Knee & Hip Osteoarthritis: Symptoms, Stages, Exercises & Physiotherapy in Newmarket

Exercise, physical activity, education, and appropriate weight management are important components of non-surgical management for knee and hip osteoarthritis. OARSI guidelines and patient resources support individualized exercise and physical activity as key components of OA management.

At RehabDNA Physiotherapy in Newmarket, physiotherapy can help you understand your symptoms, improve strength and mobility, and develop an individualized exercise and rehabilitation plan based on your goals and functional needs.

Understanding Knee & Hip Osteoarthritis

Osteoarthritis affects the structures within and around a joint.

Healthy articular cartilage provides a smooth surface that allows the joint to move with low friction and helps distribute loads through the joint. With osteoarthritis, the cartilage and other joint tissues undergo structural changes over time.

Changes associated with osteoarthritis can include:

• Cartilage changes and loss
• Changes in the underlying bone
• Narrowing of the joint space on X-rays
• Osteophytes, commonly called bone spurs
• Changes in the joint lining
• Joint stiffness
• Pain and reduced function

Osteoarthritis is therefore more complex than simply cartilage “wearing away.”

Knee Osteoarthritis

The knee is made up of several joint surfaces, including the:

• Medial compartment
• Lateral compartment
• Patellofemoral joint

Osteoarthritis can affect one or several of these areas.

Knee OA may cause pain during activities such as:

• Walking
• Standing
• Climbing stairs
• Squatting
• Getting up from a chair
• Kneeling
• Exercising

Physical therapy and specific exercises can help improve knee range of motion and strengthen the muscles supporting the joint.

Hip Osteoarthritis

The hip is a ball-and-socket joint formed by the head of the femur and the socket of the pelvis.

Hip osteoarthritis can cause pain around:

• The groin
• The front of the hip
• The outer hip
• The buttock
• Sometimes the thigh or knee

Hip OA can make activities such as walking, climbing stairs, getting into a car, putting on socks and shoes, or standing for longer periods more difficult.

Exercise and physical therapy can improve pain and function in people with symptomatic hip osteoarthritis.

Symptoms of Knee & Hip Osteoarthritis

Osteoarthritis symptoms can develop gradually, although symptoms may sometimes become more noticeable after a change in activity.

Common symptoms include:

Joint Pain

Pain may occur during or after activities that place load through the knee or hip.

Examples include:

• Walking
• Climbing stairs
• Standing
• Squatting
• Getting out of a chair
• Exercise

Joint Stiffness

Stiffness can occur after waking or after remaining in one position for a period of time.

Some people notice stiffness after sitting for a long time and feel that the joint becomes easier to move after they start moving.

Reduced Range of Motion

Hip or knee OA may make certain movements more difficult.

You may notice difficulty:

• Fully bending or straightening the knee
• Rotating the hip
• Putting on socks or shoes
• Getting into or out of a car
• Squatting
• Climbing stairs

Swelling

The knee may sometimes become swollen, particularly following increased activity.

Crepitus

Some people experience clicking, grinding, or crackling sensations during joint movement.

Crepitus by itself does not necessarily mean that the joint is becoming more damaged.

Reduced Strength

Pain and reduced activity can contribute to weakness in the muscles around the hip and knee.

This can make everyday activities more difficult.

Reduced Function

Over time, pain and stiffness can affect walking, stairs, household activities, exercise, work, and recreational activities.

Causes and Risk Factors for Osteoarthritis

Osteoarthritis does not have one single cause.

Several factors can contribute to the development of OA.

Age

Osteoarthritis becomes more common with increasing age, although it is not an inevitable part of getting older.

Previous Joint Injury

Previous injuries can increase the risk of developing osteoarthritis in the affected joint.

Examples include:

• ACL injury
• Meniscus injury
• Significant knee trauma
• Hip injury
• Previous fracture
• Previous joint surgery

Body Weight

Higher body weight can increase mechanical loading on weight-bearing joints and is associated with increased risk of knee osteoarthritis.

For people who are overweight and have OA, weight management may be one component of an overall treatment plan. OARSI guidelines support weight management for people with knee and hip OA who are overweight.

Muscle Weakness

Reduced strength around the hip and knee can affect functional capacity and make activities more difficult.

Strengthening exercises are therefore an important part of OA rehabilitation.

Genetics

Genetic factors can contribute to a person’s risk of developing osteoarthritis.

Joint Structure and Mechanics

Individual differences in joint structure, alignment, previous injuries, and movement patterns can influence joint loading and OA risk.

Does Osteoarthritis Get Worse With Age?

Osteoarthritis becomes more common with age, but symptoms do not necessarily progress in a predictable way for every person.

Some people have significant changes visible on imaging but relatively mild symptoms, while others can experience considerable pain and functional limitations despite less dramatic imaging findings.

Your symptoms, physical function, activity level, and goals are therefore important when deciding how to manage OA.

Stages of Osteoarthritis

Osteoarthritis is sometimes described using radiographic grades or stages based on X-ray findings.

A commonly used system is the Kellgren-Lawrence classification, which ranges from no radiographic OA to severe radiographic changes.

It is important to understand that an X-ray stage does not directly determine how much pain a person should have.

Someone with substantial X-ray changes may remain active with relatively manageable symptoms, while another person with less pronounced imaging findings may experience considerable pain.

Treatment should therefore consider the whole person rather than the X-ray alone.

Early Osteoarthritis

Early OA may involve relatively mild structural changes.

Some people may experience:

• Occasional joint pain
• Mild stiffness
• Symptoms after increased activity
• Minimal functional limitation

Exercise, physical activity, education, and appropriate load management can be useful at this stage.

Mild to Moderate Osteoarthritis

As symptoms become more noticeable, you may experience:

• More frequent pain
• Increased stiffness
• Reduced exercise tolerance
• Difficulty with stairs
• Difficulty walking longer distances
• Reduced strength

A structured rehabilitation program can focus on maintaining movement, improving strength, and supporting everyday function.

More Advanced Osteoarthritis

More advanced OA can involve:

• More persistent pain
• Significant stiffness
• Greater reduction in joint movement
• Difficulty with everyday activities
• Reduced walking tolerance
• Greater impact on quality of life

Non-surgical management can still play an important role, although some people may eventually require assessment for additional medical or surgical options.

Non-Surgical Treatment for Knee and Hip Osteoarthritis

Management of osteoarthritis is individualized.

Depending on your symptoms and circumstances, treatment may include:

• Education
• Exercise therapy
• Physical activity
• Strength training
• Mobility exercises
• Weight management where appropriate
• Activity modification
• Walking aids when appropriate
• Medication prescribed or recommended by a healthcare professional
• Injections in selected cases
• Joint replacement surgery when indicated

OARSI guidelines specifically address non-surgical management of knee, hip, and multi-joint osteoarthritis and emphasize patient-specific treatment approaches.

Physiotherapy for Knee and Hip Osteoarthritis

Physiotherapy focuses on improving the things that can be changed through rehabilitation.

Your physiotherapist may work with you on:

• Strength
• Joint mobility
• Balance
• Walking ability
• Functional movement
• Exercise tolerance
• Activity progression
• Self-management strategies

The aim is not simply to treat the joint in isolation but to help you improve your ability to perform the activities that matter to you.

OARSI patient guidance specifically identifies individualized exercise prescription and physiotherapy as important components of OA management.

Strength Training for Osteoarthritis

Strength training is an important component of rehabilitation for both knee and hip OA.

Depending on your assessment, exercises may target:

For Knee Osteoarthritis

• Quadriceps
• Hamstrings
• Calf muscles
• Hip abductors
• Hip extensors

For Hip Osteoarthritis

• Gluteal muscles
• Hip abductors
• Hip extensors
• Quadriceps
• Hamstrings
• Core and trunk muscles

Exercises can be performed using:

• Body weight
• Resistance bands
• Weights
• Machines
• Step exercises
• Functional movements

The appropriate resistance and number of repetitions should be adjusted according to your current strength and symptoms.

Manual Therapy for Knee and Hip Osteoarthritis

Manual therapy may sometimes be used as part of a broader physiotherapy program.

Depending on the assessment, this may include techniques intended to help:

• Improve joint movement
• Reduce stiffness
• Improve comfortable range of motion
• Address surrounding soft-tissue restrictions

Manual therapy should generally complement, rather than replace, active exercise and self-management.

Evidence-based OA rehabilitation places considerable emphasis on exercise and physical activity.

Mobility Exercises for Osteoarthritis

Maintaining comfortable joint movement can help you continue performing everyday activities.

Depending on the affected joint, exercises may include:

• Knee flexion and extension
• Heel slides
• Gentle hip mobility exercises
• Supported squats
• Controlled sit-to-stand movements
• Calf and hip mobility exercises

Your physiotherapist can help determine which movements are appropriate for your symptoms.

Best Exercises for Knee Osteoarthritis

There is no single “best” exercise for everyone with knee OA.

An appropriate program may include:

Straight Leg Raises

Lie on your back with one knee bent and the other leg straight. Tighten the thigh muscle and gradually raise the straight leg.

This can be used to develop quadriceps strength when appropriate.

Sit-to-Stand

Sit on a stable chair and stand up in a controlled manner before slowly sitting down again.

This is a useful functional strengthening exercise for many people with knee OA.

Step-Ups

Step onto a suitable step and return to the starting position in a controlled manner.

The height and repetitions can be adjusted according to your ability.

Knee Flexion and Extension

Gentle knee movement can help maintain or improve comfortable range of motion.

Cycling

Stationary cycling can provide aerobic exercise while allowing the amount of resistance and activity level to be adjusted.

Exercise programs should be individualized rather than selected solely from a generic list.

Best Exercises for Hip Osteoarthritis

Exercises for hip OA may focus on strength, mobility, and aerobic fitness.

Glute Bridges

Lie on your back with your knees bent and feet supported. Lift your hips in a controlled manner and lower them slowly.

Side-Lying Hip Strengthening

Side-lying exercises can be used to strengthen the muscles around the hip.

Sit-to-Stand

This functional exercise can strengthen the hips and thighs while practicing a movement used frequently in everyday life.

Step Exercises

Controlled step-ups can improve lower-limb strength and functional capacity.

Cycling

Stationary cycling can provide low-impact aerobic exercise and may be useful for some people with hip OA.

Water-Based Exercise

Water-based exercise can reduce the load experienced during movement while allowing aerobic and strengthening activity.

OARSI guidance recognizes aerobic, strengthening, and range-of-motion exercise as important components of hip and knee OA management.

Will Exercise Make Osteoarthritis Worse?

For most people with osteoarthritis, appropriate exercise is an important part of management rather than something that should be avoided.

Exercise can help improve:

• Strength
• Physical function
• Mobility
• Exercise tolerance
• Confidence with movement

OARSI describes exercise and physical activity as key treatment options for people with OA and recommends starting at an appropriate level and gradually increasing activity.

However, exercise should be appropriately dosed.

A temporary increase in symptoms can occur when activity is increased too quickly. Your physiotherapist can help you adjust exercise volume, intensity, and progression.

Does Walking Help Knee and Hip Osteoarthritis?

Walking can be a useful form of physical activity for many people with OA.

However, the appropriate amount depends on:

• Current symptoms
• Walking tolerance
• Strength
• Fitness
• Joint involvement
• Other health conditions

If walking is painful, a gradual progression or alternative exercise such as cycling or water-based exercise may be considered.

Can Weight Loss Help Knee Osteoarthritis?

For people with knee or hip OA who are overweight, weight management can form part of a broader treatment plan.

Reducing excess body weight can reduce the mechanical load placed on weight-bearing joints and may improve pain and physical function.

Weight management should be individualized and should focus on sustainable lifestyle changes rather than rapid weight loss.

OARSI includes weight management among its recommendations for people with knee and hip OA who are overweight.

Can Physiotherapy Prevent Knee or Hip Replacement?

Physiotherapy cannot guarantee that someone will avoid or delay joint replacement.

However, structured exercise, education, physical activity, and other non-surgical strategies can help many people manage symptoms and maintain function.

For some individuals, symptoms may eventually become severe enough that joint replacement needs to be discussed with an orthopedic specialist.

The decision depends on factors such as:

• Pain
• Functional limitations
• Quality of life
• Response to non-surgical treatment
• Overall health
• Individual preferences

What If Physiotherapy Does Not Relieve My OA Symptoms?

If symptoms remain significantly limiting despite an appropriate rehabilitation program, your healthcare provider may discuss additional options.

Depending on the joint and individual circumstances, these may include:

• Medication
• Injection treatment
• Additional medical assessment
• Orthopedic consultation
• Joint replacement

For knee OA, AAOS identifies exercise, physical therapy, appropriate weight management, medications, injections, and surgery among the available treatment approaches depending on the individual situation.

For hip OA, AAOS similarly identifies exercise and physical therapy among non-surgical treatment options, with hip replacement considered when non-surgical measures no longer provide adequate relief.

Knee and Hip Osteoarthritis: When Should You See a Physiotherapist?

Consider a physiotherapy assessment if you experience:

• Persistent knee or hip pain
• Joint stiffness
• Difficulty climbing stairs
• Difficulty getting out of a chair
• Difficulty walking
• Reduced exercise tolerance
• Difficulty putting on shoes or socks
• Reduced strength
• Difficulty returning to activities you enjoy
• Pain that is limiting work or daily activities

A physiotherapy assessment can help identify your current limitations and establish an individualized rehabilitation plan.

What Happens During an OA Physiotherapy Assessment?

At RehabDNA Physiotherapy, your assessment may include:

Understanding Your Symptoms

Your physiotherapist may ask about:

• When symptoms began
• What activities aggravate them
• What makes them better
• Morning stiffness
• Walking tolerance
• Exercise tolerance
• Previous injuries
• Previous surgery
• Your work and daily activities
• Your rehabilitation goals

Physical Assessment

Depending on your symptoms, assessment may include:

• Joint range of motion
• Muscle strength
• Balance
• Walking pattern
• Functional movement
• Sit-to-stand ability
• Stair function
• Activity tolerance

The results help determine which aspects of your movement and function may benefit from rehabilitation.

Knee & Hip Osteoarthritis Rehabilitation at RehabDNA

At RehabDNA Physiotherapy in Newmarket, rehabilitation is individualized rather than based solely on an X-ray or diagnosis.

Our approach follows:

Assess → Identify → Plan → Treat → Progress → Return

Your rehabilitation program may include:

• Education about osteoarthritis
• Individualized exercise therapy
• Strength training
• Mobility exercises
• Functional movement training
• Balance and coordination exercises
• Activity progression
• Home exercise guidance

The program can be modified as your symptoms, strength, mobility, and activity level change.

Book a Knee & Hip Osteoarthritis Physiotherapy Assessment in Newmarket

Knee or hip osteoarthritis does not have to mean giving up the activities that are important to you.

At RehabDNA Physiotherapy, we provide individualized physiotherapy and rehabilitation focused on improving movement, strength, function, and your ability to participate in everyday activities.

RehabDNA Physiotherapy

455 Harry Walker Pkwy S, Unit 7
Newmarket, ON L3Y 8T3, Canada

Call: +1 (905) 509 8469

Email: Info@RehabDNA.com

Website: https://rehabdna.com in Newmarket, Ontario.