Osteoarthritis and Exercise: How to Move Safely and Reduce Pain

Introduction

Arthritis affects millions of people worldwide, causing pain, stiffness, and reduced mobility. The two most common types are osteoarthritis (OA), a complex joint disease involving the entire joint structure, and rheumatoid arthritis (RA), an autoimmune condition that can affect multiple joints and cause fatigue.

If you have arthritis, you might worry that exercising could make your symptoms worse. However, evidence shows that regular, safe exercise is one of the best ways to reduce pain, improve mobility, and maintain independence.  This guide explains why movement is essential, debunks common myths, and provides practical exercise tips you can start today.

Understanding Arthritis: OA vs RA

Osteoarthritis (OA): A complex joint disease affecting knees, hips, hands, and spine. OA isn't simply about cartilage loss - it affects the entire joint including ligaments, bones, menisci, joint membranes, and muscles.  Risk factors include age, past injuries, obesity, genetics, and certain occupations.  OA primarily causes joint pain, stiffness, and reduced function.

Rheumatoid Arthritis (RA): An autoimmune condition where the immune system attacks the joints, causing inflammation, swelling, and fatigue. RA can lead to muscle loss, weight gain, and increased risk of heart disease.

Key takeaway: Regardless of type, gentle and regular exercise is safe and highly beneficial for managing arthritis symptoms.

Why Exercise Matters

Research consistently shows that exercise provides numerous benefits for people with arthritis:

• Reduces pain and stiffness by improving joint lubrication and mobility

• Strengthens muscles to support and protect joints

• Boosts energy and mood by reducing fatigue and promoting well-being

• Improves balance and coordination to prevent falls

• Supports weight management to reduce systemic inflammation

• Protects overall health by lowering risk of heart disease, diabetes, and osteoporosis

  
  

According to the ACSM Guidelines for Exercise Testing and Prescription (12th Edition), exercise is a core recommendation for arthritis management.

Common Myths About Exercise and Arthritis

Myth: "OA is just wear and tear - exercise will damage my joints"

Fact: This outdated view has been debunked by modern research.  OA is a complex disease driven by multiple biological processes, not simple mechanical wearing down.  When done correctly, exercise is safe and can actually reduce joint pain and inflammation. In fact, recreational runners have less knee OA than sedentary people.  Even high-intensity resistance training has been shown not to damage cartilage.

Myth: "Pain after exercise means I'm causing harm"

Fact: Some pain during exercise is normal and acceptable - research shows that pain up to 5-6 on a 10-point scale (0= no pain 10 = excruciating pain) during a single exercise session is safe.  The key is that pain should return to baseline within 24 hours.  If it doesn't, adjust your programme.  

Mild muscle soreness is normal, especially if you're new to exercise.  True joint damage from appropriate exercise is extremely rare.

Myth: "I should rest completely during flare-ups"

Fact: Gentle movement, even during flare-ups, is better than total rest.   Short bouts of activity help prevent stiffness and maintain strength.  Complete rest can actually increase pain sensitivity and lead to a fear of movement.

Myth: "I need specific joint exercises to help my arthritis"

Fact: The benefits of exercise for OA are mainly systemic (whole-body effects like reducing inflammation) rather than local effects on the specific joint.  This means even generic resistance training programmes can improve your symptoms - you don't need to do joint-specific exercises.

Understanding Why Movement Helps

Motion is Lotion for Your Joints

Your cartilage works like a sponge - it has no blood supply and depends on movement to stay healthy.  When you load and unload a joint through movement, synovial fluid (the joint's natural lubricant) is pushed out of the cartilage and then absorbed back in, bringing essential nutrients with it.

Without regular movement, this vital lubrication and nutrition process doesn't happen effectively. This is why "motion is lotion" for your joints.

Why Does it Hurt if Movement is Good?

Our pain system functions as an alarm system to warn us of potential danger to our body, in much the same way as a smoke detector warns of a potential fire and damage: the alarm could indicate a fire, but more commonly it will be something like burnt toast, or even dust.

Pain is not an accurate measure of tissue health; rather pain is a protector.  Therefore understanding that pain does not necessarily mean damage can help you move with more confidence.  Thus, a short-term increase in manageable pain (5-6/10 on the pain scale) during exercise is normal, and over time will help to reduce the painful symptoms.

Practical Exercise Tips for Arthritis

Aerobic Exercise (3–5x per week)

Examples: Walking, cycling, swimming, water-based exercises

Benefits: Improves heart health, boosts energy, supports weight management, reduces systemic inflammation

Tip: Start with short bouts (5–10 min) if needed and gradually increase.  Remember, exercise doesn't have to be intense to be beneficial.

Strength / Resistance Training (2–3x per week)

Examples: Bodyweight exercises, resistance bands, free weights, gym machines

Benefits: Strengthens muscles around joints, reduces pain, improves functional ability, protects against other chronic diseases

Tip: Begin at low intensity (50–60% of your maximum 1 repetition lift) and progress gradually.  Research shows that different programmes (varying in exercises, intensity, sets, and reps) can all be successful - choose what you enjoy and can stick with.

Flexibility & Range of Motion (Daily)

Examples: Gentle stretches, Pilates, shoulder rolls, wrist circles

Benefits: Reduces stiffness, improves mobility, shortens morning stiffness episodes in RA

Tip: Move to the point of tightness, not pain. Consistency matters more than intensity.

Balance & Functional Exercises

Examples: Sit-to-stand, step-ups, split-squats, walking on uneven surfaces/changing direction

Benefits: Reduces fall risk, improves coordination and confidence in daily activities

5 Simple Exercises to Try at Home

1. Hands: Finger Roll Downs

• Start with the palm open and fingers extended straight up

• Starting with the tips of the fingers, slowly roll the fingers down towards the palm until you make a fist

• Then reverse the movement by rolling the fingers back up to the starting position

• Make a hook fist, return to a straight hand

• Repeat 4-6 times on each hand

2. Feet & Ankles: Standing Heel Raises

• Use a counter or chair for support

• Rise up on your tiptoes, with your knees straight

• Slowly lower your feet back down

• Repeat 10 times

3. Knees: Pilates Squats

• Stand upright, with feet hip-width distance apart (use a counter or chair for support if required)

• Keeping your torso in neutral (i.e. flat back), bend simultaneously and equally at the hips, knees and ankles

• Press through the feet to return to standing

• Repeat 8–12 times, 1–3 sets

4. Hips: Bridges

• Lie on your back with your knees bent and feet flat on the floor

• Press into the feet to lift your pelvis and lower back off the floor

• Hold the position for five seconds and then lower down slowly

• Repeat 8–10 times

5. Back: Bird Dog

• Kneel on all fours with your back straight

• Keeping the rest of the body still, reach one arm in front of you and hold for 5 seconds

• Alternate arms, repeat 10 times each side

• Progression: keeping the hands on the floor, slide one leg back and lengthen it until it floats away from the floor. Again, keep the rest of the body still (pay attention to the low back – try to not let it arch). Alternate legs, repeat 10 times each side.

Staying Consistent

• Choose the right time: Exercise when pain is lowest or after medication

• Track progress: Celebrate small wins and notice improvements over time

• Start small: Gradually increase intensity and duration - avoid doing too much, too soon

• Wear supportive shoes: This helps with shock absorption when walking

• Focus on function: Choose movements that mimic daily activities

• Find what you enjoy: The best exercise is one you'll stick with long-term

• Allow at least 12 weeks: Give yourself time to see results, as OA symptoms naturally fluctuate

When to Seek Professional Guidance

If you experience severe pain, swelling, or loss of function, it's important to speak to your doctor or a physiotherapist.  For personalised guidance, a movement professional specialising in arthritis can design a safe, progressive programme tailored to your needs.

Finding the Right Movement Practice for You

Arthritis doesn't mean you have to stop moving; in fact, consistent movement is one of the most powerful tools you have for managing symptoms and maintaining your independence.

The best exercise programme is one you'll actually stick with long-term. Whether that's Pilates, walking, swimming, strength training, or yoga, what matters most is finding movement that's meaningful to you and fits into your life.

Look for These Qualities in a Class or Programme

When choosing where to exercise, look for:

·       Small class sizes where instructors can provide individual modifications

·       A supportive environment where people of different abilities feel welcome

·       Qualified instructors who understand arthritis and can adapt exercises appropriately

·       Consistency - regular sessions help build the habit and track progress

·       Community - exercising with others provides motivation and accountability

Whether you join a local Pilates studio, a gym class, a walking group, or prefer guided sessions at home, the important thing is to start moving.

Training Options in Folkestone

If you're in the Folkestone area, I run small Pilates classes specifically designed to support people in building strength safely.

For Those Who Prefer Online Training

I'm also developing online movement sessions for people who prefer the flexibility of training at home or can't access suitable classes locally.  If this interests you, drop me a message and I'll keep you updated.

Get in touch: Website: www.core-pilates.co.uk Email: caroline@core-pilates.co.uk WhatsApp: 07718 189 661

Remember: every movement counts, motion is lotion for your joints, and it's never too late to start feeling stronger and more mobile.

Other Blogs that might also be of interest: Should You Worry About Noisy Knees? New Research Says Keep Moving How to Exercise Safely When You Have Pain, Injury or Stiffness

Two Things You Can Do To Overcome Pain

References 

American College of Sports Medicine (2022). ACSM's Guidelines for Exercise Testing and Prescription (12th Edition). Wolters Kluwer.

Bricca A, Juhl CB, Steultjens M, Wirth W, Roos EM. (2019). Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials. British Journal of Sports Medicine, 53(15):940-947.

Ringberg M. (2024). Osteoarthritis & Movement: Facts vs. Fiction. Jenni Rawlings Yoga & Movement Blog.

Skou ST, Roos EM. (2019). Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice. Clinical and Experimental Rheumatology, 37 Suppl 120(5):112-117.