Here’s the Link between Osteoarthritis and Exercise | Chris Kresser
Last Chance – ADAPT Health Coach Training Program Enrollment Ends May 26   Learn more

Here’s the Link between Osteoarthritis and Exercise

by Chris Kresser

Published on

Osteoarthritis and exercise are connected. Engaging in regular, moderate workouts—like this woman swimming—can help prevent the condition or ease symptoms.
Osteoarthritis and exercise are connected. Regular, moderate workouts—like swimming—can help prevent the condition or ease symptoms. iStock/torwai

If you have osteoarthritis (OA) and are struggling to find an effective solution to manage the pain and other symptoms it causes, you have options. It’s also possible to stave off the condition as you grow older.

You may be able to control and even prevent this debilitating disorder by going it on your own—that is, without pharmaceutical or surgical intervention. How? Good ol’ physical activity. Let’s explore the well-established link between osteoarthritis and exercise.

Is It OA? What You Need to Know about This Joint Disorder

Osteoarthritis (OA) is the most prevalent form of arthritis and the most common joint disorder in the United States, affecting some 30.8 million American adults—that’s nearly one in every 10 of us. This number is only expected to increase as the population ages and more and more people live their lives overweight or obese. (1, 2, 3) If you’re carrying extra pounds, you put added stress on your joints, which increases your likelihood of developing the disease. Obesity may also lead to metabolic changes that bring about the disorder. In addition to age and weight, other risk factors for OA, some of which are modifiable and some not, include: (4, 5)

  • Joint injury and repetitive use: Any joint damage, whether from serious injury or being overworked, increases risk; if you’re an athlete or work a physically demanding job, you may be more susceptible to OA.
  • Gender: Women over the age of 45 are more likely to develop OA than their male peers.
  • Genetics: If you have a family member with OA, you’re more likely to develop it as well.
  • Race: Studies show that the risk of developing osteoarthritis by age 85 is higher in Caucasians than in African Americans (41 percent compared to 29 percent).
  • Muscle weakness and low bone density: These factors are thought to contribute to the development and progression of OA.

If you’re concerned about developing osteoarthritis or you’re already experiencing joint pain, exercise may help. Check out this article to find out which workouts can help with OA. #healthylifestyle #wellness #chriskresser

Normally, cartilage cushions the ends of bones in your joints, allowing your joints to glide smoothly during motion. With OA, the cartilage breaks down and the smooth gliding surface becomes rough. As OA worsens over time, the underlying bone begins to change. Although these changes usually develop slowly, the cartilage can wear away completely, leaving bone to rub directly on bone. The results?

  • Pain
  • Swelling
  • Stiffness
  • Cracking or grinding sounds when moving
  • A loss of range of motion (flexibility) and function; OA is a leading cause of disability
The chronic condition can affect any joint, but it occurs most often in knees, hips, hands, big toes, and the spine, including the lower back and neck. Although there is no cure, the above symptoms can be managed.

The Connection between Osteoarthritis and Exercise: Managing Risk and Preventing Pain

Exercise, we now know, is a vital part of any OA prevention or treatment plan. In fact, exercise is typically recommended, even in conventional medical circles, as a first-line defense and management strategy before over-the-counter medicine or prescription drugs. Studies have shown comparable OA pain-relieving effects between physical activity and oral analgesics. (6, 7, 8)

Unfortunately, despite recommendations by physicians, clinicians, and health coaches to get moving, people with OA just aren’t exercising. It could be a holdover from previous generations, when doctors told their patients to rest and avoid movement that caused pain. Unfortunately, some elderly people with OA likely get worse as times goes by because they follow this outdated advice. Or perhaps some individuals are fearful that any discomfort means they’re causing joint damage. Whatever the reason, a national survey found that roughly 40 percent of those diagnosed with arthritis are inactive, meaning they don’t engage in any sustained periods of physical activity (10 minutes or longer) within an average week. (9, 10) I hope this article will help change that.

The research clearly shows that exercise is a must, whether you want to prevent OA or already have a diagnosis. Here’s why.

Exercise Keeps Your Joints Healthy and Pain Free

The adage “use it or lose it” applies here—regular moderate exercise keeps the body moving as it is designed to move, preventing joints from weakening and that all-important cartilage from breaking down. Animal studies even suggest that exercise can prevent further cartilage degradation in older or injured joints that have already suffered some loss. (11) Research in rats has also shown that exercise effectively relieves OA joint pain, including pain resistant to nonsteroidal anti-inflammatory drugs. (12)

It Helps You Lose Weight

You already know that obesity is a significant risk factor for OA. One meta-analysis of 47 previously published studies found a threefold increased risk for knee OA in overweight or obese individuals. (13) But here’s the good news: It’s also one of the most modifiable risk factors when it comes both to the development of OA and its progression. It’s been suggested that at least half of all cases of symptomatic knee OA could be prevented if the obesity epidemic were better controlled. The Framingham Study found that women who lost 11 pounds or more over 10 years reduced their risk of knee OA by 54 percent. (14, 15)

As previously shared, excess weight puts added stress on joints, particularly weight-bearing joints like the hips and knees, increasing the odds that cartilage will break down, the joint will fail, and OA will develop. Losing those extra pounds relieves that pressure. But that isn’t the only reason obesity and OA go hand in hand. Overweight individuals typically have inadequate muscle mass to properly support their weight, which can advance the onset of OA. They may also be less active, which only leads to further weight gain and muscular deficits and a further risk for the disease. (16) Evidence also suggests that added stress on joints leads to the release of arthritis-promoting pro-inflammatory cytokines, while weight loss reduces cytokine levels. (17, 18) And it appears that obesity brings on metabolic abnormalities, including excessively high levels of insulin, that are associated with OA. Not surprisingly, exercise may prevent or mitigate these changes. (19, 20, 21)

It Gets You out of Your Chair and off the Couch

A sedentary lifestyle can also cause metabolic shifts that may lead to OA, alterations that can be prevented through physical activity. (22, 23) After all, sitting six hours or more a day is far outside of the evolutionary norm for humans. Beyond the connection to metabolism, prolonged sitting is generally associated with an increased risk for OA and increased risk for pain and other complications from the disease. This may be because sedentary behavior degrades muscle strength and posture, impacting joints, especially in the spine. Sedentary individuals who spend significant time on smartphones and tablets further increase their risk of OA in hand joints. What’s more, lack of activity decreases pain tolerance and stiffens joints (24, 25). Conversely, physical activity appears to lubricate joints and strengthen cartilage. (26, 27)

Exercise Strengthens Your Muscles and Builds Bone

In one study, women who developed knee OA had quadriceps muscles that were 18 percent weaker than those without OA; the weakness predated the onset of the disease and was likely a contributor to its development. Weak quadriceps muscles cause the knee to become less stable, of special concern for athletes and others at increased risk for OA from joint injury or overuse. (28, 29) Treadmill exercise, in particular, has been found to block bone loss, which might help stabilize joints. (30) Of course, strength training is also a very effective way to build muscle as well as bone.

The Best Proven Exercises for Osteoarthritis

For overall health benefits, including OA prevention and treatment, experts recommend adults engage in around 150 minutes of at least moderate physical activity weekly.

Moderate activity three times or more per week has been shown to reduce the risk of arthritis-associated disability in study groups by an average of 47 percent. (31, 32, 33) That said, any activity is better than none, and every minute of movement is beneficial. Since joint injuries can cause or worsen OA, if you’re looking to prevent the condition or manage symptoms, choose moderate low-impact activities, such as:

  • Walking
  • Cycling
  • Swimming

These guidelines line up with the recommendations set by my colleague Dan Pardi, which I support, to occasionally push yourself as our ancestors did with bouts of relatively intense activity. (34, 35) In addition to the aerobic exercises mentioned above, we also encourage low-impact muscle-strengthening activities like lifting weights and yoga. Yoga also promotes flexibility to help maintain joint range of motion. Hatha yoga, or the practice of physical postures called asanas, has been found to provide marked improvements in pain and function in subjects with knee OA. (36)

Exercises that strengthen the quadriceps muscles in particular may be especially useful in the prevention and treatment of OA. As one study above highlighted, quadriceps have been shown to be weak in subjects who develop OA, suggesting it’s a risk factor. Research indicates that quadriceps-strengthening exercises can improve strength and function and reduce pain in those with knee OA. These include isometric exercises (in which a particular muscle is contracted without moving the affected joint) and isotonic resistance exercises (where both muscle and joint move, such as in weightlifting) when tolerated. (37, 38, 39)

Tai chi may also be beneficial: Its weight-bearing postures help improve strength while simultaneously promoting flexibility and balance. Studies show it may help relieve OA pain. (40, 41)

Can Exercise Actually Increase the Risk of OA?

It’s true that certain athletic injuries and extreme and excessive physical activity could set the stage for OA, but there isn’t any convincing evidence linking moderate or even vigorous low-impact exercise with an increased risk of OA or an accelerated progression of the disease. (42, 43, 44, 45, 46)

However, as you now know, there is a wealth of research showing that exercise has profound benefits for joint health. I hope you’ll get moving to stave off OA or help manage its symptoms, as well as improve your overall well-being.

Bonus: Another Great Way to Protect Your Joints

In addition to exercise, incorporate gelatin into your diet for extra joint (and bone) protection. Research shows it may be effective in treating osteoporosis and osteoarthritis, as it helps combat pain and inflammation and build stronger bones.

Do you plan on working more exercise into your daily life as a way to prevent OA? Or are you already experiencing symptoms of the condition? Leave a comment below and tell your story.

  1. I’m a 63 year old female and have lifted since my mid 20s. I ran 5 miles a day also, until I couldn’t run anymore due to fallen metatarsals, and severe plantar fasciitis. I continued to weight lift until I hit 58, when I found myself in severe pain every time I worked out. It took a couple of years to realize all the pain was caused by osteoarthritis on my neck, lower back and foot. It has now developed in my shoulders, elbows, wrists and thumbs. I’ve learned to lighten up the weights, use machines more, and avoid certain exercises. I use my elliptical and walk for cardio now. I take CBD for the pain everyday and use a CBD cream on my joints before I workout. I’ve been Paleo 8 years and lately follow AIP and include collagen, glucosamine and chondroitin daily. I know it is hereditary because my mother had it pretty severe, but didn’t exercise a day in her life. I wonder if I could have avoided OA, had I not been such a diehard in my younger years. I’ve found my joints can’t handle the weight that my muscles can, so I’m actually going to meet up with a trainer who has an MS in physical rehabilitation. It has been very difficult to find someone who has expertise in helping older women who have lifted most of their lives. Any thoughts, or suggestions?

Leave a Reply