This fact sheet has been written to provide general information about physical activity and exercise for people living with osteoarthritis. This sheet does not provide advice on specific individual exercises. For information about pacing and managing fatigue, refer to the managing fatigue fact sheet.

Osteoarthritis and physical activity

Physical Activity is any movement of your body that uses physical energy, it includes all planned and unplanned movements such as:

• activities of daily living
• leisure
• sport
• transport e.g., walking of cycling to work or the shops
• gardening
• work activities

Physical activity is good for osteoarthritis

Research has found that being physically active is one of the most effective ways to manage osteoarthritis.^1,2 Physical activity can help to:

• Improve

  • mobility and flexibility of joints
  • muscle strength
  • posture and balance

• Decrease

  • pain
  • fatigue (tiredness)
  • muscle tension and stress

Physical will improve your overall health. It can improve the fitness of your heart and lungs, increase bone strength, reduce body weight and reduce the risk of conditions such as diabetes.

Physical activity is also beneficial in improving sleep, energy levels and mental wellbeing.

Don't forget that activities such as gardening, playing with pets or taking the stairs rather than the lift can also count towards your physical activity needs.

Exercise is good for osteoarthritis and helps with joint pain

Everyone withs or without osteoarthritis should be doing regular exercise.³ The important thing is to choose a type of exercise that best suits your condition, health, and lifestyle.

What types of exercises should I do for osteoarthritis?

There is no one size fits all all approach to exercise for osteoarthritis, it is often a process of trial and error to find the exercise that works best for your ability and lifestyle⁴. Everyone’s fitness level will be different, so start with activities that suit you. While some people with osteoarthritis will find a 5km walk comfortable, others may find walking around the block difficult enough when starting. Generally, doing a mix of these different types of exercise is recommended:

• fitness: To improve the health of your heart and lungs. These activities usually use the larger muscles in the body, rather than exercising a specific area, and may make you ‘puff’ a little. An example is going for a brisk walk.  
• Muscle strengthening: to support and take pressure off sore joints, strengthen your muscles and bones, and improve balance. An example is using weights or dumbbells. 
• flexibility: to maintain or improve the mobility of your joints and muscles. Examples include muscle stretching, resistance and yoga. 

There isn't just one particular exercise or activity that is recommended for all people with osteoarthritis, so it’s important to choose an activity that you enjoy and that is convenient for you to do. Some people with osteoarthritis may prefer lower-impact exercise that feel gentler on the body. While others may enjoy high-impact activities. It's really up to you which type of exercise you prefer doing and what works for you.

Examples of low-impact activities include:

• walking
• exercising in water, such as hydrotherapy (with a physiotherapist), swimming or water exercise classes. 
• strength training
• tai chi
• yoga and pilates
• cycling

Some examples of high impact exercise activities include:

• jogging
• running 

How much exercise and physical activity should I do to manage osteoarthritis?

All Australian adults should be aiming to do at least 30 minutes of activity on most days of the week. You can do 30 minutes continuously or combine several shorter sessions. If you have osteoarthritis and you have not exercised for a while, you may need to start with shorter sessions and then build slowly. Talk to your doctor or a physiotherapist about getting started to help you avoid an injury or over-doing it.

How will I know if I've done enough exercise?

Some people find that using fitness Apps on their smart phones helps promote and track physical activity and exercise, current research also supports this approach⁵. Some commonly used apps include. Strava, Garmin, FitBit or the Health App on Apple. It can be hard to predict how your body will cope with a new activity or type of exercise. The most important thing to do is to listen to your body and not over-do it. A general guide to monitor this is the ‘two-hour pain rule’ – if you have extra or unusual pain for more than two hours after exercising, it might be an indication that you have done too much. Next time you exercise, slow down or do a little less.

Should I exercise through pain?

Many people with osteoarthritis have some amount of pain all the time. This is not a reason to avoid exercise. You should only stop exercising if it is causing you unusual pain or increases your pain beyond what is normal for you. Some muscle soreness after exercise is normal and to be expected. If you are uncertain, it is important to check in with your health your care team to receive advice on ways to exercise comfortably and reduce exacerbations in pain.

When is the best time to exercise?

It doesn't matter when you exercise, as long as you do. However, the best time to exercise is when:

• You have least pain
• you are least stiff
• you are least tired
• your medicines are having the most effect (ask your doctor or pharmacist about how to time your medicines with exercise. This may help to make your exercise session more comfortable). 

Safety tips for exercise

• It is not always necessary to talk to your doctor and/or health professional before starting an exercise program. But do check in with your Health Care team if you have any concerns or need advice.
• A physiotherapist or exercise physiologist can suggest safe exercises and make sure you are doing these correctly.  
• you may need to adjust your exercise during a ‘flare’, or a period of increased pain and stiffness. Do not over over-exercise a joint that is red, hot, swollen or painful.

Examples of how to adjust exercise include:

• Reduce the session time of exercise or activity 
• Reduce the intensity of exercise or activity e.g. reduce the number of repetitions of a movement  
• Reduce the amount of weight you are using if strength training
• Always build up activity slowly. When you first start, do less than you think you will be able to manage. If you cope well, do a little bit more next time. 
• Always start your exercise session with some gentle movements warm up your body and your joints. This can help prevent pain and injury during exercise.
• Cool down at the end of your session with some gentle movements and stretches. This can help prevent muscle pain and stiffness the next day. 

Other resources

State and Territory arthritis offices

Your local Arthritis Office can provide further information to assist you and will have a range of education and support activities. Click here to find your local office

Physiotherapist

To find a physiotherapist, talk to your doctor, or visit the Australian Physiotherapy Association website at www. physiotherapy.asn.au

Exercise physiologist 

To find an exercise physiologist, talk to your doctor, contact Exercise and Sports Science Australia on (07) 3856 5622 or use the ‘find an exercise physiologist’ feature at www.essa.org.au

Podcasts

1. Getting started with physical activity for osteoarthritis: insights from experts part 1
2. Getting started with physical activity for osteoarthritis: insights from experts part 2
3. Exercising with knee and/or hip osteoarthritis with Prof Melanie Holden 
4. Does running cause OA?

Websites

• Australian Government’s National Physical Activity Guidelines are available at www.health.gov.au (look under the ‘For consumers’ section)
• ‘My Knee’ education and self-management toolkit. https://myknee.trekeducation.org/

References

The below references have been used to develop this fact sheet with the most up-to-date evidence available:

1. Gray B, Gibbs A, Bowden JL, et al. Appraisal of quality and analysis of the similarities and differences between osteoarthritis Clinical Practice Guideline recommendations: A systematic review. Osteoarthritis and Cartilage. 2024.
2. Gibbs AJ, Gray B, Wallis JA, et al. Recommendations for the management of hip and knee osteoarthritis: A systematic review of clinical practice guidelines. Osteoarthritis and cartilage. 2023;31(10):1280-1292.
3. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462.
4. Goh SL, Persson MSM, Stocks J, et al. Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis. Sports Med. 2019;49(5):743-761 
5. Feter N, dos Santos TS, Caputo EL, da Silva MC. What is the role of smartphones on physical activity promotion? A systematic review and meta-analysis. International journal of public health. 2019;64(5):679-690.