Can You Strength Train With Osteoarthritis? What the Guidelines Say

Yes. The Physical Activity Guidelines for Americans say strong scientific evidence shows muscle-strengthening activity has therapeutic benefits for people with osteoarthritis, and that when done safely, activity does not make the disease or the pain worse. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) lists strengthening with weights or bands in its exercise program for osteoarthritis. Plan it with a health care provider.

1. The worry, and the evidence

The Guidelines acknowledge the concern directly: people with osteoarthritis commonly worry that physical activity will make their condition worse, and the pain and fatigue of osteoarthritis can make it hard to start or keep exercising.

The evidence summary is reassuring:

• Strong scientific evidence shows that both aerobic activity and muscle-strengthening activity provide therapeutic benefits for people with osteoarthritis.
• Adults with osteoarthritis can expect improvements in pain, physical function, quality of life, and mental health with regular activity.
• When done safely, physical activity does not make the disease or the pain worse.
• The benefits can continue even after a person stops a physical activity program.

Activity also matters beyond the joints. The Guidelines note that people with osteoarthritis should stay active to lower their risk of other chronic diseases, such as heart disease and type 2 diabetes, and to help maintain a healthy weight.

2. How much

The Guidelines' advice is to match the type and amount of activity to your abilities and the severity of your condition. As a reference point, most people with osteoarthritis can usually tolerate 150 minutes a week or more of moderate-intensity activity, for example being active 3 to 5 days a week for 30 to 60 minutes at a time. Some can safely do more, and some can handle vigorous activity.

One detail often surprises people: the Guidelines state that walking up to 10,000 steps a day does not appear to worsen knee osteoarthritis.

The Guidelines also say adults with a chronic condition should work with a health care professional or physical activity specialist to adapt activity to their condition.

3. Which activities fit best

The Guidelines say health care professionals typically counsel people with osteoarthritis toward activities that are low impact, not painful, and low risk of joint injury. Their examples: swimming, walking, tai chi, and many muscle-strengthening exercises.

NIAMS's treatment guidance lists what a well-rounded program may include:

• Range-of-motion and stretching activities to keep joints limber.
• Strengthening exercises with weights or exercise bands to strengthen the muscles that support affected joints.
• Water exercises, which lower stress on the joints.
• Balance and agility exercises to help maintain daily living skills.
• Low-impact activities such as walking, cycling, swimming, tai chi, water aerobics, or low-impact aerobics classes.

The idea behind strengthening is straightforward: stronger muscles around a joint support it.

4. How to start

NIAMS's first instruction is to start any exercise program slowly and take time to adjust to each new level of activity, and to speak with your doctor or a physical therapist about a safe, well-rounded program.

A cautious beginner week that follows that advice might look like:

This is an illustration of the mix NIAMS describes, not a prescription. Your provider or physical therapist can adjust exercises around your specific joints.

5. Other things that help

NIAMS lists several supports that make activity easier:

• Weight management reduces stress on weight-bearing joints such as knees and hips, and losing weight, if you are overweight, can reduce pain and improve mobility.
• Heat and cold. Heat increases blood flow, pain tolerance, and flexibility; cold numbs the nerves around the joint and may relieve inflammation.
• Braces, orthotics, or shoe inserts fitted by a professional can support a joint and lower pain during standing and walking.
• Avoiding repetitive motions such as frequent bending.

6. A note on intensity

"Not painful" is part of the Guidelines' description of the activities health care professionals typically suggest. If an exercise is painful, discuss it with your provider or physical therapist before continuing.

7. Key takeaways

• Strong evidence shows muscle-strengthening and aerobic activity help osteoarthritis pain, function, and quality of life.
• Done safely, activity does not make osteoarthritis or its pain worse, according to the Guidelines.
• Most people with osteoarthritis tolerate 150 minutes a week of moderate activity, such as 30 to 60 minutes on 3 to 5 days.
• NIAMS recommends strengthening with weights or bands, plus range-of-motion, water, balance, and low-impact activity.
• Start slowly and plan your program with a doctor or physical therapist.

This article is general information, not medical advice. Talk with a doctor or physical therapist before starting a new exercise routine, especially if you have a health condition or injury.