If your knees hurt when you climb the stairs, your hips feel stiff after a long day at work or your fingers ache when you wake up, exercise may not be the obvious reason.
I have often heard patients become scared of exercise and blame it for their joint pain and stiffness. In fact, several people with joint pain either stop exercising altogether or exercise in ways that are not appropriate for their condition. The truth is simpler than that. Most painful joints will respond well to the right sort of movement. The trick is finding what works for you.
This is especially true in India, where knee and back pain are common reasons for people to cut back on physical activity. A multicentre study in India in 2025, with more than 56,000 people, estimated the prevalence of musculoskeletal pain at 16.14 per cent and osteoarthritis at 4.39 per cent. So should you walk every morning, or lift weights or join a yoga class? There is no single answer.
Walking: Start here if you have stopped walking.
Walking is the easiest exercise to get started with. No gym membership or expensive equipment required. You need a good pair of shoes and a little bit of consistency.
For example, if you have mild knee osteoarthritis, you can start by walking 10 minutes on flat ground. If it feels good, slowly increase the length of time.
The World Health Organization recommends regular physical activity for people with osteoarthritis. It can assist in improving function and overall health. The US CDC also recommends arthritis-friendly activities like walking, cycling and swimming for people with arthritis. But don’t assume more walking is always better.
If you have significant pain, start to limp, or your knee swells after a walk, stop and get it checked. I'd rather have a patient walk comfortably for 15 minutes a day than push through an hour and then be sore for the next two days.
Strength training: Your joints need muscles, too.
I think that’s where a lot of patients underestimate the importance of exercise. When your knee hurts, you think about it. But the muscles around it also play a big role in supporting movement.
Weak thigh and hip muscles can make even simple tasks like getting up from an Indian-style floor sitting position, climbing stairs or getting out of a car more difficult.
Strength training might help. You don’t have to begin by lifting heavy weights at the gym. Depending on your condition, exercises such as sit-to-stand exercises, resistance-band exercises and controlled leg strengthening can be sufficient to start with.
The National Institute for Health and Care Excellence (NICE) recommends that people with osteoarthritis do tailored therapeutic exercise, including muscle strengthening and aerobic fitness.
One thing I tell my patients is, don’t be afraid of a little effort. Beware of doing too much too soon. A physiotherapist can lead you to the correct exercises and increase the load gradually.
Yoga: Useful, but don't push the pose
Yoga is a natural part of many Indian homes. It can be beneficial for flexibility, balance, mobility and body awareness. But if you have joint pain, not all yoga poses are for you.
Deep squatting, prolonged kneeling or sitting on the floor can be uncomfortable if you have knee or hip arthritis. What seems like a perfectly fine pose for one person may aggravate symptoms in another. You don’t need to show you’re flexible.
Change the pose. Use a chair or the bed if needed. Inform your instructor about your joint problem. Most importantly, don’t force your body into a pose just because everyone else in class can.
So what's the best exercise?
Walking, strength training and yoga all have their place, and there is no competition between them.
Walking keeps you fit. Resistance training helps build the muscles that support your joints. Yoga can increase flexibility and balance. And for many people, mixing all three might work better than using just one.
Begin where you stand. If you have been sedentary for months, do not wake up one day and decide to walk 10,000 steps. Never lifted weights? Don’t start with heavy dumbbells. And if your knees are sore, don't force yourself into deep yoga squats.
If you are still in pain, your joint continues to swell, or you are having difficulty with everyday activities, get a proper assessment before embarking on a new exercise programme. You don't need to rest your joints completely. They need to do the right movement, at the right speed, over and over again. And sometimes the best exercise is the one you can keep doing without dreading it tomorrow morning.
(The author is a consultant orthopaedic surgeon at HOSMAT Hospital)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
