Staying Active When It Hurts: How a Physio Can Help
Updated: 5 days ago
Moving Through the Myths
Arthritis is often seen as the enemy of movement: creaky joints, achy mornings and a constant reminder of getting older. Yet the evidence is clear: for most people with arthritis, exercise is one of the most effective treatments available. This article explains why keeping active matters, how to move safely and how physiotherapy can help you live well with arthritis.
1. Understanding Arthritis
What it is, and what it isn't. "Arthritis" covers more than 100 different conditions. The two most common are:
Osteoarthritis (OA): the whole joint is affected, including cartilage, bone and the surrounding tissues. It used to be described as "wear and tear", but we now know the joint is constantly repairing itself and responds well to the right kind of activity.
Rheumatoid arthritis (RA): an autoimmune condition in which the immune system attacks the joint lining.
Arthritis isn't only a condition of older age. It can affect people in their twenties or thirties, particularly after a joint injury or where there is a family history.
Pain does not always equal damage. A sore joint doesn't automatically mean new damage is happening. Pain can come from stiffness, inflammation or a sensitised nervous system, and X-ray findings often match symptoms poorly. Physiotherapists help you interpret these signals so that discomfort doesn't lead you to avoid activity unnecessarily.
2. Why Staying Active Matters
Movement nourishes joints. Cartilage has no direct blood supply and relies on movement and loading to circulate the fluid that nourishes it. Gentle walking or cycling helps "oil the hinges".
Exercise strengthens supporting structures. Stronger muscles help support painful joints. Strengthening the thigh and hip muscles can reduce knee pain and improve function.
Activity has wider health benefits. Regular exercise improves heart health, mood and sleep, can modestly reduce inflammation, and helps with weight management, which matters for weight-bearing joints such as knees and hips.
International guidelines, including those from NICE, recommend exercise and education as the first-line treatment for osteoarthritis.
3. Busting Common Myths
"Exercise wears my joints out." Research shows that exercise does not damage cartilage and may even benefit it. Sensible, gradually progressed exercise is good for your joints.
"I should stop when it hurts." Some discomfort during exercise is normal and safe. Sharp or steadily worsening pain should be discussed with a physiotherapist.
"Arthritis always gets worse." Many people's symptoms stay stable or improve with good management, regular movement and strength training.
"Only medication helps." Medication can help with pain and, in inflammatory arthritis, is essential to control the disease. For osteoarthritis, exercise, education and lifestyle changes are the foundation of long-term improvement.
4. The Physio Approach
A physiotherapist's role is to guide safe, effective activity while addressing stiffness, weakness and fear of movement.
Assessment. We start by understanding which joints are affected, your pain patterns, your movement and your goals. Your physio may assess your walking, strength and balance.
Education. Understanding why pain occurs helps you regain confidence. Physiotherapists often use a simple "traffic light" guide to explain when to continue (green), modify (amber) or stop and rest (red).
Exercise prescription. A personalised plan may include:
Range-of-motion exercises: gentle knee bends, shoulder circles, ankle pumps
Strengthening: sit-to-stands, resistance-band exercises, step-ups
Low-impact cardio: walking, swimming, cycling, aqua aerobics
Balance work: single-leg stands, heel-to-toe walking
Hands-on treatment. Joint mobilisation or soft-tissue techniques can temporarily ease stiffness and make exercise more comfortable. They work best alongside exercise, not instead of it.
Lifestyle support. Managing arthritis also involves sleep, stress, weight and pacing.
5. Gentle Exercises You Can Try
Important: these suggestions are general. If you have significant pain, swelling or instability, speak to a physiotherapist before starting.
A. Morning mobility routine (5 minutes)
Knee hugs (10 reps): lying on your back, bring one knee gently towards your chest.
Ankle circles (10 each way)
Shoulder rolls (10 forwards and backwards)
B. Strength snack (10 minutes)
Sit-to-stand from a chair (3 × 8): builds thigh strength
Wall push-ups (3 × 10): strengthens the arms and shoulders
Low step-ups (2 × 10 each leg): builds hip and knee control
C. End-of-day stretches (5 minutes)
Hamstring stretch sitting on the edge of the bed (30 seconds each side)
Calf stretch against a wall (30 seconds each side)
Gentle spinal twist lying on your back (10 seconds each side)
Consistency beats intensity: little and often works far better than an occasional big effort.
6. Managing Flare-Ups
Even well-managed arthritis flares up from time to time. Recognise the early signs, such as more pain, swelling or morning stiffness, and act early:
Reduce load, don't stop completely. Swap jogging for swimming, or walking for cycling, for a while.
Use the two-hour rule: soreness that settles within about two hours of exercise is acceptable. If it lasts longer, or you are worse the next day, ease back a little next time.
Use heat and gentle movement rather than prolonged rest.
Get advice if the flare persists or feels different from usual. If you have rheumatoid or another inflammatory arthritis, contact your GP or rheumatology team about flares.
7. The Emotional Side of Arthritis
Living with persistent pain can affect mood, sleep and motivation, and research shows that anxiety and low mood can heighten pain. Physiotherapists can work alongside GPs and psychologists, teaching pacing, relaxation and breathing techniques. Learning to stay active alongside some discomfort, rather than waiting for pain to disappear first, can make a real difference to quality of life.
8. Examples From Practice
(Illustrative examples based on typical cases.)
Mary, 68, had painful knees that limited her gardening. After eight weeks of strengthening and pacing advice, she was walking two miles comfortably and back to tending her garden.
Tomás, 55, with shoulder arthritis, regained overhead reach after consistent resistance-band strengthening.
Aoife, 42, who lives with rheumatoid arthritis, combines medication from her rheumatology team with physiotherapy and yoga to manage fatigue while caring for her children.
The common thread? Each found a way of moving that suited their life.
9. Everyday Strategies for Joint Care
Manage your weight: if you're carrying extra weight, each kilogram lost takes about four kilograms of load off your knees with every step.
Choose good footwear: comfortable, cushioned shoes make walking easier.
Warm up: five minutes of gentle marching or cycling before chores or walks.
Change position: alternate sitting, standing and moving regularly.
Pace yourself: short breaks between tasks help you keep going for longer.
10. When to Seek Help
Seek medical advice the same day if a joint becomes suddenly hot, red and swollen, especially if you feel unwell or feverish.
Book a GP or physiotherapy assessment if you have:
Pain that regularly wakes you at night
New swelling in one or more joints
Locking, giving way or a significant loss of movement
New pain after a fall or accident
Getting advice early can help prevent problems such as muscle weakness and loss of confidence.
Keep Moving, Keep Living
Arthritis doesn't mean giving up the things you enjoy. With the right advice and a tailored exercise plan, movement becomes medicine, not a threat. Whether your goal is climbing stairs comfortably or getting back to golf, physiotherapy can help you progress safely and steadily towards managing well on your own.
Want to move with more confidence? Book an arthritis assessment at RW Physiotherapy and get a clear, tailored plan to keep your joints strong and active.
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