Osteoarthritis: which exercises are suitable for different joints and levels of discomfort?
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Having osteoarthritis does not mean putting your joints under glass and avoiding movement. Quite often, the opposite happens: when we move less because we are afraid of pain, everyday tasks gradually become harder. Muscles lose strength, range of movement decreases and balance may feel less reliable, encouraging even more avoidance.
Exercise is a core part of osteoarthritis management. Muscle strengthening, mobility work, endurance activity and exercise in water can all help reduce pain and the impact of symptoms on everyday life. The French Haute Autorité de Santé (HAS) regards appropriate physical activity as a first-line approach in peripheral osteoarthritis. But that does not mean copying any exercise programme you find online. A sensitive knee, a stiff hand and someone restarting after months of inactivity all have different needs.
The most useful question is not “What is the single best exercise for osteoarthritis?” but “What movement will help me today, and how can I progress without exceeding what my joint can tolerate?”
Why is exercise so important in osteoarthritis?
A joint never works alone. Standing up, climbing stairs or carrying a bag also depends on surrounding muscles, balance, coordination and endurance. Strengthening the thigh muscles can improve control of the knee; strengthening the gluteal muscles supports pelvic stability and walking mechanics.
Strength is only part of the picture. Range of motion, endurance, balance and proprioception — the sense of where your body is and how it moves — may also need attention. HAS recommendations therefore emphasise combining several exercise approaches rather than relying on one activity alone.
Should exercises be adapted to the stage of osteoarthritis?
Yes, but not by following an oversimplified internet chart that assigns one exercise to “stage 1” and another to “stage 4”. X-ray grading describes structural changes, but it does not tell you precisely what someone can still do. People with similar imaging may have very different symptoms and mobility.
HAS guidance supports adapted activity at all stages of osteoarthritis when the condition is stable. The programme should reflect actual difficulties: stiffness, muscle weakness, reduced balance, walking problems or limitations in daily tasks. In practice, adapt the exercise to the person, not simply to the number on a report.
Does mild discomfort during exercise mean you should stop?
Not necessarily. After a period of inactivity, muscles may feel more noticeable and there may be a small, temporary increase in discomfort as activity resumes. This does not automatically mean that the joint is being damaged. NICE acknowledges that pain may increase briefly at the start of an exercise programme even though regular activity can improve pain, function and quality of life in the longer term.
However, exercising through severe or rapidly worsening pain is not the goal. Marked pain during movement, swelling, limping or substantial deterioration after each session means the load should be reduced and the situation may need assessment. Aim to challenge your body at a level from which you recover comfortably.
Which exercises can help with knee osteoarthritis?
For the knee, simple exercises can work on thigh strength, bending and straightening the joint, and functional tasks such as standing up from a chair. Start with a manageable number of controlled repetitions and increase gradually.
Standing up from a chair
Sit on a stable chair with your feet flat on the floor. Lean your upper body slightly forward, press through your feet and stand up, then lower yourself slowly. If this is difficult, begin with a higher chair or use your hands lightly for support. As you improve, try rising without pushing with your arms. A few well-controlled repetitions matter more than aiming for twenty straight away.
Seated knee extension
While seated, slowly extend one leg until the knee straightens comfortably, without forcing it into a locked position. Briefly contract the thigh muscle, then lower the foot. This works the quadriceps without the full load of standing exercises and may be more manageable when squats feel too demanding.
A shallow squat, if your knee tolerates it
Stand with your feet approximately hip-width apart. Move your hips slightly backwards as though sitting down. There is no need to squat deeply: a small amount of knee bend can already engage the thigh and gluteal muscles. Use a worktop or sturdy chair for support if needed. The goal is better control, not a perfect gym squat. For background on this joint, see our guide to gonarthrosis.
Which exercises can help with hip osteoarthritis?
When the hip becomes sensitive, people often focus on stretching, yet strength around the pelvis matters just as much. The gluteal muscles help stabilise the body when walking and standing on one leg.
Standing hip abduction
Stand beside a stable table or chair for balance. Keep your upper body upright and slowly move one leg sideways without rotating the pelvis. The movement can be small. Try to feel the muscles on the outside of the hip working without leaning in the opposite direction.
The bridge
Lie on your back with your knees bent and feet on the floor. Gradually lift your pelvis, engaging the gluteal and back-of-thigh muscles. Start with a small range of movement. If the exercise causes clear hip or back pain, reduce the range or choose another exercise.
Simple mobility work
Move the hip regularly within a comfortable range. While sitting, alternately lift each knee a few centimetres or perform small, controlled hip rotations. Walking can also help when tolerated. Our walking guide looks at how to adjust distance and pace.
Hand osteoarthritis: which movements may help?
With the hands, the goal is often to preserve mobility, dexterity and the ability to use the fingers for everyday tasks, rather than to develop strength in the same way as with the thighs.
Gently opening and closing the hand
Straighten the fingers without forcing them backwards, then gradually close the hand again. You do not need to make an extremely tight fist. Move gently through the available range, particularly after a period of inactivity.
Practising thumb opposition
Touch the tip of the thumb to the index, middle, ring and little fingers in turn. This supports a movement essential to everyday fine-motor tasks: making a pinch grip between the thumb and fingers.
Sliding the fingers
Place the hand flat and slowly bring the fingers together or move them apart without forcing the maximum range. A few regular movements may be more useful than one long occasional session. Reviews discussed by HAS suggest that hand exercises can improve pain, activity limitations and finger mobility in the short term.
If pain is concentrated at the base of the thumb, rhizarthrosis may be involved and exercises should be more targeted. See our guide to thumb-base osteoarthritis.
What about osteoarthritis of the foot or ankle?
Generic advice needs particular care here: osteoarthritis of the big toe is not managed in exactly the same way as an ankle that has become stiff after an old injury. Walking barefoot is not universally recommended and may increase discomfort for some people.
When tolerated, simple ankle movements can be useful: while seated, gently point the toes towards you and away again or make small ankle circles. Heel raises exercise the calves and ankle control but may need modification when the big toe or forefoot is painful. If pain changes how you bear weight or walk, a medical or podiatry assessment is preferable to experimenting with random exercises.
What if osteoarthritis affects the back or neck?
Avoid one-size-fits-all programmes. Neck and lower-back pain have many possible causes, and osteoarthritis visible on an X-ray may not fully explain symptoms. In the absence of warning signs, gentle movement and progressively building strength and mobility are often preferable to remaining immobile.
For the lower back, comfortable pelvic movements, walking and gradual trunk strengthening may be suitable. For the neck, favour small, controlled movements rather than forceful rotations. Pain radiating into an arm or leg, persistent tingling, weakness or neurological symptoms need professional assessment rather than an online exercise routine.
Should you stretch if you have osteoarthritis?
Stretching can help when tight muscles restrict movement, and HAS includes muscle–tendon stretching among approaches that may help range of motion and function. But stretching should not be the only activity in the programme, and forcing a joint into pain is not useful.
A stretch should create progressive tension in a muscle, not deep joint pain. To improve stair climbing, standing up or walking endurance, strengthening exercises will usually also be important.
Do cycling, swimming and walking count as exercise for osteoarthritis?
Absolutely. Exercise does not have to be a forty-five-minute physiotherapy routine. Aerobic activity matters as well. Cycling moves the legs through a regular repeated pattern; water-based activities may feel more manageable when body weight makes some movements difficult; and walking relates directly to independence.
HAS evidence reviews describe benefits from aquatic exercise in knee and hip osteoarthritis and from aerobic exercise in knee osteoarthritis. A useful programme often combines daily movement, endurance activity and a few carefully chosen strengthening exercises.
How often should you do the exercises?
There is rarely a need to begin with a huge programme. HAS highlights the value of learning a small number of simple, memorable exercises, because long-term consistency is essential.
Start with two or three movements suited to your needs and a few controlled repetitions. See how your body responds. As exercises become easier and are well tolerated, gradually increase repetitions, duration or resistance. This is usually more useful than attempting fifteen exercises once and then stopping for ten days.
When should you reduce or stop exercising?
There is an important difference between stable osteoarthritis and a very painful swollen flare. During a flare, pain may increase substantially and movement may become difficult. Activity may need to be reduced temporarily, with relative rest, before returning gradually as symptoms settle.
Unusual pain, joint locking, giving way, significant swelling or continual worsening require medical advice. If you are not sure what is causing your pain, our joint pain guide may help you understand why assessment matters before choosing targeted exercises.
Can exercise really reduce osteoarthritis pain?
Yes — this is one of the most important messages. HAS evidence reviews indicate that exercise for knee osteoarthritis can reduce pain and activity limitations and improve quality of life. Targeted strengthening has also shown benefits for symptoms and function. Positive effects are reported for hip osteoarthritis, while some improvements in mobility and activity have been observed with hand osteoarthritis exercises.
Exercise is not merely generic advice to “move because movement is healthy”: it is an important part of evidence-based osteoarthritis management.
Should you work with a physiotherapist?
Not for every walk or small movement, but individual support is particularly useful if you do not know where to start, have lost substantial mobility, experience difficulty with several activities or find that exercising alone repeatedly makes symptoms worse.
A physiotherapist can assess your walking pattern, strength, range of motion and compensatory movements, then build a programme tailored to your abilities. HAS recommends physiotherapy in particular when there is substantial stiffness, muscle weakness or impaired proprioception.
And what about food supplements?
Supplements do not replace movement. Even a carefully formulated joint food supplement cannot strengthen your thigh muscles for you or substitute for mobility work. A nutritional approach may be used as part of a broader routine.
Laboratoire Vital Santé offers two different formulations, Cartilamine Phyto and Cartilamine Chondro. Their ingredients and intended approaches are explained in our joint supplement comparison. Our glucosamine and chondroitin guide explores the individual substances.
Which exercises are worth remembering?
There is no “miracle exercise”. The most useful approach is often less dramatic: a few well-chosen movements, practised regularly and progressed at a pace you can sustain. Strength matters for the knees and hips; mobility matters for stiff joints; small controlled movements can support hand dexterity; and suitable walking, cycling, swimming or other aerobic activity helps maintain endurance and independence.
Rather than asking how to do more, ask which exercises help you most and how to repeat them often enough to become a habit. That is usually more productive than one heroic session followed by a week of inactivity.
Sources
- Haute Autorité de Santé — Prescribing physical activity for peripheral osteoarthritis: muscle strengthening, mobility, endurance, balance and water-based exercise.
- French National Health Insurance — Management of knee osteoarthritis: physical activity, rehabilitation and painful flares.
- French National Health Insurance — Management of hip osteoarthritis: exercise and adaptation to symptoms.
- NICE — Osteoarthritis in over 16s: tailored therapeutic exercise and strengthening.