Osteoarthritis: Does High-Impact Exercise Really Wear Out Your Joints?

​For years, people with knee or hip osteoarthritis have been told to avoid activities like running, tennis, jumping, or other high-impact exercises because they might "wear out" their joints faster.
But new research published in the British Journal of Sports Medicine is challenging that long-held belief.

https://pubmed.ncbi.nlm.nih.gov/42414085/

What Did the Study Find?

Researchers followed more than 17,000 people with hip or knee osteoarthritis over a 12-month period to determine whether participating in high-impact physical activity increased the likelihood of needing a joint replacement.
The results were surprising (not to us of course):

• People with hip osteoarthritis who participated in high-impact activities had a 36–48% lower chance of needing a hip replacement within the following year.
• People with knee osteoarthritis who remained active with higher-impact exercise did not have an increased risk of knee replacement.

In other words, staying active—even with higher-impact activities when appropriate—did not appear to damage joints or speed up arthritis progression.

Does This Mean Everyone Should Start Running?

Not necessarily.
The key message isn't that everyone with osteoarthritis should suddenly begin high-impact exercise. Instead, the study suggests that high-impact activity isn't automatically harmful for people with osteoarthritis.
The best exercise depends on several factors, including:

• Your current pain level
• Joint mobility
• Muscle strength
• Balance
• Overall fitness
• Personal goals

For some people, walking may be the right starting point. Others may safely continue jogging, hiking, pickleball, tennis, or recreational sports.

Why Movement Matters

One of the biggest misconceptions about arthritis is that painful joints should be rested.
In reality, the opposite is often true.
Regular exercise helps:

• Strengthen the muscles that support your joints
• Improve flexibility and mobility
• Reduce stiffness
• Improve balance
• Increase endurance
• Support a healthy weight, reducing stress on joints
• Improve confidence in movement

The study also found that people with better physical function had a slightly lower risk of knee replacement, highlighting how important strength and mobility can be.
Don't Let Fear Stop You
Many people avoid activity because they're worried they'll make their arthritis worse.
Fortunately, research continues to show that "hurt" does not always mean "harm."
Some soreness after activity is normal, especially when beginning a new exercise program. That doesn't necessarily mean you're causing damage.
A physical therapist can help you understand the difference between expected discomfort and signs that an activity should be modified.
How Physical Therapy Can Help
Every person with osteoarthritis is different.
A physical therapist can evaluate your movement, identify areas of weakness or stiffness, and develop a personalized plan that helps you stay active safely.
Your treatment plan may include:

• Strength training
• Balance exercises
• Flexibility and mobility work
• Walking or running progression
• Sport-specific training
• Pain management strategies
• Education about safely returning to activities you enjoy

The goal isn't simply to reduce pain—it's to help you continue doing the things that matter most to you.

The Bottom Line

This new research offers encouraging news for people living with osteoarthritis.
Higher-impact activities do not appear to increase the risk of joint replacement for most people with knee osteoarthritis and may even be associated with a lower risk of hip replacement in people with hip osteoarthritis.
Rather than avoiding movement out of fear, work with a physical therapist to determine what types of exercise are safe and appropriate for your body. With the right guidance, staying active can help you move better, feel stronger, and maintain your independence for years to come.​



Reference: Liew BXW, Grønne DT, Roos EM, Skou ST. High-impact physical activity participation and 12-month risk of joint replacement: a longitudinal mediation analysis of 17,661 patients with knee or hip osteoarthritis. British Journal of Sports Medicine. Published online July 9, 2026.

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