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Types of exercise

Aerobic exercise, strength training, or individualized exercises? There are several ways to keep physically active if you have osteoarthritis.

Photo of an elderly woman in a black and white striped top and white trousers with nordic walking sticks walking on a footpath in the woods.

Aerobic exercise

Regular aerobic exercise not only relieves osteoarthritis (OA) symptoms but also improves physical and mental health. Aerobic exercise is exercise that increases both heart rate and the body’s oxygen uptake. Increased oxygen uptake not only strengthens the heart but also boosts cardiorespiratory endurance. It also triggers the brain to release endorphins, our body's natural painkillers, and happiness hormones.

If you have OA, not all types of aerobic exercise are beneficial.  Running, football, and tennis, for example, are often not ideal for people suffering from moderate to severe OA. However, this is very individual and a person with mild symptoms who is used to running, for example, may just need to adjust their pace and distance to be able to continue running. It is simply about finding a form of exercise that doesn’t overload the joint and aggravate symptoms. Exercising regularly and in moderation can both reduce joint pain and improve joint function and quality of life.

Strength training

Most people who suffer from OA also have decreased muscle strength. With the help of strength training, you can, amongst other things, strengthen your leg, hip, and upper body muscles to stabilize your joints. Aerobic exercise strengthens the muscles to some extent, but through strength training, you are more easily able to target specific muscle groups (such as the muscles around the OA-affected joint). Strength training can both reduce joint pain and improve joint function. Strength training exercises can be done at home or in the gym, with or without equipment.

If you have OA of the wrist or fingers, you can with the help of specific hand exercises, strengthen the muscles in your hands to increase hand function and reduce pain. These exercises can also be done with or without equipment.

Strength training exercises for a specific joint that are also tailored to your ability, can be obtained from a physiotherapist or an occupational therapist.

Individualized exercises

OA can negatively affect your balance, muscle strength, joint stability, and mobility.  You may feel like your body can’t rely on your knees or hips when you move. Joint pain may change the way you move, for example, you might begin limping when walking. To improve balance, stability, and mobility, individualized exercises aimed at re-learning and optimizing movements are a good start for people with OA who need to improve their movement patterns.

You can find examples of individualized exercises online. A physiotherapist can also provide you with your own individualized exercises, tailored to your abilities and needs. One thing to always keep in mind when doing your exercises is that quality is more important than quantity, i.e., focus should be on doing the exercises correctly.

Examples of suitable aerobic exercise for people with OA of the knee and hip:

Aquatic exercise: If you suffer from a lot of joint pain or are very overweight, aquatic exercise (for example, swimming or water aerobics), which is a low-impact form of aerobic exercise, is ideal. Exercising in water puts less pressure on the joints than exercising on land. However, certain leg movements when swimming (for example the breaststroke kick) sometimes hurt or are slightly difficult to do if you have severe OA of the knee or hip. If so, other swimming strokes or water exercises may be more fitting.

Cycling: Cycling is easy on the knees and can be done either indoors or outdoors. When cycling, you exercise the large muscles in your legs which increases muscle strength and creates stability around the knee and hip joints. Remember to adjust the saddle and handlebar height so that you sit comfortably.

Walking/Hiking: Walking or hiking can be done almost anywhere at any time. A pair of comfortable stability shoes is all you need. If you have a dog, taking it for a longer walk is a great way to get exercising. Walking enables you to easily decide your distance and pace based on your abilities and symptoms. Walking on softer surfaces, for example in sand, strengthens leg muscles and improves stability. However, if you find that too painful, it may be better to walk on a flat, even surface.  If that is also painful, try using walking poles

Nordic walking: Nordic walking is a version of walking that uses special walking poles. Walking with poles reduces joint load in the lower limbs whilst activating the muscles in the upper body. Nordic walking has become a popular form of exercise amongst people with and without OA.

Elliptical trainer: An elliptical trainer is an exercise machine found in most gyms. The motion is similar to running, but unlike running, your feet are in constant contact with the pedals, meaning less stress is placed on your knees.