How much exercise should I do and how often?
We should all aim to do at least some physical activity every day.
Exercise is one of the best things you can do to improve your symptoms of arthritis.
Ideally, we should all aim to do at least 30 minutes of exercise that makes us a bit short of breath five times a week. It’s also recommended that we spend 30 minutes a day on our feet – such as walking or climbing stairs.
Try three or four 10-minute sessions throughout the day if it suits you better than doing it in one go.
If you have joint pain, start gently and gradually increase the length of time you’re exercising. You can break this into smaller chunks if you need to. Doing 5–10 minutes of exercise each day is important to keep your joints moving and your muscles strong.
Try our exercises to manage pain a couple of times a day and build it into your daily routine.
Guidelines for Physical Activity
How will I know if I’ve overdone it?
If an hour after you’ve finished exercising, you’re still aching or feel more sore than when you started, you may have overdone it. You should feel as if your muscles have done some work and have stretched a little after exercise, but you should not be exhausted or in more discomfort.
Most people take a while to learn how much exercise they can do. Have a rest for the following day and start again the day after, but halve the amount of exercise. Then gradually increase it by a few minutes each day.
If you’ve overdone it, particularly if a joint is hot or swollen, cover the joint with an ice pack or a pack of frozen peas wrapped in a damp towel for 10–15 minutes.
I'm new to exercise – how do I get started?
How to get started with exercise
It’s never too late to start keeping yourself fit. Your body is designed to move and not doing so can harm the tissues in and around your joints. Exercise and sport are good for your physical and mental health.
Many people are afraid to exercise because they believe that it damages their joints. But keeping active will help to:
- keep your joints supple
- reduce pain
- strengthen your muscles and bones.
Start off by doing a small amount of gentle exercise that’s in your comfort zone, and gradually increase the amount you do – both in terms of the time you spend exercising and the effort you put in.
You shouldn’t need a doctor’s advice to get started. However, if you’re finding it difficult then a GP, physiotherapist or a personal fitness trainer at your local gym should be able to give you good advice and support.
How can I stay motivated?
To stay motivated, it's important to:
- do exercise that you enjoy
- set realistic goals - it's normal for these goals to change as your condition changes
- do it regularly.
Exercising with a friend or relative can be a really good way to stay motivated and have fun.
It’s important to eat well if you’re doing regular exercise. You’ll need plenty of energy, which you can get from eating lots of carbohydrates There are three types of carbohydrates, sugars starches and fibres. You should be able to get plenty or carbs in a healthy balanced diet that contains fruit, bread and dairy. Wholemeal bread, rice and pasta are great sources of starchy carbohydrates that are high in fibre.
If you’re trying to lose weight, try to reduce the fat content of your diet but don’t cut out all carbs. Always check the labels of your food and keep an eye on your recommended daily allowances of fats, protein, carbohydrates, sugar and salt.
If you don’t eat enough carbohydrates you’ll get tired and fatigued easily. Fatigue can affect your technique as your muscles get tired and respond more slowly, altering the timing of your movements. This in turn may increase your risk of injury.
A healthy balanced diet should also contain protein, which is the main building block for your body and is essential for growth and repair. You should increase your protein intake if you’re regularly lifting heavy weights or building up your muscle strength to prepare for sport.
Water acts as our body’s natural cooling system, so when we exercise we need to drink plenty of it to avoid dehydration. You should drink a small glass of water before exercise and then regularly pause during activity to drink more. This is especially important if you’re exercising in a hot environment, either outside on a sunny day or in a gym.
How do I recover from an injury?
If you’ve had an injury, for example from playing sport, a fall or over training, you’ll need to rest the injured part of the body for a period of time and allow it to heel.
These injuries are sometimes called trauma injuries. They need to be treated differently from a long-term health condition, such as arthritis.
Your body is good at healing itself, if it’s allowed to do so. This means that you must not return to full activity after an injury until you’re completely healed and your strength and fitness is back.
A good guide would be to begin gentle exercise again as soon as the pain will allow. If you’re having a break in training due to injury it’s still important to remain active as this will help keep you fit and prevent further injuries.
The amount of exercise should be gradually increased but should never cause significant pain. A sport and exercise medicines specialist or a physiotherapist would be able to advise you on specific exercises and other ways to help your injury. There are many exercises that can be easily performed at home. We have examples of these exercises on our website.
What is an overuse injury?
If you get pain or stiffness that you start to feel earlier and earlier in your exercise sessions or that lasts for a long time afterwards, you may have an injury. This could mean you have to change your activity or seek professional advice. These symptoms are different from the muscle ache you get the first time you do a new exercise, as they don’t go away when you repeat the same activity.
General aches and muscle pain are signs of tired muscles and are nothing to be concerned about as long as they don’t persist. You shouldn’t feel this sort of pain for longer than a couple of hours after you finish exercising. Sudden pain may indicate muscle or tissue damage.
How do I know if I have got an overuse injury?
Overuse injuries occur when we overstress the tissues and don’t allow enough time for recovery. Common overuse injuries include:
- muscle strains
- inflamed and painful tendons, known as tendinopathy
- pain at the front of the knee
- jumper’s knee
- shin pains, sometimes referred to as shin splints
- tight calves or Achilles tendons
- sore heels.
The most common symptom of an overuse injury is pain, but you may also experience tingling, numbness, swelling, stiffness or weakness in the affected area.
Traumatic injuries are often the result of contact during sport and can happen whether or not you have a careful warm up. They can also happen as a result of a fall or accident. They need to be treated differently to long-term conditions, such as arthritis.
Common traumatic injuries include:
- bruising or cuts
- sprains and strains, for example an ankle sprain, wrist sprain or knee ligament strain
- fractures or broken bones
- dislocations, when a joint ‘pops out’.
Common symptoms of acute injuries include sudden, severe pain, swelling, restricted movement and inability to bear weight. There may also be obvious signs of a dislocation or a broken bone.
When should I see a doctor?
Most overuse injures will get better with rest or a reduction of your activity levels, although it’s important to keep gently stretching the affected muscle or joint.
If you’re in a lot of pain after 24 hours and the injury hasn’t responded to simple measures such as applying ice wrapped in a damp towel, and taking things gently, you should get medical help as soon as possible.
If you think there may be a fracture or dislocation then you should get medical attention as soon as you can.
Overuse injury recovery
The first thing to do if you have an overuse injury is to stop doing the activity that’s causing pain. This doesn’t mean you have to stop all exercise, just try to avoid using the injured body part to give it time to recover. Specific exercises or stretches may be needed to treat the injury.
Specific muscle-strengthening exercises may help prevent a recurring injury from happening again, but you should get professional advice about this from a specialist personal trainer or physiotherapist. You may also want to have another look at your training technique or running style, as this may have caused the injury in the first place. It’s often helpful to keep an exercise diary.
Traumatic injury recovery
Treatment for traumatic injuries should start straight away, unless it’s very minor. Apply ice and compress the injured area to help prevent bleeding, bruising and swelling. If possible, try to raise the injured body part.
You should keep applying ice for the first 48 hours after injury. Do this for 10-15 minutes at a time and always wrap the ice in a damp towel to protect your skin. You can do this often throughout the day.
You should try to gently move the injured part of your body as soon as possible – ideally the same day but certainly after the first few days once the swelling is under control. However, if you think you may have a fracture or dislocation it’s important to get medical help as soon as you can.
Following a traumatic injury you should try to get back to walking as soon as you can. You should also think about doing some muscle strengthening exercises to help strengthen the injured body part and prevent further damage.
The PRICE principles
For many injuries, particularly traumatic injuries, you need to apply the PRICE principles:
- Protection – Stop the activity that caused the injury and try to prevent further injury by using padding, taping, supports, splints or crutches.
- Rest – Give an injury time to heal.
- Ice – Use ice to reduce pain and swelling. Wrap in a damp towel and use in 10-minute intervals.
- Compression – Pressure on the injury site will help reduce swelling and bleeding in some cases.
- Elevation – Lifting the injured part above the heart reduces blood flow and swelling.
Some physiotherapists are now also promoting the POLICE principles:
- Optimal Loading
The emphasis here is on ‘active rest’ and getting things moving again early on. The principle is that within the first 72 hours after getting a sports injury, for example of the knee or ankle, that you try moving it and if pain allows walking on the injured leg.
You might need to protect the joint at first, either using a support, a crutch or a walking aid. If it’s painful then stop and seek medical advice.
What is the best exercise to do if I have arthritis?
The best type of exercise for you is something you enjoy and so keep doing it.
If you have arthritis it’s very important to remain active as this will improve your health and make your pain better.
Low-impact exercise is recommended for people with all types of arthritis. This is any exercise which puts less stress on your joints, and includes activities like swimming or cycling.
Doing low-impact exercise doesn’t mean you can’t push yourself. For example, people with arthritis talk about how swimming is a good way to do vigorous exercise without hurting themselves.
If you have rheumatoid arthritis, or another type of inflammatory arthritis, you can continue exercising without damaging your joints or causing a flare-up of symptoms.
If you have osteoarthritis low-impact exercise is suitable, but you might need to try different activities to find the one that suits you.
You can get further advice and support about exercise from a GP, or you could ask them for referral to a physiotherapist. If you are a member of a gym, they may well have fitness instructors trained to a high standard who can give you good advice.
Why is exercise important?
Exercise that makes you out of breath and gets the heart going is very important to your overall health and fitness and is an important part of maintaining a healthy weight. Exercising will help you manage your arthritis by strengthening your muscles, easing your stiffness and improving your joint movement.
Exercise also has positive mental effects. Often you will feel much better and more self-confident when you've done some exercise.
What happens when you exercise?
Build up your exercise gradually
A good approach to exercise is to start off with small and regular amounts of activity and to gradually build up what you do. This will improve your health and fitness, and will help prevent injury as your body gets used to exercising.
To build up your exercise, try to gradually increase the following:
- frequency - how often you do it
- duration - the length of each session
- Intensity - how hard you try.
Warming up before you exercise prepares you physically and mentally and will help to prevent injuries. A good warm up will gradually increase your body temperature and heart rate, and prepare your muscles for exercise.
A warm up could include a run through of some of the movements or activity you’re about to do. For example, you could walk, cycle, jog or swim gently and gradually increase the intensity until you’re a bit out of breath. Doing some range of movement exercises, such as rotating your arms, and stretching are also good ways to warm up.
It’s also important to warm down after exercise by repeating the movements you did in your warm up. This will stop you getting stiff muscles and joints and will help to prevent cramp. Give yourself plenty of time to recover and refuel your body with suitable food and drink.
What if I am in pain when I exercise?
It's normal for your muscles to feel a bit sore after exercise, especially if you're not used to it, but you should stop if you have sudden or severe pain in your muscles or joints. See a doctor if the pain carries on after you’ve finished exercising.
If you’re back to normal by the next day then start again, but start slowly. If all's well after that, gradually increase the amount you do each day.
Stretching exercises keep your joints moving properly. They are designed to help ease aches and pains by stretching the joints and muscles in your body.
They're often simple and most of us already do some without even realising it – stretching your arms when you wake up, for example.
How should I do stretching exercises?
- Move as far as you can until you feel a stretch in the muscles around your joints.
- Hold for about 5–10 seconds, then relax.
- Repeat 5–10 times if you can.
Strengthening exercises help you to strengthen your muscles so they can support your joints. This is very important because if your muscles are weak, your joints can become unstable and painful. You probably won't want to move much when you’re in pain, but not exercising can actually make your symptoms worse.
How should I do strengthening exercises?
Do strengthening exercises slowly. Start with a low number of repetitions and build up gradually.
You may want to try Pilates, which focuses on strengthening the muscles involved in improving posture and keeping your joints in the correct position.
If your joints are especially hot or swollen, leave the strengthening exercises until your joints settle down again. You can still do the stretching exercises, but do them gently and only do a few repetitions once a day.
We have examples of good stretching and strengthening exercises that you can do at home. These can greatly improve your symptoms. You can find these exercises at the back of our Keep Moving booklet.
Types of fitness exercise
Fitness exercises are very important to keep your heart healthy. You don't need to join a gym or buy special equipment to exercise. It can be as simple as walking a bit further or faster than normal.
Swimming is an excellent all-round exercise for people with arthritis:
- The water supports your joints, which makes it easier to move them.
- You can strengthen muscles and exercise your heart and lungs by moving your limbs firmly against the resistance of the water.
If you have neck problems, breaststroke may make it worse. If so it's worth checking your technique. Remember, it's never too late to go to a swimming class if you need to.
Some sports centres offer water aerobics. It gives a good overall workout but won't put too much stress on your joints. Check with your doctor first and go at your own pace if you feel the exercises are too fast for you.
Hydrotherapy is a set of exercises done in warm water under the supervision of a physiotherapist. It's safe and effective for arthritis and back pain so ask your healthcare team what's available in your area.
Walking is a simple, cheap and very effective way to exercise. Putting weight through your legs when you walk helps keep your bones as strong as possible.
Start gently and gradually increase the amount you do each time. Start by walking a few houses away and back. Time yourself and then try to improve on the time each day. Or try gradually increasing the distance or walking uphill more often.
Some people find that doing exercise in a group gives them extra motivation to keep going. It can also be a good way to meet someone with a similar level of fitness. Buddying up with this person will make exercising more fun, and you might even find that you get more out of the experience as you push and support each other to do your best.
General keep fit classes and T'ai chi are suitable for people with arthritis of all ages.
Low-impact aerobics, such as step aerobics, may be more suitable than high-impact aerobics. If you have joint pain some of the exercises may make it worse.
Yoga has also been shown to help some people with arthritis.
It would be a good idea to tell the person taking a fitness class that you have arthritis. They will be able to give you specific advice.
Cycling is very good for strengthening your knees and for general fitness. Use an exercise bike or traffic-free cycle routes if you prefer not to go out on busy roads.
If you get a lot of knee pain you may have to take it very gently to start off with. Stop if your pain gets worse after cycling.
You may find it useful to join a gym and use different equipment to strengthen muscles and get fitter. Using weights can increase pain if they're too heavy so it's better to use very low weights and do lots of slow, controlled repetitions.
Most gyms have fitness instructors trained to a high standard. If you tell a fitness instructor that you have arthritis they should be able to give you some good advice and maybe even a programme for you to have a go at.
Please see our exercise and sports injuries information booklet (PDF, 2.94 MB) for more information.
I was at my best when I turned 50. I’d decided I was going to celebrate my own golden jubilee by doing all the things I wanted to do. I’d spent years taking care of people. My son and daughter were grown up and doing really well.
I’d worked as a teaching assistant, then a court officer and, at 47, I joined Greater Manchester Police as a community support officer – I loved my job. I wanted to be a yoga instructor – that was my big plan. So, I took myself off to a mountain retreat in Spain. I used to be able to stretch my body in every direction.
Then everything changed. First, I was diagnosed with breast cancer. I asked, ‘am I going to die?’. When the consultant said no, I thought ‘let’s get on with it’.
I’d just got over my cancer and I thought finally everything was going to be OK. Then, I was sitting on the sofa one day and suddenly I just couldn’t move.
I was in so much pain. I never knew rheumatoid arthritis felt like that. I’ve never been in that amount of pain. In the end, I spent a year and a half in a wheelchair. I never wanted my son to have to push me around. It was horrible.
I couldn’t manage. I loved my job but eventually I had to be medically retired.
I was always told to try to keep moving but it’s difficult when you’re in so much pain. Sometimes it’s hard to remember it’s not movement that’s attacking your joints, it’s rheumatoid arthritis and your immune system.
Then, about six months ago something changed. I got a new medication that worked. It was the fifth one I’d tried. I had two doses and it kicked in – I started feeling just that little bit better. It was just small, but I realised I could move my hand.
That was the chance I needed. I started small – slow, gentle movements, just moving my hands and my wrists, then my arms. I’d sit in front of the TV and move my feet and ankles, just gently. They were the type of tiny movements other people don’t think much of, but the more I did it the easier it became, and the better I felt.
At first, I’d do 10 minutes of movement in a chair every day - most standing exercises can be done in a chair. I’d say to myself ‘Get up Nafisa. Before this who were you? You can do this – get up’.
I’d try to walk every day using my frame. It took a good four months until I felt strong enough to stop using it – now I make sure I walk for 45 minutes every day. It hasn’t happened overnight, but now I don’t use my frame at all.
I can now touch my knee to my nose. I have such a sense of achievement just by doing that. My next goal is to get my head down to the floor – I’m going to do it.
After two years living with this illness, I feel ready to tell people how I feel. I know we’re all different, but sometimes when you hear someone else’s story you realise you have something in common and it gives you the confidence you need to just make a small change.
When you’re in pain getting up off a chair is massive, I understand that. I can now get off the sofa, and move my body, and walk around. I’ve got my independence back – I can be Nafisa again.