Osteoarthritis

Do you have osteoarthritis?

Osteoarthritis (OA) is a condition that affects the joints and can cause pain and stiffness. This condition is also known as age-related changes or wear and tear. It is the most common form of joint condition, with the knee most commonly affected.

Typical physical signs are:

tenderness over the joint
creaking of the joint
joint swelling
restricted movement
decreased joint stability
weakness of your thigh muscles

About osteoarthritis

Watch information about osteoarthritis

Spotlight on osteoarthritis

Read these instructions to get the most from our video.

Please pick 1 exercise from each of the bullet points unless stated otherwise by your physiotherapist.

Hip extension - videos 2 to 4
Hip abduction - videos 5 to 7
Hip external rotation - videos 8 to 10
Knee extension (non-weight bearing) - videos 11 to 13
Knee extension (weight bearing) - videos 14 to 16
Balance - videos 17 to 19
Joint movement and stretching - videos 20 to 24

Please select the arrow on the video to see the full playlist.

Educational videos

Further education and advice

What is osteoarthritis

Management of osteoarthritis

Pain and osteoarthritis

How is osteoarthritis diagnosed?

Read information about how osteoarthritis is diagnosed

Clinical diagnosis is made based on signs and symptoms.
An x-ray may show the degree of osteoarthritis.
Blood tests may rule out other forms of Arthritis.

Top 5 tips for managing knee or hip osteoarthritis

1. Try to keep to a healthy weight, it will help to reduce pain and strain on your joints.
2. Wear sensible, well-fitting shoes (e.g. trainers) to cushion the impact of walking.
3. Keep active but pace yourself – don’t overdo it on ‘good’ days and keep moving on ‘bad’ days by altering your activities.
4. Apply a heat or ice pack to ease pain and stiffness. Ensure you protect your skin to avoid burns or irritation. Do not use ice if you have poor sensation over the area, an infected wound, Raynauds Syndrome, or Cryoglobulinaemia.
5. Don’t stay in the same position for long periods of time (e.g. sitting, lying). If you are struggling to walk and need assistance, walking aids can be provided by the NHS. If you wish to purchase your own, please seek assistance in measuring to ensure the right fit.

How much exercise should I do?

This is a guide to measure how hard you feel your body is working during physical activity. You do not need to do a certain number of exercises, but rather stop when you get above level 7 or cannot do anymore.

Aim to achieve within the middle range (5 to 7 out of 10).
The exercises are generally in order of difficulty.
Repeat the exercise until you feel you have achieved this level of intensity.
If you feel you are working beyond this, it may be that the exercise is too difficult so you should return to the previous exercise.
If you do not reach this, it may be that the exercise is too easy, so you may wish to progress onto the next exercise.
The lying exercises can be done on the floor or on a bed - you can use a pillow.
The standing exercises should be done with support available, should you need it.

1 - Inactive/very light

Little or no effort at all, anything other than sleeping or complete rest.

2-3 - Light

Slow walking or jogging at your own very comfortable pace. Could maintain or keep going for hours, breathing easily and can carry a conversation.

4 - Slightly more effort

Breathing heavier and heart rate a little faster, feeling warmer. Can hold a strong conversation.

5 - Medium/slightly hard

Still reasonably comfortable. You don't want to stop yet, but if you went much harder you'd be uncomfortable.

6 - Moderate/hard

Breathing hard, sweating and finding it hard to talk.

7 - Hard/vigorous

On the verge of becoming uncomfortable. Short of breath, but can speak a sentence.

8 - Very hard

You can still go on, but you really have to push yourself. Breathing very hard, can only say a few words.

9 - Extremely hard

Cannot sustain the effort for very long. Can barely breathe and speak a single word.

10 - Hardest/max effort

Feeling almost impossible to keep going. Completely out of breath, unable to talk. Your limit.

Exercises

Simple exercises for knee and hip osteoarthritis

See sections A to E for exercises to strengthen muscles around the hip and knee
See section F for exercises to improve balance and mobility
See section G for exercises to improve joint range of movement and stretches.

It is advised that you pick 1 exercise from each section, unless stated otherwise by your physiotherapist.

Section A - Hip extension

A) Bridge

1. Lie on your back with your knees bent as far as comfortable.

2. Tense your tummy muscles, clench your buttock muscles and lift your bottom off the floor or bed. Hold for several seconds before slowly returning to the starting position.

3. You can progress by transferring your weight onto one leg, to straighten the other, but make sure that your hips remain level (single-leg bridge).

B) Hip extension in standing

1. Stand with something to lean against.

2. Tense your tummy muscles and clench your buttock muscles to bring your leg backwards, keeping your knee straight. Try to keep your body upright. Hold for several seconds before slowly returning to the starting position.

3. If this is difficult, you can try doing it leaning forwards onto a firm surface, such as a table.

4. You can progress by adding resistance with an exercise band, which is tied around your ankle and anchored to a stable structure in front of you.

C) Backwards walking

1. Ensure you do this in a safe environment, so that you have something to hold onto, should you lose your balance.

2. Slowly, repeatedly, place 1 foot behind the other to walk backwards. You can progress by wearing ankle weights.

Section B - Hip abduction

A) Hip abduction in side lying

1. Lie on your side with the underneath leg bent and the upper leg straight.

2. Lift the upper leg straight up with the toes pointing forwards and the ankle leading the movement. Try to keep the leg in line with your body. Hold for several seconds before slowly returning to the starting position.

B) Hip abduction in standing

1. Stand up straight with something to lean against.

2. Lift your leg sideways with those toes pointing forwards and the ankle leading the movement. Try to keep your body upright. Hold for several seconds before slowly returning to the starting position.

3. You can progress by adding resistance with an exercise band, which is tied around your ankle and anchored to a stable structure out to one side, so that the band crosses in front of the opposite leg.

C) Side stepping

1. Ensure that you do this in a safe environment, so that you have something to hgold onto, should you lose your balance.

2. Take one foot out to the side, leading with the ankle. Transfer your weight onto this leg and allow the other leg to come towards it. Continue to side-step in one direction, before repeating in the opposite direction.

3. You can progress by wearing ankle weights.

Section C - Hip external rotation

Pick 1 exercise from this section.

A) Clam

1. Lie on your side with your knees bent and feet together.

2. Rotate from the hip to lift your top knee up as far as you can, without letting your body follow the movement.

3. Try to keep your feet together and back straight during the exercise. Hold for several seconds before slowly returning to the starting position.

4. You can progress by raising your feet in the air, so that they are level with your spine, and hold them there throughout the exercise.

B) Standing clam

1. Stand with something to lean against. Transfer your weight onto one leg and tense your tummy muscles. Rest your foot against the inner side of the opposite knee.

2. Turn your bent knee out to the side by tightening your buttock muscles. Do not allow your body to twist. Hold for several seconds before slowly returning to the starting position.

C) Resisted hip external rotation in standing

1. Stand sideways against a wall. Slide 1 hip and knee along the wall up to a right angle.

2. Squeeze your buttock muscles and press your leg against the wall. Keep your back straight. Hold for several seconds before slowly returning to the starting position.

Section D - Knee extension (non weight bearing)

Pick 1 exercise from this section.

A) Static quadriceps

1. Lie on your back with one knee bent and the other leg straight.

2. Pull your toes up and tense your thigh muscles to push your knee down into the floor or bed. Hold for several seconds before slowly relaxing.

B) Straight leg raise

1. Lie on your back with 1 leg straight and the other knee bent.

2. Pull your toes up, straighten the knee and lift your leg up off the bed or floor. Hold for several seconds before slowly returning to the starting position.

C) Knee extension in sitting

1. Sit on a chair.

2. Pull your toes up, tighten your thigh muscle and straighten your knee. Hold for several seconds before slowly returning to the starting position.

3. You can progress by adding weight/resistance with the opposite leg crossed over the leg that you are working.

Section E - Knee extension (weight bearing)

Pick 1 exercise from this section.

A) Sit-to-stand

1. Sit on the edge of a chair. Place your feet hip-width apart with toes pointing forwards.

2. Lean forwards and stand up from the chair, keeping your knees hip-width apart and keeping your arms folded, if possible. Slowly return to sitting again.

3. Alternatively, you can stand behind the chair and use this to hold as you do a mini-squat. You can progress by stepping away from the chair and doing a full squat.

B) Single-leg knee dips

1. Stand with something to lean against.

2. Lift 1 foot off the ground and perform a small knee bend on your standing leg. Try to keep your weight backwards and your knee in line with your toes. Slowly return to the starting position.

C) Step ups and step downs

1. Stand facing a step. Step up several times with one leg leading and then the other.

2. Now try step downs - stand completely on a step, facing downwards. Step down with 1 leg leading and then the other.

Section F - Balance

Pick one exercise from this section.

A) Single-leg stand

1. Stand with something to lean against.

2. Lift one foot off the floor and balance for as long as possible.

B) Heel-toe walking

1. Stand and place one foot in front of the other.

2. Practice walking heel-to-toe, as if you are on a balance beam or tightrope.

3. Try to look straight ahead.

4. Alternatively, you can practice walking on your heels or on your toes.

C) Heel raises

1. Stand with something to lean against.

2. Push up on your toes. Hold for several seconds before slowly returning to the starting position.

3. You can progress by doing this on one leg.

Section G - Joint movement and stretching

Pick 1 exercise from this section.

A) Knee flexion/extension

1. Lie on your back.

2. Bend your knee as far as is comfortable. Hold for several seconds before returning to the starting position.

3. You may wish to assist further using your hands or with a towel around your shin.

B) Knee hugs

1.Lie on your back with your knees bent.

2. Lift 1 knee up towards your chest. Hold for several seconds before returning to the sitting position.

3. You may wish to assist further using your hands or with a towel around your shin.

C) Quadriceps stretch

1. Stand with something to lean against.

2. Bend your knee as far as is comfortable. Take hold of your ankle with your hand and gently pull your foot closer to your buttock. Feel the stretch along the front of the thigh.

3. Hold for 20 to 30 seconds before slowly returning to the starting position.

D) Hamstring stretch

1. Stand with 1 leg out in front and the other knee
slightly bent.

2. Keeping your back straight, bend forwards from the hips. Feel the stretch along the back of the straight leg. Hold for 20 to 30 seconds before slowly returning to the starting position.

E) Calf stretch

1. Stand with something to lean against.

2. Take 1 foot forwards and the other backwards. Keeping the toes pointing forwards and the heel of the back foot on the floor, bend the front knee. Feel the stretch along the back of the back leg. Hold for 20 to 30 seconds before slowly returning to the starting position.

What other help is available?

Steroid injections

Steroid injections are mainly used for very painful osteoarthritis.
They are not clinically suitable for everyone but can help some patients significantly. The injection is given directly into your joint.
It can start to work within a day or so and may improve pain for several weeks or even months.
If successful the injection will provide short term relief but is not a fix.
Reducing pain through exercises that stretch and strengthen joints, muscles, and other soft tissues will provide longer term relief.

Joint replacement

This may be considered as a suitable treatment option if you have or develop uncontrolled, intense, persistent pain resulting in substantial impact on your life.
This means pain of almost continuous nature (e.g. pain when standing or walking on level surfaces for less than half an hour and requiring the use of walking aids).
You may find you are having to continuously use anti-inflammatory pain-relief medication to control symptoms.
There would be significant limitation of daily activities (e.g. you may be only being able to complete a few or none of your normal activities and self-care). However, it is important that you have had symptoms for at least 6 months and trialled conservative management (e.g. exercises, pain relief) for at least 3 months, as flare-ups of pain in osteoarthritic joints can settle within this timeframe.

How can I improve my aerobic fitness?

In short anything that raises your heart rate. 2 main ways are:

A young blonde woman in a life jacket is sitting in a canoe with the sea rippling around her. she holds orange ores and is paddling with them.

Through activity

For example - swimming, walking, cycling, fitness classes etc.

Young asian man running on the spot wearing a t-shirt and shorts in their living room on a wooden floor.

Adding a warm up

By adding a warm-up to your strengthening exercises, for example, marching the spot.

Need more help?

Consider self referring using the link below:

If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.

If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.

Refer yourself to physiotherapy

Osteoarthritis

Do you have osteoarthritis?

About osteoarthritis

Spotlight on osteoarthritis

Educational videos

Further education and advice

How is osteoarthritis diagnosed?

Top 5 tips for managing knee or hip osteoarthritis

How much exercise should I do?

1 - Inactive/very light

2-3 - Light

4 - Slightly more effort

5 - Medium/slightly hard

6 - Moderate/hard

7 - Hard/vigorous

8 - Very hard

9 - Extremely hard

10 - Hardest/max effort

Exercises

Simple exercises for knee and hip osteoarthritis

What other help is available?

Steroid injections

Joint replacement

How can I improve my aerobic fitness?

Through activity

Adding a warm up

Need more help?

Consider self referring using the link below:

Need more information?

You must log in to save content

You must log in to save content