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Feeling At A Loss With Arthritis? To Exercise Or Not To Exercise? Surgery Or Not To Have Surgery?

Knee Arthritis

In clinic we have been hearing a lot of people confused and worried about whether they should exercise if they have arthritis.

We have heard some clients mention that they rest and avoid exercise when they experience pain from arthritis.

We have also worryingly heard that many clients regard arthritis as something they have no control over and therefore avoid exercising altogether as they think their arthritis will just get worse anyway so "what’s the point in doing exercises, I’m doomed for a life of misery and end up in surgery".

If you are struggling with pain and stiffness you know that nothing can kill your optimism for a recovery faster than being told by a doctor that you have Osteoarthritis (OA). 

Osteoarthritis is often seen as a kind of death sentence for joints. Many people believe that if you have OA your pain will never improve, and it will keep getting worse until a joint replacement is needed.

This has been conventional wisdom for decades. Many of us see our bodies like cars, when a part ‘wears out’ it needs replacing with a new one. The truth with the human body is that it is much more complicated than a car, mainly due to our body’s incredible ability to adapt and change.  

Let me give you some facts about Osteoarthritis. It’s a very common condition where the cartilage surface which covers the bone ends wears down gradually over time. Now this cartilage is different to the cartilage that is between your knee called your ‘meniscus’, so when you hear people say I’ve torn my cartilage it is the meniscus they are talking about and not the cartilage involved in arthritis.

Cartilage acts as a buffer/shock absorber between bones, however unlike other tissue does not have a blood supply which means it does not heal when damaged. It’s best to think of the cartilage covering your bones like the tyres on your car.

The more miles you do in your car the more worn the tyres will be and it’s the same for the cartilage covering your joints. Fact! - It is true that you can’t change the condition of the cartilage of your joint HOWEVER, you can limit the progression of the wear and the only way to do this is by EXERCISING.

While exercise is a very powerful treatment, it’s not that you can choose any old exercise at and that expect that it will take away any pain so please don’t rush off to doctor Google or Dr. YouTube and type in exercises for arthritis as these could cause more pain and stiffness. 

And…. please please please do not try exercises recommended by family and friends thinking “I’ll just give these a try and see how I go”, as what works for them probably will not work for you.

Ask The Experts

Specialist physiotherapists are the best people to talk to when it comes to Osteoarthritis as we have always known that the pain and disability that comes with arthritis can be improved with a closely targeted exercise programme. In some cases, the pain that is attributed to Osteoarthritis is actually due to another, entirely treatable cause. In other cases, strengthening the muscles around the painful joint can have a significant effect by providing the joint with extra support.  

The way we move is often affected by pain and this in itself can create a downward spiral. 

1. Keep Those Joints Moving

So, with that in mind the first and most important aspect of managing arthritis is to improve/maintain the movement you have. Joints have a fluid inside them called synovial fluid, this fluid lubricates the joint so that they can move freely, and this fluid also nourishes the joint.

If joints do not move through their full range not all areas of the joint will get nourished by the synovial fluid so they will indeed wear down quicker. 

2. Get Fully Assessed

To be effective, you will need to have a full assessment and have a personalised treatment programme created by your specialist physiotherapist. This can involve identifying weak muscles, limitations in flexibility, finding painful trigger points, help restore movement to stiff joints and providing biomechanical assessment. By making a combination of changes a large difference can be made to your pain and helping you get back to activities you are currently missing out on.

A specialist physiotherapist will not give you a generic sheet of exercises out of the drawer or off their computer that kind of treatment is as good as doctor Google and really irritates me. A specialist physiotherapist will give you time to explain what’s been going on with you, complete a thorough assessment and put together a tailor made programme specific to you and your needs.

A specialist physiotherapist will be able to identify any external factors that may be contributing to your pain. These can include unsupportive footwear, the way you sit, doing the wrong type of exercise to name but a few.

3. Get Active

Cardiovascular exercise is very important to remember to do when you have Osteoarthritis as it helps keeps your heart healthy, reduce weight so as to take strain of the joints and to strengthen your bones. If you haven’t exercised for a while start with going out for a gentle walk every day. Aim for at least 20 minutes but if you can’t manage that at the moment start with what you can manage even if it’s only a few minutes, as something is better than nothing.

Swimming is another great way to exercise as it takes the stress off your joints whilst keeping them moving and working your heart all at the same time. We often treat clients in the water so if walking aggravates your joints why not go to your local pool.

4. Strength Training

Strength training is very important for arthritic joints. The stronger the muscles are that surround the joint the more stable the joint will be, the better it will move and the less likely it is to degenerate as fast. For example, in knee Osteoarthritis it is particularly important to get the knee as straight as possible and if you have weak thigh muscles you will not be able to achieve this. Scary fact if knee straightening is limited by even only 10% this can cause much more stress on the knee cap and cause pain, stiffness, it will affect your ability to walk well, go up and down stairs and even your ability to get out a chair easily.


So, let’s go back to surgery as I know some of you reading this will think but I’ve had physio before and my knee/hip or whatever joint it is, is still the same and my doctor is recommending surgery.

It is true that in some cases, surgery is the best and most effective option to improve your quality of life but please see a specialist physiotherapist first to seek treatment for your arthritic pain as all too often we’ve seen people in clinic who either have had a physio treatment plan that is quite frankly so awful it’s an embarrassment to our profession or they’ve had a joint replacement done too early and they do live to regret it.  

So why is it that they regret having surgery?.... The simple answer is their brain still remembers what it was like to have a joint that moved well and with no pain. A new replacement joint will never be as good as the original joint you were born with so my tip is try and keep it for as long as you can. 

So with this in mind I would like to let you know about a recent study has shown that with targeted exercises, directed by physiotherapists – many people who were scheduled to have surgery were able to improve their quality of life dramatically, avoiding surgery and getting back to their favorite activities.  

Don't Forget There Is Help Out There

So, as you can see there is plenty that can be done to ensure you are able to keep your joints in the best condition possible without needing to have surgery. This will mean you can keep active, independent and mobile and able to enjoy doing the things you love to do for the longest time possible.

Talk to us to see how we can help you manage your osteoarthritis. 

None of the information in this article is a replacement for proper medical advice. Always see a specialist physiotherapist for advice on your individual condition. 

P.S. If you’ve got any aches and pains right now, and your knee feels bad, head to this website to download our free tips guide with plenty more actionable advice to help ease knee pain: www.wdcphysio.wpenginepowered.com/physiotherapy/knee-pain/

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Knee Pain Guide

Download our FREE Guide: "7 Simple Ways To Stop Daily, Annoying Knee Pain"

– by lead Physiotherapist Wendy McCloud



Wendy founded WDC in September 2006. She has worked in both the public and private sectors. Within the NHS, Wendy worked as a Senior Musculoskeletal Physiotherapist and an Extended Scope Practitioner Physiotherapist as part of an Orthopaedic Consultant’s team specialising in Shoulder Pain. Wendy has treated royalty for Shoulder pain through referrals from her close links with a top Orthopaedic Shoulder Surgeon. More recently, Wendy has been the sole choice physiotherapist for all Essex-based referrals from London Shoulder surgeon Mr Matthew Sala. Wendy also worked within the national rugby union as the head physiotherapist for Southend Rugby Football Club. She led the medical service at the club for 11 years, working with players who achieved county honours and representative honours for various countries such as England, Samoa, Australia, and New Zealand.
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