Got Osteoarthritis Symptoms? Try Exercise First, Surgery as a Last Resort

Work with your doctor to fine-tune pain medications, begin physical therapy, and control your weight. Only then should you consider joint replacement.

Seniors in aerobic swimming class.

Dive into exercise you love—in this case, an aerobic swimming class. Workouts in water keep the pressure off of your joints.

© Arne9001 |

Medications, injections, supplements, surgery. They’re helpful treatments that have provided pain relief and improved function for millions of arthritis patients.

But perhaps nothing can do as much for your joints, and possible rheumatoid arthritis or osteoarthritis symptoms as the things you can do yourself—namely, exercise and weight management.

Getting in Shape

Exercise is an important part of any comprehensive arthritis treatment plan because it improves joint mobility, muscle strength, and overall conditioning, and it helps you maintain a healthy weight. Additionally, staying active may improve your level of pain and functioning and boost your overall health.

Exercise and strength training are of particular importance to rheumatoid arthritis (RA) patients, because a large number of them have only the minimum strength needed to handle a variety of daily activities, such as walking, rising from a seated position, and climbing stairs. Any further decline in strength, even if small, could put them below the threshold needed to carry out these activities and threaten their ability to maintain an independent lifestyle.

For those with osteoarthritis symptoms, exercise combined with weight loss can lead to dramatic improvement. One study found that losing just five percent of total body weight within a 20-week period should be enough for overweight or obese people with knee osteoarthritis symptoms to feel and function better. Exercise also can help strengthen your hips and shoulders.

Exercise Guidelines

Exercise guidelines from the American College of Sports Medicine include recommendations tailored for adults over age 65 who have osteoarthritis symptoms. Among the recommendations:

  • Do moderately intense aerobic exercise 30 to 60 minutes a day for five days a week, or vigorously intense exercise 20 to 30 minutes a day for three days a week. With moderate-intensity exercise, you should still be able to talk to the person next to you while exercising, but not so with vigorous exercise.
  • Do eight to 10 strength-training exercises (eight to 12 repetitions of each), at fairly light to mildly strenuous exertion, on two or more nonconsecutive days of the week. Rest one or two seconds between each repetition.
  • Do balance exercises if you’re at risk of falling. Try standing on one foot while holding onto a chair. Or, try a tai chi class taught by a certified instructor. Don’t attempt balance exercises for the first time when you’re alone.
  • Do 10 minutes of flexibility exercises (stretching) at least two days a week. Do your stretches after your other exercises, or independent of them.

If you have arthritis, your physician and/or an exercise professional can help customize an exercise regimen tailored to your individual capabilities. Develop a physical activity plan that addresses each type of exercise, how to monitor your activity, and how to re-evaluate your exercise regimen as your health status changes.

Stretching, or range-of-motion, exercises: In range-of-motion exercises, or stretches, you condition your joints to become more flexible by slowly and gently bending and straightening them as far as they will go, but not to the point of discomfort. Over time, and with repetition, a joint’s comfort range can gradually be broadened and, in some cases, approach normal.

Strength or resistance exercises: Whether done on a mat, in a pool, with free weights or weight machines, resistance or strength exercises challenge your body to build stronger, larger muscles that give you better posture and help you move your joints more easily. And because muscle tissue burns more calories than fat tissue, having larger muscles is a way to turn your overall metabolism up a notch and more easily keep your weight in check.

Aerobic or endurance exercise: If your overall health and fitness level are good enough, aerobic or endurance exercises should be added to stretching and resistance exercises. In endurance exercise, you work the large muscles of your body for an extended period of time, with the goal of gradually increasing the stamina of your heart, lungs, and overall cardiovascular system. This exercise trains your body to use oxygen better, improves overall circulation, and helps you develop stronger muscles. It also is a proven method for weight control, especially when combined with a healthy diet, which in turn can ease osteoarthritis symptoms.

Talk to your doctor or therapist to determine what starting level of endurance exercise is right for you. Even if you start out with just five minutes of sustained exercise, you should be able to gradually build up to 30 minutes a day. Your pace should be comfortable, yet challenging, allowing you enough breath to have a normal conversation. Ideally, you want to do 30 minutes of endurance exercises daily—all at once or in three 10-minute sessions—at least five days a week. Warm up with a low-intensity form of your exercise for at least five to 10 minutes before each workout, and then cool down with another five minutes of range-of-motion movements afterward.

Exercise Caution—But Do Exercise!

Although exercise, in general, is an effective tool for managing your arthritis, in some instances, it can do more harm than good. Be wary of exercises that require bending forward (sit-ups, toe touches), that increase the likelihood of falls (step aerobics, anything done on a slippery floor), or that jar the spine (running on a hard surface, jumping, or high-impact aerobics).

It’s a common belief that the impact of running or jogging can

contribute to or exacerbate knee or hip osteoarthritis symptoms. Running places excessive stress on the leg joints, resulting in forces of more than seven times your body weight on the knees and five times your body weight on the hips. Yet a 2014 study suggests that running may, in fact, reduce the risk of knee OA.

Sports Smarts

Just because we age, it doesn’t mean we have to stop taking part in the sports we love. But it does mean we need to be a bit smarter about the activities we choose and, in some cases, adjust our technique or equipment in order to reduce the stress on aging joints. Here are some sport-specific tips that should help you compete, despite having arthritis.

senior golfer golfing

Swinging a golf club can enhance the range of motion in our shoulders, arms, and legs. Just watch out for those water and sand traps!

  • Golf: According to the Arthritis Foundation, swinging a golf club can enhance the range of motion in your shoulders, as well as improve balance and overall coordination. However, be careful on the links if you’ve recently had a knee replacement. Although golf typically is considered a low-impact activity, one study found that a full golf swing can take its toll on new artificial knees, generating high forces in the forward knee and less on the opposite knee.

  • Swimming: Water exercise is often a part of arthritis therapy, since it helps take the load off joints even while you put them through a workout. Modify your technique to fit your needs:

    • Cut back on total distance, but swim the shorter distance at a faster rate.
    • Pick a stroke and intensity level that are comfortable. The breaststroke, rather than freestyle, might be better if you have arthritis in your upper body.
    • Include some resistance exercises that help strengthen your rotator cuffs and the muscles that stabilize the shoulder blades.
  • Tennis: Play doubles instead of singles to cut back on the need for the frequent starting, stopping, and changes of direction that makes tennis so taxing on the knees.
  • Skiing: Switch to somewhat less challenging slopes to cut back on the range of motion required. Mix in some cross-country skiing, which is easier on the joints and probably closer to home.

For further reading on exercise basics, especially for seniors, see these University Health News posts:

Originally published in May 2016 and updated.

As a service to our readers, University Health News offers a vast archive of free digital content. Please note the date published or last update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Helen Boehm Johnson, MD

Helen Boehm Johnson, MD, is a medical writer who brings the experience of a residency-trained physician to her writing. She has written Massachusetts General Hospital’s Combating Memory Loss report (2019, 2020, … Read More

View all posts by Helen Boehm Johnson, MD

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