How Exercise Can Help Manage Arthritis Symptoms

If you have arthritis, the most natural instinct in the world is to protect the sore joint by using it less. It aches when you move it, so you move it less, and the logic feels sound.

The research says the instinct has it backwards. For osteoarthritis, the most common form of arthritis, exercise is not just safe for affected joints, it’s recommended as first-line treatment in every major clinical guideline, ahead of medications and well ahead of surgery for most people.

Here’s why moving a sore joint helps it, what kinds of exercise work best, and how to start without stirring everything up.

First, Which Arthritis Are We Talking About?

Arthritis is an umbrella term, and the distinction matters for how exercise fits:

• Osteoarthritis (OA) is the most common form, involving changes to joint cartilage and surrounding structures, most often in knees, hips, hands and spine. This article is mainly about OA, where exercise is a cornerstone of treatment
• Inflammatory arthritis, such as rheumatoid arthritis, is an immune-system condition that needs ongoing medical management. Exercise still helps, research supports strength and aerobic training as safe and beneficial in rheumatoid arthritis, but it works alongside your rheumatologist’s treatment, never instead of it

If you’re not sure which you have, or your arthritis hasn’t been formally diagnosed, that’s a conversation to have with your GP first.

The Myth Worth Retiring: “Exercise Wears Out the Joint”

Many people with OA carry a mental picture of cartilage as tread on a tyre, something exercise grinds away. It’s an understandable image, and scan-report phrases like “bone on bone” reinforce it. But the evidence points the other way:

• Cochrane’s reviews of both knee and hip osteoarthritis found exercise can reduce pain and improve function
• International guidelines list exercise, education and weight management as core first-line treatments for OA
• Structured exercise-and-education programs for hip and knee OA, such as the GLA:D program developed in Denmark and now running across Australia, have reported meaningful improvements in pain and function in large participant groups

Joints are living tissue, and like the rest of the body, they adapt to sensible loading. It’s long-term unloading that serves them worst.

How Exercise Helps an Arthritic Joint

Several mechanisms work together:

• Stronger muscles unload the joint. The muscles around a joint act as shock absorbers, and building them means the joint surfaces take less of every step
• Movement maintains range. Arthritic joints stiffen when parked. Regular motion keeps the range you have
• Exercise influences pain itself. Regular activity can raise the threshold at which joints complain, beyond any structural change
• It supports weight management. For knees and hips, research shows combining exercise with weight loss, where relevant, reduces joint load and improves pain and function
• It protects everything else. Sleep, mood, heart health and independence, all of which arthritis tends to erode, and all of which make pain easier to live with

The Best Kinds of Exercise for Arthritis

No single type is mandatory. The best program is the one you’ll keep doing, usually built from:

Strength Training

The heavy lifter, figuratively and eventually literally. Two or more sessions a week targeting the muscles around affected joints, sit-to-stands, step-ups, bridges and their gym equivalents, scaled to your starting point.

Low-Impact Aerobic Exercise

Walking, cycling, swimming or water-based exercise keeps joints moving and fitness up without heavy impact. Water work is especially useful during flares or for very sore joints, since buoyancy takes much of the load.

Range and Control Work

Gentle daily range-of-motion work keeps stiff joints usable, and structured options like clinical Pilates add supervised strength and control for people who want guidance.

Structured Programs

Supervised programs combining education and exercise, delivered by physiotherapists, take the guesswork out of the early months and are a well-supported way to start.

How to Start Without Flaring Up

The rules of engagement for arthritic joints:

1. Start lower than feels necessary and build gradually, the same load-management principle that governs all tissue
2. Some discomfort is acceptable. Mild joint awareness during or after exercise that settles by the next day is generally fine, and doesn’t mean damage is occurring
3. Escalating pain is a signal to adjust, not to abandon. Reduce the load or swap the exercise, and keep the habit
4. Flares happen. During one, ease back to gentler options, water work, range exercises, shorter walks, rather than stopping entirely
5. Consistency beats intensity. Most days, modestly, wins

When to Get Professional Input

Exercise for arthritis works best with some structure, and it’s worth getting assessed if:

• You’re unsure what your joints can safely handle, or fear is holding you back
• Pain keeps escalating despite sensible pacing
• A joint is significantly limiting daily life
• You have inflammatory arthritis and want your exercise coordinated with your medical care
• You’re considering surgery and want to build capacity beforehand, or exhaust conservative options first

See your GP promptly if a joint becomes hot, red and swollen, if you’re feverish or unwell alongside joint pain, or if symptoms change suddenly, as these need medical assessment.

Arthritis Support at Next Phase Injury Therapy

At Next Phase Injury Therapy in Yagoona, our physiotherapists and team work with people with arthritis at every stage, from first diagnosis to preparing for or avoiding surgery.

We work with you to:

• Assess what your joints can currently handle and where the opportunities are
• Build a strength and movement program matched to your joints, goals and life
• Adjust the plan through flares and progress, so the habit survives both

Sore Joints Still Like to Move

Arthritis changes what your joints need, but what they need most is still sensible, regular movement, and there’s strong evidence behind starting.

Explore our physiotherapy, chiropractic, remedial massage and clinical Pilates services, or book an appointment with Next Phase Injury Therapy. We’re open 8am to 8pm, seven days a week. Yes, even Sundays.

References

• Fransen, Marlene, et al. “Exercise for Osteoarthritis of the Knee.” Cochrane Database of Systematic Reviews, no. 1, 2015, https://doi.org/10.1002/14651858.CD004376.pub3.
• Fransen, Marlene, et al. “Exercise for Osteoarthritis of the Hip.” Cochrane Database of Systematic Reviews, no. 4, 2014, https://doi.org/10.1002/14651858.CD007912.pub2.
• Bannuru, Raveendhara R., et al. “OARSI Guidelines for the Non-Surgical Management of Knee, Hip, and Polyarticular Osteoarthritis.” Osteoarthritis and Cartilage, vol. 27, no. 11, 2019, pp. 1578–1589, https://doi.org/10.1016/j.joca.2019.06.011.
• Skou, Søren T., and Ewa M. Roos. “Good Life with osteoArthritis in Denmark (GLA:D): Evidence-Based Education and Supervised Neuromuscular Exercise Delivered by Certified Physiotherapists Nationwide.” BMC Musculoskeletal Disorders, vol. 18, 2017, article 72, https://doi.org/10.1186/s12891-017-1439-y.
• Hurkmans, Emalie, et al. “Dynamic Exercise Programs (Aerobic Capacity and/or Muscle Strength Training) in Patients with Rheumatoid Arthritis.” Cochrane Database of Systematic Reviews, no. 4, 2009, https://doi.org/10.1002/14651858.CD006853.pub2.

Information on this page is general in nature and is not a substitute for individualised advice from a registered health practitioner. Our practitioners are registered with AHPRA.