What to know about physical activity and osteoarthritis

Low impact aerobic activities

Aerobic activities are those that use large muscle groups and increase the heart rate for a prolonged period.

It is important for people with OA to choose forms of exercise that do not add too much pressure to the joints. They may wish to try the following low impact aerobic activities:

Walking

A 2022 study of 1,212 people with OA of the knee found that those who walked for exercise experienced symptoms less often than those who did not walk.

Additionally, a 2021 review suggests that people with knee OA should walk for at least 10 minutes every day. However, those who feel comfortable do not need to stop at 10 minutes. The review authors cite an older 2014 study, which found that the more people with OA walked, the better knee function they had.

Swimming and other water exercises

According to a small, older 2016 study, swimming may help reduce joint pain and stiffness in people with OA. It may also help improve muscle strength and function.

A 2020 study suggests that swimming can be a helpful part of an OA exercise program. The researchers theorize that it may help improve strength and endurance without putting pressure on joints that usually bear weight.

Because people float in water, swimming is ideal for older adults and those with overweight or obesity who have a higher risk of OA.

According to the Arthritis Foundation, other types of water exercise, such as aqua aerobics, may also benefit people with OA.

Cycling

Cycling is a low impact activity that works muscles that support the ankles, feet, and knees. The repetitive movements produce more protective fluid around the joints, which may reduce stiffness throughout the day.

A 2021 review of data from 724 participants found that cycling on an exercise bike might reduce pain from arthritis and improve a person’s ability to take part in other sports. However, cycling had no significant effect on stiffness, quality of life, or daily function.

Muscle-strengthening exercises

Aerobic exercises target some muscles, but exercises that focus on muscle strength may help reduce stiffness and pain and improve mobility in people with OA.

People may try using free weights, resistance bands, or gym exercise equipment. The Arthritis Foundation suggests trying to do two or three 30-minute weight training sessions per week. This may improve energy and muscle tone within 4–12 weeks.

According to the United Kingdom’s National Health Service (NHS), exercises such as backward lunges, knee extensions, and leg raises may help improve knee movement over time.

A small 2023 clinical trial found that exercises that strengthened both the quadriceps (thigh muscles) and hamstrings (the tendons in the back of the leg) were the most effective way to reduce morning stiffness and pain in people with knee OA.

Flexibility exercises

Because joint stiffness is often a feature of OA, especially in the mornings, exercises that support flexibility can be important for daily function.

Yoga is an ancient practice that involves breathing, meditation, and physical poses. There are several types of yoga, some of which can be gentle ways to reduce muscle tension and increase flexibility, according to the Arthritis Foundation.

Yoga may also improve pain, stiffness, and daily function in people with knee OA, according to a 2019 review.

A 2022 review of 19 randomized controlled trials found that stretching helped relieve pain in people with knee OA.

Balance exercises

People living with OA may develop muscle weakness and balance problems. Some forms of light exercise may help people maintain balance. For example, limited evidence suggests that tai chi may support balance and overall health alongside more formal treatments for OA.

Tai chi is an ancient Chinese practice involving slow, sweeping movements and controlled breathing. According to the National Center for Complementary Integrative Health, tai chi may help prevent falls and improve balance in older adults.

Additionally, the Centers for Disease Control and Prevention (CDC) recommends that people with arthritis practice balance exercises, such as walking backward or standing on one foot, to help reduce the risk of falls.

Tips for exercising safely

People should consider the following tips for exercising safely:

• Start exercising at a low intensity level and for short periods. Over time, a person may be able to slowly increase the intensity and length of workouts.
• People who experience OA symptoms such as pain or stiffness should change their activity but try to avoid being inactive. This may involve exercising less often, for shorter periods, or at lower intensity.
• Stick to low impact exercise that is easy on the joints.
• Try a supervised exercise class with a qualified instructor before doing new types of exercise independently.
• Warm up before exercising and cool down afterward.

When to see a doctor

People should see a doctor if they feel:

• sharp, stabbing pain after exercise that does not go away
• pain that gets worse at night or 2 hours after a workout
• pain that does not get better with medication, rest, or ice packs
• increased swelling, redness, or “hot” sensations in the joints
• pain that causes them to limp

Summary

Physical activity may help improve strength, mobility, flexibility, and balance in people with OA. People living with this condition may benefit from activities such as swimming, cycling, and yoga.

Healthcare professionals and qualified fitness instructors can offer further advice about how to exercise safely with OA.