The secrets of no-trauma exercise for arthritis

By Kim Crawford, M.D. Last updated: December 6, 2018
exercise for arthritis

What can you do to make your arthritis feel a lot better?

Yes, I’d like you to think about that question and say out loud what, besides drugs will make your arthritis feel better. I know exercise for arthritis is just one thing. Sometimes an ice pack or a heating pad or a hot shower, whirlpool bath, massage or a moorbath will indeed help.

However, this article will focus on the specific exercises for arthritis that will make you feel better. It’s important that you exercise safely because “traumatic” exercise is a major cause of osteoarthritis; many people don’t know what is OK and what is not. The article linked is the “don’t do” article, and this is the “please do” article! Enjoy!

treatment of osteoarthritis

Exercise for Arthritis is great pain relief when done correctly:

Long gone are the days when doctors told people with arthritis to “just rest your joints.” In fact, physical activity can reduce pain and improve joint function.

It also produces a noticeable increase in joint mobility which means less stiffness. It improves the general and quality of life for most adults with arthritis, and that includes a definite elevation of mood.

The majority of people with arthritis can safely participate in a self-directed physical activity program. Alternatively, they (you) can join one of many programs available in communities across the country. Some people may benefit from physical or occupational therapy. We’ll get to that in a bit.

What are the benefits of physical activity for adults with arthritis?

Regular physical activity is just as important for people with arthritis as it is for all adults for their general health. Numerous studies have shown that participation in moderate-intensity, low-impact exercise for arthritis (meaning the “right” physical activity) improves function, pain, and quality of life without worsening arthritic disease severity.

Being physically active can also delay the onset of disability if you have arthritis.  Both aerobic and muscle-strengthening activities are proven to work well, and both are recommended for people with arthritis. In fact, muscle strengthening will add muscle mass and therefore “padding” (protection) around affected joints.

If those of you with arthritis are having a difficult time “getting moving” due to symptoms of pain and stiffness, you may benefit from Physical therapy or Water therapy (I’ll discuss this in-depth in this article).

Physical Activity Guidelines for Americans with Arthritis:

Adults with arthritis should follow the Active Adult Guidelines or, preferably the guidelines of the American College of Sports Medicine. Don’t “overdo” it at first. Take all types of activity as tolerated and work up to your goals. (More about how to accomplish this below.)

People with arthritis should also include daily flexibility exercises to maintain proper joint range of motion and add balance exercises if they are at risk of falling. Again, a good Physical Therapist (we’ll discuss) can be useful here to do a personalized “gait and balance” program.

Many adults with arthritis are inactive, even though their doctor may have told them being active will help their arthritis. Perhaps you want to be more active but just don’t know where to start or how much to do. You may be worried that using your joints and muscles may make your arthritis worse. The good news is that the opposite is true, physical activity will help your arthritis! Of course, that means doing the “right” exercise for arthritis-meaning specifically for your arthritis.

The First Step

The first key to starting activity safely is to start slowly. This may mean you are only able to walk 5 minutes at a time every other day. That’s just fine. The second key is to progress slowly. People with arthritis may take more time for their body to adjust to a new level of activity. For example, older adults and those with chronic conditions may take 3–4 weeks to adjust to a new activity level. You should add activity in small amounts, at least 10 minutes at a time, and allow enough time for your body to adjust to the new level before adding more activity.

The most important thing to remember is to find out what works best for you. The ACSM exercise recommendations of 150 minutes of activity per week might sound like a lot of activity. However, if you just work up to this as gradually as you want, you will get there!

Studies show that some increase in pain, stiffness, and swelling is to be expected when you first start an exercise program. If you have increased swelling or pain that does not get better with rest, talk to your doctor. It may take 6–8 weeks for your joints to accommodate to your increased activity level, but if you stick to your exercise program, the result will be long-term pain relief.

Modify activity as needed:

Remember, any activity is better than none. Your symptoms of arthritis, such as pain, stiffness, and fatigue, will come and go. You’ll have good days and bad days. You may want to stop activity completely when your arthritis symptoms increase.

It is important that you first try to modify your activity to stay as active as possible without making your symptoms worse.

If you currently do some sort of activity or feel confident that you can safely plan your own exercise program, you should look for safe places to be physically active. For example, if you walk in your neighborhood or a local park make sure the sidewalks or pathways are level and free of obstructions, are well-lighted, and are separated from heavy traffic.

What Type of Activities Count?

Cardiovascular or aerobic activity is also called “cardio”  or endurance exercise. It is any activity that makes your heart beat faster and makes you breathe a little harder. Please use the guidelines for “breathlessness” and heart rate in this article.

Choose an activity that is moderate or vigorous intensity, and that does not twist or “pound” your joints. Some people with arthritis can do vigorous activities such as running and can even tolerate some activities that are harder on the joints like basketball or tennis.

However, I’m not a fan (even though I’m a former triathlete and marathoner) of anything that “pounds” your back, hips, and knees such as running. But, you know your body, and you like what you like. You should simply choose the exercise that you enjoy which does not cause continued pain. Obviously, if the activity or activities are fun, you are more apt to do them, right?

Muscle strengthening activities:

Muscle-strengthening activities are especially important for people with arthritis because (again) having strong muscles takes some of the pressure off the joints. Do activities that strengthen your muscles at least 2 days per week in addition to your aerobic activities.

You can do muscle strengthening exercises in your home, at a gym, or at a community center. Perform exercises that work all the major muscle groups of the body. These include your back, chest, abdomen, shoulders, hips, legs, and arms.

Instead of trying to follow “traditional guidelines” or doing 2-3 “sets” it is much better for your joints (and you’ll get nearly the same effect) if you do one set of 8–12 repetitions for each muscle group. Here are the steps outlined in an article about how to get a great body in less than an hour per week. Age doesn’t matter! Go ahead and get that great body while you’re at it!

Ways to do muscle strengthening activities:

Lifting weights using machines

Working with resistance bands such as a gym-in-a-bag (my favorite)

Using your own bodyweight as resistance (push-ups, sit-ups, triceps dips, chair mini-squats)

Dumbbells (be careful using these for any affected joints due to balance issues)

Muscle strengthening exercise videos

Balance activities:

Some adults with arthritis may be prone to falling due to muscle imbalances from weakened muscles around arthritic joints. If you have fallen or have even come close, you should see a Physical Therapist for a good balance and gait program.

If you are worried about falling you should include activities that improve balance at least 3 days per week as part of your physical activities plan. Balance activities can also be part of your aerobic or your muscle strengthening activities.

Examples of Balance activities:

degenerative joint disease treatment

Doing Tai Chi is truly wonderful.

Stand on 1 foot and slowly let go of a balancing rail, then hold onto the rail and balance on the other foot. Eventually, the goal is not to use the rail.

Backward walking, sidestepping, and heel and toe walking are all included. Again, start with a rail, if needed.

Aquatherapy for arthritis:

For people suffering from osteoarthritis, the pain relief felt in the hips, back, and knees while in a warm bath is comforting and quite noticeable. For some people with arthritis, especially those who have continued discomfort “on land,” water may be the answer.

It’s a good answer!

Pool therapy, also referred to as aqua therapy or water therapy, allows for cardio and weight training without any discomfort at all.

A pool or tank of warm water provides an ideal environment in which to exercise. Its buoyancy counteracts gravity, thereby decreasing the weight placed on painful joints and the spine. In a buoyant, gravity-reduced environment like water, gentle movements to improve strength, flexibility, and endurance are possible.

water exercise for arthritis

A primary goal of pool therapy is to teach participants new ways of moving. To clarify, you are basically retraining the musculoskeletal system to accommodate the effects of osteoarthritis.

In waist-depth water, buoyancy can support 50 percent of body weight. Obviously, this decrease in weight-bearing stress is one of the great advantages of pool therapy for people who have arthritis. This is especially the case if it’s on the spine and lower extremities.

Spinal arthritis and pool therapy:

People who have osteoarthritis of the spine, sometimes referred to as spinal arthritis, can benefit greatly from pool therapy. What is osteoarthritis of the spine? Osteoarthritis occurs when the cartilage between adjoining facet joints in the back portion of the spine breaks down, causing the joints to become inflamed.

Then, this causes pain when someone is sitting, standing or walking; any activity at all which places weight or friction on the spine. Therefore, the buoyancy of warm water aqua therapy relieves the friction on the painful joints. Joint pain can be especially worse in the lower back (lumbar spine) and the neck (cervical spine). In fact, some patients refer to pool therapy as a form of “floating traction” which allows them to stretch their spine in a way that would be impossible if they weren’t in water.

Examples of Pool Therapy Exercises:

Many movements that are part of pool therapy for osteoarthritis patients look similar to stretching or resistance exercises conducted on land. The difference is that they use the more gentle resistance of water rather than gravity to perform this with their muscles.

Popular pool exercises:

Stretching to improve flexibility is one of the first things most “pool programs” do first. You will stretch your hamstrings and lower back by slowly raising your knees to your chest. Another stretch for the upper back and neck is done by standing away from the side of the pool and leaning forward with arms outstretched to grasp the pool edge.

Strengthening, including using foam dumbbells to complete bicep curls or lateral side raises that work against water resistance will work your upper body. Moving against the resistance of the water with or without light ankle weights will strengthen your lower body. Often you will be asked to simply walk around the pool, raising your knees up high.

Water “cardio” includes the water-walking just described. You’d be surprised at what a workout it is! In addition, slow jogging in a shallow pool will nicely loosen up the lower back and hips.

A great ‘combo’ is called Ai Chi which is a form of Tai Chi developed specifically for aquatic exercise. Ai Chi improves strength, balance, and joint flexibility through slow, gentle movements, controlled breathing and a focus on relaxation.

Physical Therapy for Arthritis

natural pain relief for arthritis

If arthritis is limiting your activities, a physical therapist can help. I am a big fan of physical therapy, especially for individuals 65 and over. So many people “just stop moving” and a good P.T. can crank up the motor again quite nicely!

Physical therapy focuses on the body’s ability to engage in movement. Movement can be anything from getting in and out of chairs to climbing stairs, walking in your neighborhood, playing a sport or doing recreational activities.

Goals of physical therapy in arthritis include improving the mobility and restoring the use of affected joints, increasing strength to support the joints, and maintaining fitness and the ability to perform daily activities.

Physical therapists are licensed professionals who examine, diagnose and treat or help prevent conditions that limit the body’s ability to move and function in daily life, according to the American Physical Therapy Association.

How can a Physical Therapist Help you?

They can teach you proper posture and body mechanics for typical daily activities to relieve pain and improve function.

They can develop an individualized plan of exercises to improve flexibility, strength, coordination and balance to achieve optimal physical function.

They can show you how to use assistive devices such as walkers and canes properly.

They can suggest modifications to your environment, such as ergonomic chairs or a cushioned mat in your kitchen, to relieve pain and improve function.

They can recommend different treatment options, such as braces and splints to support joints, shoe inserts to relieve stress on the lower extremities, and hot and cold therapy to ease joint pain and stiffness.

What Happens during a Physical Therapy session?therapy for arthritis

When visiting your P.T., think clearly about what your complaints are and what you would like to be able to do after physical therapy.

Your goal can be getting in and out of your car without pain, raising up on your toes or raising your arms to reach items in your kitchen cabinets.

Perhaps your goals are to take a walk or perform your job without pain in your knees. Your therapist can then work with you to develop a plan that is right for you to achieve your goals. Don’t take “someone’s plan” for you; it must be discussed and shared.

The goal of a physical therapy session is to teach you how to do things in your treatment plan such as performing certain exercises, or how to use hot/cold compresses best yourself. The visits are often short, and they focus on two basic areas. One is to help you identify problems with your physical function, and the other is to give you strategies for care that you can do at home. These include specialized (“ther-x”) therapeutic exercise for arthritis.

The key to a successful outcome is learning the exercises from a physical therapist and practicing them at home regularly. Improvement is gradual. The body gets stronger and steadier over time, so you need to practice what you learn on your own.

What about Occupational therapy?

Occupational therapy can teach you how to reduce strain on your joints during daily activities. Occupational therapists can show you how to modify your home and workplace environments to reduce motions that may aggravate degenerative joint disease AKA osteoarthritis. They also may provide splints for your hands or wrists, and recommend assistive devices to aid in tasks such as driving, bathing, dressing, housekeeping, and certain work activities.


You only have one body, so you must take care of it. Being as healthy as you can will help to stop the progression of your arthritis. Please take a look at the foods to avoid with arthritis article and know that you don’t have to take drugs; there are safe and effective natural remedies for arthritis.


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