Can You Exercise With Arthritis? How to Stay Active When Your Joints Feel Stiff.
Stiff knees when you get out of bed. Achy hips after sitting. Hands that need a few minutes to loosen up before your day begins.
When your joints feel uncomfortable, exercise may be the last thing you want to do. You might even worry that movement will make the arthritis worse.
For most people with arthritis, appropriately chosen exercise is part of the treatment. It can help reduce pain, improve function, and support the activities you care about—from walking your dog to gardening or enjoying your favorite sport. CDC
The key is finding the right activity, starting at a manageable level, and adjusting as your symptoms change.
Why movement matters
Having arthritic changes does not mean you need to stop using that joint.
Guidelines recommend individualized therapeutic exercise, including strengthening and aerobic activity, for people with osteoarthritis. Some discomfort can occur when you begin, but regular exercise can improve pain, function, and quality of life over time. NICE
Arthritis includes many different conditions. If you have inflammatory arthritis, such as rheumatoid arthritis, activity should fit your medical treatment plan and current disease activity.
Why the pool can be a helpful place to start
If walking, stairs, or standing exercises feel difficult, aquatic exercise offers another way to move.
Aquatic exercise does not have to involve swimming laps. Many exercises can be done standing in the water, using a pool rail for support. You don't even have to get your hair wet.
The water changes how your body experiences movement:
Buoyancy reduces weight-bearing demands. Water supports some of your body weight, which can make movement more comfortable for painful hips, knees, or feet.
Water provides resistance. Moving your arms and legs through water gives your muscles something to work against. Speed and movement size can be adjusted to change the challenge.
Warm water may help you feel less stiff. Some people find gentle movement easier in a comfortably warm pool.
A supported environment gives you options. You may be able to practice movements that are currently difficult on land. Appropriate supervision and safe pool access still matter.
A Cochrane review of 13 trials involving 1,190 people with knee or hip osteoarthritis found small short-term improvements in pain and disability after aquatic exercise, with possible improvements in quality of life. It does not reverse arthritis, but it can make staying active more manageable. Cochrane
Aquatic exercise for fibromyalgia and chronic pain
Fibromyalgia syndrome (FMS) can involve widespread pain, fatigue, and sleep difficulties. It is different from arthritis, although someone can have both.
Exercise is a key part of fibromyalgia management, but the starting dose matters. A gentle session may be plenty at first. NIH guidance recommends beginning at a low level and gradually increasing activity. niams.nih.gov
A Cochrane review found that aquatic exercise may improve pain, stiffness, and physical function in people with fibromyalgia compared with no exercise. The certainty of the evidence varied, and aquatic exercise was not consistently better than exercise on land. The best setting is often the one that helps you participate comfortably and consistently. Cochrane
There is also research supporting aquatic exercise for certain chronic pain conditions. In a randomized trial of 113 adults with chronic low back pain, aquatic exercise improved pain and disability more than electrical stimulation and infrared heat, with benefits observed through the 12-month follow-up. This does not establish that pool exercise is better than a well-designed land exercise program, or that the same results apply to every chronic pain condition. JAMA Network
For someone who struggles to tolerate activity on land, the pool may provide a useful entry point for building an exercise routine.
What might an aquatic session include?
Depending on your needs, a physical therapist might select:
Gentle forward walking or side stepping.
Supported marching or heel raises.
Hip movements through a comfortable range.
Arm movements against the water’s resistance.
Supported balance practice.
The amount of exercise, water depth, pace, and rest breaks should match your symptoms and goals. These are examples, rather than a routine everyone should follow.
If you have open wounds, recent surgery, or significant heart or lung conditions, discuss pool participation with your healthcare team first. Safe entry and exit are part of the plan, too.
How to stay active outside the pool
Start small and build gradually
A five-minute walk or a short cycling session can be a useful starting point. You do not need to begin with a full workout. Short bouts count, and you can add time as your tolerance improves. CDC
Include strength training
Gentle mobility work can help you get moving, but strengthening also deserves a place in your routine. Depending on your needs, options might include standing up from a higher chair, resistance-band exercises, or supported heel raises. A PT can help choose exercises and progress them appropriately. CDC
Warm up before asking more of your joints
Begin with easy movement before increasing your pace or resistance. For example, start a walk slowly or pedal gently before turning up the bike’s resistance. CDC
Adjust the activity when symptoms increase
If a longer walk aggravates your knees, try a shorter route, cycling, or water exercise. You can also reduce resistance, movement range, or session length. Avoid pushing through sharp pain or a worsening limp. CDC
For fibromyalgia or chronic pain, aim for an amount you can repeat without a substantial symptom flare. On a good day, resist the urge to make up for every activity you missed. Build gradually and leave room for recovery. niams.nih.gov
Work toward a mix of activities
The CDC recommends at least 150 minutes of moderate aerobic activity weekly and strength training on at least two days, with balance activities for older adults. Treat this as a longer-term goal, not an entry requirement. Start where you are, and be as active as your health allows. CDC
Support your health between workouts
Make space for sleep, regular meals, hydration, and recovery. With fibromyalgia, addressing sleep difficulties is an important part of managing fatigue. If you are living with increased weight or obesity, supported weight management can also help reduce osteoarthritis pain and improve function. niams.nih.gov
How much discomfort is okay?
Some temporary discomfort can occur when starting exercise. However, pain should not keep escalating as you continue.
Reduce or stop an activity that causes sharp pain, a worsening limp, or substantial swelling. Contact your healthcare provider if symptoms persist, worsen at night, or the joint becomes hot or red. A suddenly hot, swollen joint—especially with fever—needs prompt medical assessment. CDC
You do not have to judge every symptom on your own. A physical therapist can help you find an appropriate starting point and adjust the plan based on your response.
Keep moving toward what matters to you
Your goal might be walking along the Seacoast, getting back to Pilates, or enjoying your garden with fewer limitations. Exercise can be built around that goal, even when your joints feel stiff.
At Kinetix PT & Wellness, I offer mobile physical therapy and aquatic PT to help you find practical ways to stay active. We meet where is most convenient for you, both literally and metaphorically. Together, we can build a plan that fits your symptoms, your schedule, and the life you want to keep enjoying.
Interested in exploring land-based or aquatic PT? Book a 15-minute discovery call through the Kinetix website.
Move better. Play longer. Live well.
Sources
NICE. Osteoarthritis in over 16s: diagnosis and management. 2022.
Bartels EM, et al. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev. 2016;3:CD005523. doi:10.1002/14651858.CD005523.pub3.
NIAMS. Fibromyalgia: Diagnosis, Treatment, and Steps to Take.
Bidonde J, et al. Aquatic exercise training for fibromyalgia. Cochrane Database Syst Rev. 2014;10:CD011336. doi:10.1002/14651858.CD011336.
Peng MS, et al. Efficacy of therapeutic aquatic exercise vs physical therapy modalities for patients with chronic low back pain: a randomized clinical trial. JAMA Netw Open. 2022;5(1):e2142069. doi:10.1001/jamanetworkopen.2021.42069.
CDC. Pain During or After Exercise. Archived guidance.
Comments