Is Walking Good for Knee and Hip Arthritis?

Physio · 7 minute read

For most people, yes. Walking is one of the simplest things you can do for an arthritic knee or hip, and the research does not back up the worry that every step wears the joint out faster.

When a joint aches, resting it feels like the sensible thing to do. It is a very natural instinct. But osteoarthritis is a long-term condition, and the joint does better when it is kept moving.

Why walking helps an arthritic joint

Healthdirect, the Australian Government’s health information service, puts it simply: regular exercise keeps your joints and muscles healthy and flexible and can help reduce pain. It lists brisk walking alongside swimming and cycling as ways to build general fitness.

Australia’s clinical care standard for knee osteoarthritis says the same thing in its own words: being active can help manage knee pain and improve function.

Walking also has practical advantages. It needs no equipment, it fits into everyday life, and you can make it easier or harder just by changing the distance, the pace or the route.

What the research says

The Royal Australian College of General Practitioners guideline for knee and hip osteoarthritis strongly recommends walking for people with knee osteoarthritis, along with strengthening exercise and Tai Chi. For hip osteoarthritis it strongly recommends land-based exercise in general, without singling out one type as better than another.

One of the most useful studies followed 1,212 people aged 50 and over with knee osteoarthritis in the United States. Nearly three in four walked for exercise. Over four years, the walkers were less likely than the non-walkers to develop frequent knee pain, and worsening of the joint space on X-ray was less common among them.

That study observed people rather than assigning them to walk, so it shows a link rather than proof. But it points away from the idea that walking wears an arthritic knee out, and its authors concluded that walking for exercise should be encouraged for people with knee osteoarthritis.

How much, and how fast

Start with what your joint is comfortable with today, even if that is only ten minutes. Then add a few minutes every week or so. Two shorter walks in a day count just as well as one longer one.

Over time, a good goal to build towards is the national guideline. For Australians aged 65 and over, it is 30 minutes or more of moderate activity on most days, plus muscle-strengthening activities on two or more days a week. Moderate means you are breathing a little harder but can still talk.

There is no prize for getting there quickly. A steady build that your joint can keep up with beats a big week followed by a flare-up.

The 24-hour rule

A little discomfort while you walk is normal when you have arthritis, and it does not mean you should stop. The rule of thumb used in the GLA:D program is simple: some mild pain during or after exercise is fine if it settles within 24 hours.

If the joint is more sore the next day, or it has swollen up, that walk was a bit too much for now. The answer is to go a little shorter, slower or flatter next time, not to stop walking altogether.

Making walks easier on your joints

1. 1Wear stable, supportive shoesA University of Melbourne trial compared flat, flexible shoes with stable, supportive shoes in people with knee osteoarthritis. Over six months, the supportive shoes eased knee pain while walking more than the flat ones, and fewer people had side effects in them.
2. 2Start on flat, even groundFootpaths, parks and tracks are a good place to start. Hills and stairs can come later as your legs get stronger.
3. 3Consider a walking stick or polesThe RACGP guideline says a walking stick or other aid may help some people with knee or hip osteoarthritis with pain, mobility and balance. A stick is usually held in the hand on the opposite side to the sore joint.
4. 4Add some strength workWalking works best alongside exercises that strengthen the legs, which the guidelines also strongly recommend for knee osteoarthritis. Standing up from a chair without using your hands, a few times a day, is a good place to start.
5. 5Have a plan for flare daysBad days happen. On those days, go shorter and flatter rather than skipping it, and pick it back up when the joint settles.

What if walking hurts too much?

If you cannot walk far without pain that lingers into the next day, you are not doing anything wrong, and it does not mean walking is off the table. It usually means you need help setting the right starting point and building from there.

That is exactly what a structured, physio-supervised program is for. Some people also find water-based exercise or a stationary bike easier to start with. The RACGP guideline says water-based exercise may suit some people with knee or hip osteoarthritis, and stationary cycling may suit some people with knee osteoarthritis.

Common questions