and physical capacity.
Appropriately prescribed exercise is strongly recommended for osteoarthritis and can help reduce pain, improve function and keep you active and independent. The key is to find the right starting point and progress gradually.
Osteoarthritis is a common cause of knee pain and hip pain.
If joint pain or stiffness is stopping you from exercising or doing the activities you enjoy, visit Pivotal Motion Physiotherapy. Our team of physiotherapists and exercise physiologists can assess your symptoms and develop an individualised exercise programme to help you move with greater confidence.