Motion without guesswork

Which arthritis exercises are useful?

Use a simple mix of walking, strength and balance. Rise slowly from a firm chair, then sit back down without dropping. For balance, hold a counter and step onto a low step. Keep your knee over your foot and your body upright. Gentle arm movement can help a stiff shoulder keep moving. You don't need a gym. Stop when you can't keep the movement slow and controlled. You'll need some rest before repeating it.

Useful exercise makes daily work easier.

What if movement keeps making it worse?

Stop guessing when each try brings swelling, a lasting limp or less movement. Note what you did, how long it took and how the joint felt later. A clinician will use those notes during the exam. QC Kinetix also offers regenerative treatments for joint soreness. That means a clinic clinician prepares material from your body and places it into the sore joint with a needle. It's non-surgical care, but you'll still need a medical review. Ask what you can expect afterward and what would rule it out.

Don't accept care you don't understand.

When can I add more?

Don't add more until the current workout feels manageable. Then increase either time or effort, but not both. Use your usual route when you walk longer. Keep the chair-rise count unchanged when you squat lower. If the joint feels near normal next morning, the increase was likely reasonable. If soreness builds for days, you'll need to do less.

A useful gain won't cost you several bad days.

Sources

1. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis extracted data from 54 studies, with high-quality evidence from 44 trials (3,537 participants) that exercise reduces pain immediately after treatment, and further high-quality evidence that it improves physical function. Benefit attenuates but persists for at least two to six months after the programme ends.

   Fransen M, et al. — Exercise for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD004376.pub3.

2. The Cochrane review of exercise for HIP osteoarthritis found high-quality evidence from nine trials (549 participants) that exercise reduced pain (SMD -0.38, 95% CI -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment, equivalent to about 8 points of pain relief on a 0-100 scale with a number-needed-to-treat of 6.

   Fransen M, et al. — Exercise for osteoarthritis of the hip.. Cochrane Database Syst Rev, 2014. DOI: 10.1002/14651858.CD007912.pub2.

3. In 1,212 Osteoarthritis Initiative participants aged 50+ with knee OA, those who walked for exercise had a LOWER likelihood of developing new frequent knee pain than non-walkers (odds ratio 0.6, 95% CI 0.4-0.8), and less progression of medial joint space narrowing - evidence against the belief that walking wears the joint out faster.

   Lo GH, et al. — Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals With Knee Osteoarthritis: Data From the Osteoarthritis Initiative Cohort.. Arthritis Rheumatol, 2022. DOI: 10.1002/art.42241.

4. A 52-week single-blind randomized comparative-effectiveness trial in 204 people with symptomatic knee OA found Tai Chi twice weekly for 12 weeks produced WOMAC improvement of 167 points versus 143 points for standard physical therapy, a non-significant between-group difference of 24 points. Benefits were maintained to 52 weeks and the Tai Chi group had significantly greater improvement in depression and the physical component of quality of life. No serious adverse events occurred.

   Wang C, et al. — Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial.. Ann Intern Med, 2016. DOI: 10.7326/M15-2143.

5. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use, hand orthoses for first-CMC joint OA, tibiofemoral bracing, topical NSAIDs for the knee, oral NSAIDs and intra-articular glucocorticoid injections for the knee; acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol are only conditional.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

6. OARSI designates arthritis education plus structured land-based exercise (with dietary weight management for the knee) as CORE treatments for knee, hip and polyarticular OA. Topical NSAIDs are Level 1A for knee OA. Intra-articular corticosteroids, intra-articular hyaluronic acid and aquatic exercise are Level 1B/2 for the KNEE only and are NOT recommended for hip or polyarticular OA. Acetaminophen is conditionally not recommended, and no oral NSAID is recommended for people with cardiovascular comorbidity or frailty.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.