Exercise Won’t Wreck Your Joints, It Will Save Them
If you’ve been told you have arthritis, or you’re starting to feel that stiffness in your hips and knees, there’s a good chance your instinct is to protect the joint by moving it less. It makes sense on the surface. If something hurts when you move it, stop moving it, right?
Orthopaedic surgeon and sports scientist Dr Thomas Naylor sees the fallout from this thinking every day in his clinic, and he’s on a mission to correct it. For years, doctors described osteoarthritis as “wear and tear”, a phrase that quietly told patients their joints had simply worn out from use. Naylor believes that language did real damage. Genetics largely determine whether your cartilage breaks down, and a previous injury can compromise the joint surface, but using your joints isn’t what causes arthritis.
More importantly, a recent study from Arthritis UK found exercise to be the most effective way to reduce arthritis pain and improve mobility. It’s not a neutral activity that you can take or leave. It’s protective.
Why movement helps
There’s a simple mechanical reason exercise benefits arthritic joints. Cartilage, the smooth surface that lets your bones glide against each other, relies on movement to stay nourished. Movement flushes fluid through the cartilage, keeping it healthy and functional.
On top of that, exercise builds strength and range of motion around the joint, and general activity improves blood flow. Naylor describes these benefits as compounding on one another, which is why he considers getting back into exercise the single best thing you can do for painful, arthritic hips and knees. He’s seen patients arrive convinced they need a hip replacement, only to find their symptoms improve enough that surgery is no longer necessary.
What to expect when you start
If you haven’t exercised in a while, expect some discomfort, particularly with movements that target your range of motion. A joint that hasn’t moved much resists moving again. Naylor’s advice is to push through that initial discomfort, because the joint will become more supple and day to day pain will reduce as a result.
Start conservatively with your repetitions. These exercises look simple, but your stabilising muscles will be working hard, and some delayed onset muscle soreness in the following days is normal.
Aim for this routine at least three times a week. Most people notice a real difference after about three months, at which point you can return to the activity you actually enjoy, whether that’s walking, swimming, cycling or something else entirely. If your pain gets progressively worse over a few weeks rather than easing, that’s the signal to check in with your GP or a musculoskeletal practitioner.
The routine
For each exercise below, work towards three sets of ten repetitions. For the stretches, hold for at least twenty seconds. Build up the repetitions and stretch duration as your body allows.
Seated knee extension – strengthens the quadriceps and improves knee range of motion. Sit in a chair with both feet flat on the floor and your back braced against the chair. Straighten one leg out in front of you, hold for around five seconds while contracting the thigh muscle, then lower slowly. Work through one side before swapping. If you can’t fully straighten the leg, go as far as you comfortably can, your range will improve over time.
Sit to stand – builds the quadriceps and glutes while improving hip and knee mobility. From a seated position, stand up without pushing off with your hands, keeping good posture and pushing your hips forward as you rise. If that’s too much, try a supported squat instead: hands on a sturdy surface, a chair behind you for safety, and lower yourself as far as you safely can before standing back up.
Standing hip abduction – strengthens the glutes and hip abductors to stabilise the hip joint. With your hands resting on a chair for balance, lift one leg out to the side as high as you can, keeping your toes pointing forward, then hold for five seconds before lowering. If it’s too demanding, lift the leg less; you can also add ankle weights later to increase the challenge.
Standing knee raise – works the hip flexors and improves hip range of motion. Standing next to a chair for support, raise one leg in front of you as if starting a kick, aiming to bring your thigh parallel to the floor. Lift only as high as feels comfortable.
Lying leg raise – engages the quadriceps and hip flexors, reducing pressure on the joint. Lying flat with legs straight, lift one leg off the floor while keeping it as straight as possible, hold for five seconds, then lower. If this is too hard on the resting leg, bend that knee with the foot flat on the floor to take some load off.
Heel slides – improves hip and knee range of motion while working the hamstrings. Lying flat, bend one knee and slide the foot as close to your bum as possible, hold for five seconds, then slide back out. A towel looped around the ankle can help if your leg muscles alone aren’t enough to bring the knee in.
Step up – strengthens the quadriceps and glutes while improving movement control. Facing a step or stair, place one foot on it and push through to bring the other foot up, then step back down slowly, one foot at a time. Use a smaller step to start, and progress to a bigger step or two at a time as your confidence grows.
Three stretches to add in
Knee extension stretch – improves knee range of motion and activates the quadriceps. Sit with your back against a wall, legs straight out, one knee bent with the foot flat on the floor. Place a rolled towel under the ankle of your straight leg so it’s slightly elevated, then contract the thigh and press the knee down towards the floor. Gently pushing on the knee with your hands deepens the stretch further.
Hip flexor stretch – improves flexibility around the hip. Lying flat, bring one knee up to your chest and hold either the back of the thigh or the front of the knee, pulling it as close as comfortable. Repeat on the other side.
Lying hip external rotation – improves outward rotation and range of motion in the hip. Lying on your back with knees bent and feet together on the floor, slowly lower your knees out to the sides. Resting your hands on the inside of your knees and gently pressing down deepens the stretch.
The takeaway
Arthritis doesn’t mean your joints are fragile or that movement is the enemy. The evidence, and Naylor’s own clinical experience, points the other way. Consistent, appropriate loading through exercises like these is what keeps cartilage nourished, joints mobile and pain manageable, often to the point where patients avoid surgery altogether.