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Osteoarthritis and Adherence to Home Exercise

Why Is It So Hard to Stick With an Exercise Regimen?


Updated December 01, 2012

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Experts recommend regular exercise and physical activity for people with osteoarthritis. The benefits of exercise are well-known. Exercise can reduce pain, strengthen your muscles, improve your balance, improve your range of motion, boost your mood and sense of well-being, help control your weight, and more. Yet, while the recommendation for regular exercise and its benefits are known, many people can't seem to stick to a regular home exercise regimen.

This seems especially true for osteoarthritis patients who have participated in physical therapy sessions. Once they have been coached by a physical therapist regarding proper execution of the exercises and given a workout to do at home, too often, it ends there.

Exercise Potentially Improves Physical Function

The World Health Organization reports that 80 percent of people with osteoarthritis have limitations in movement and 25% are restricted in performing activities of daily living. Exercise, by reducing pain and improving strength, can improve physical function and the ability to perform daily activities. Why aren't these facts enough of an impetus to get people moving and keep them moving? Why doesn't the knowledge of exercise benefits translate into adherence to exercise?

Benefits of Exercise Require Commitment

Many osteoarthritis patients will tell you that they can't stick to a regular home exercise program because exercise causes them more pain. Stated simply, it hurts to exercise. Many people believe it is better to rest their joints. They don't buy into the "no pain no gain" theory. They aren't convinced that long-term benefits require long-term dedication. Another very common reason given for not exercising is "no time". Given, we have busy lives. But taking care of ourselves and trying to improve our health should not fall to the bottom of a priority list.

Poor adherence to home exercise has also been attributed to certain psychological factors. To be able to adhere to a home exercise program, you must have a positive attitude, motivation, the ability to focus on goals, and self-efficacy (the belief that you can do it). Home exercise programs, by definition, mean that you are your own coach. Are you wondering how you can invest yourself in a home exercise program and remain committed? It's never too late to consider these suggestions:

Consult With Physical Therapist
If you haven't already done this, perhaps through referral from your doctor or required therapy following joint replacement surgery, discuss appropriate exercises which you can perform at home with a physical therapist. Have the therapist explain what is to be gained from performing the exercises at home.

Prepare Yourself Mentally
Develop a positive attitude about exercise. How this is accomplished may be different for everyone, but it is necessary to get beyond the feeling that exercise is drudgery. Rather than perceiving exercise as unpleasant, start thinking of it as essential and beneficial.

Realize the Benefits of Exercise for You
Personalize the advice you hear about exercise. We sometimes tend to think advice is not directed at us. Realize that advice about the importance of regular exercise for managing osteoarthritis pertains to you, not just to others. Don't dissociate yourself from the advice.

Adapt Home Exercise to Make It Enjoyable
Sometimes a fun atmosphere can carry over and make a routine more enjoyable. If you listen to music while exercising, it may improve the experience. If not music, perhaps watch a favorite show while you exercise.

Set Goals for Home Exercise
Achievement can be motivating. If you set goals and track your progress, you will likely be motivated to continue with your exercise regimen. Build on your progress.

Have Both Short-term and Long-term Goals
Once short-term goals are attained, there may be a sense of completion. But exercise should continue with new goals. Your goals should be used to move progress forward. You are never done.

Keep an Exercise Journal
Keeping a journal is a good way to track your progress. Have your original routine in the journal and then you can add or subtract from the routine. You can write about your physical progress and you can use the journal to express your satisfaction or dissatisfaction. Vent your feelings.

Get an Exercise Buddy
It helps to not feel alone in the process. Your buddy can be a friend or family member who actually exercises with you or it can be an online buddy with whom you keep in touch. Your exercise buddy can serve as coach, cheerleader, or someone who holds you accountable.

Have a Plan in Case Pain Increases
There will likely be times when exercise does temporarily increase your pain level or bring about a flare of symptoms. Follow your doctor's recommendations for dealing with those situations. For example, does your doctor want you to increase pain medications? Should you stop exercising for a couple of days? Should you apply heat or ice, if either, to your sore joints? Know ahead of time what you should do.


Exercise adherence improving long-term patient outcome in patients with osteoarthritis of the hip and/or knee. Martijn F. Pisters et al. Arthritis Care & Research. Volume 62, Issue 8, pages 1087-1094, August 2010.

The World Health Report. 50 Facts. World Health Organization.

Factors Determining Exercise Adherence. Theresa Dwyre Young, American Fitness. Jan-Feb 2005.

Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Reviews. Jordan JL et al. January 20, 2010.

Exercise Adherence Tips. Association for Applied Sport Psychology. Accessed 9/28/2011.

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