If your knees or hips ache when you stand up, climb stairs, or walk further than the shops, you are not alone. Around 2.1 million Australians live with osteoarthritis. The evidence is clear that exercise and education help with the day-to-day pain, and Australian and international guidelines recommend them ahead of medication or surgery. This post explains what works, why, and how we run ours.
01 · The evidence
What the evidence actually says about exercise for osteoarthritis
Hip and knee osteoarthritis is the most common form of arthritis in Australia. The Australian Institute of Health and Welfare reports that around 2.1 million Australians (8.3 per cent) were living with osteoarthritis in 2022, and it becomes much more common with age.
For the last decade, the international consensus has been the same. International osteoarthritis guidelines (OARSI) place arthritis education and structured land-based exercise as the core treatments for knee, hip, and polyarticular osteoarthritis. The RACGP guideline for the management of knee and hip osteoarthritis reaches the same conclusion for Australian general practice: land-based exercise, weight management where relevant, and patient education are first-line care.
A Cochrane review of land-based exercise for knee osteoarthritis adds the detail. It graded the evidence for pain relief as high-quality, found short-term reductions in pain and improvements in physical function that were sustained for two to six months after the supervised program ended, and reported no serious adverse events across the included trials. The reviewers noted the size of the pain-relief effect was comparable to anti-inflammatory medication.
02 · What GLA:D is
What GLA:D® is, and what the research has shown
GLA:D® (Good Life with osteoArthritis: Denmark) is a structured supervised education and exercise program for people with symptomatic hip or knee osteoarthritis. It is a registered program owned and licensed by GLA:D Denmark, with international chapters in Canada, Australia, and several European countries. GLA:D Australia is hosted by La Trobe University.
The program structure is consistent across countries: two to three group education sessions plus twelve supervised neuromuscular exercise sessions over about eight weeks, delivered by clinicians who have completed the GLA:D certification course.
The reason GLA:D matters for an evidence discussion is the registry. Every participant fills in a standardised questionnaire at baseline, after the program, and at twelve months. That has produced a large, comparable dataset of patient-reported outcomes.
A pooled three-country registry analysis of 28,370 patients reported average improvements of 26 to 33 per cent in pain intensity and 12 to 26 per cent in joint-related quality of life from baseline to immediately after the program, along with better walking speed and chair-stand ability across Denmark, Canada and Australia. About 43 to 47 per cent of participants had a clinically meaningful reduction in pain. The GLA:D Australia evaluation reported reduced pain and improved quality of life at three and twelve months in 1,945 Australian patients across every state and territory.
These outcomes do not mean every person with osteoarthritis gets the same result. They mean that, on average, supervised structured education plus graded neuromuscular exercise has produced meaningful improvements across tens of thousands of patients.
First-line care means trying structured supervised exercise before reaching for medication or surgery.
03 · Our program
How the Optimum OA program works
Optimum Health Solutions runs its own structured program, the Optimum OA program. It incorporates the GLA:D approach and builds on it, drawing on the same published evidence base plus the OARSI and RACGP guidelines and the Cochrane review to shape how we pair patient education with supervised exercise.
What that looks like in practice for a person walking into one of our clinics:
- Assessment first. Your Physiotherapist takes a history, looks at your joint, watches you stand up from a chair, walk, and squat to whatever depth is comfortable, and asks about your goals. We want to know what you can and cannot do, what you have already tried, and what matters to you, whether that is gardening again, walking the grandkids to school, or sleeping through the night.
- Education paired with exercise. Understanding what osteoarthritis is, and is not, changes how people experience pain. We talk through what the imaging means and does not mean, why exercise does not wear out the joint, and what to expect as you build up.
- Graded neuromuscular exercise. The exercise component focuses on control, confidence, and functional strength around the affected joint. We start at a level you can complete with minimal post-exercise soreness, and progress as your tolerance and capacity build. Sessions can be one-to-one or in small supervised groups depending on the clinic.
- Outcomes you can see. We use measurable benchmarks (sit-to-stand counts, walking speed, pain ratings, function scales) so you can see what is changing across weeks four, eight and twelve.
The shape of a program varies. A 58-year-old recovering from a meniscus tear with early knee osteoarthritis looks different from a 75-year-old with osteoarthritis in both hips on the surgical waitlist. The structure stays the same: paired education, graded neuromuscular exercise, measurable outcomes, supervised by your Physiotherapist.
04 · Who benefits
Who an osteoarthritis exercise program suits, and who needs medical clearance first
A structured supervised exercise program suits most people with mild to moderate hip or knee osteoarthritis, including:
- Adults with painful, stiff, slow-to-warm-up joints in the morning, or pain after activity.
- People on a surgical waitlist for hip or knee replacement who want to build up their function before the operation (sometimes called prehabilitation).
- People who have already had a joint replacement and want a structured strength program in their second or third post-operative phase.
- People with osteoarthritis who have been told to keep moving and want a structured plan rather than guesswork.
There are situations where you should have a conversation with your GP first, and bring the result of that conversation to your first Physiotherapy assessment:
- A new or sudden change in joint pain that has not been investigated.
- Active joint infection, a recent corticosteroid injection in the past two weeks, or recent surgery.
- Unmanaged cardiovascular conditions where exercise intensity needs clearance from a cardiologist or GP.
- Inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, gout flare) that is not yet stable on medical management.
These are scoping questions, not stop signs. Your Physiotherapist will walk you through them at your first appointment and may ask you to bring a letter or referral from your GP if anything in your history warrants it.
05 · How to start
How to start with Optimum Health Solutions
If you would like to talk through whether an osteoarthritis exercise program is right for you, the first step is a Physiotherapy assessment.
Our Physiotherapy team runs the Optimum OA program at our clinics. Sessions can be one-to-one or in small supervised groups. Where it suits your goals and your funding, your Physiotherapist may also bring in our Exercise Physiology team to extend the program once the early supervised weeks are complete.
What to bring to your first appointment:
- Any imaging reports (X-ray, MRI) you have for the affected joint.
- A short list of your goals, the activities you want to be able to do at the end of twelve weeks.
- Your current medication list.
- Any relevant letters or correspondence from your GP, rheumatologist, or surgeon.
For more on osteoarthritis itself, see our osteoarthritis explainer. For broader exercise-and-bone-health framing, see our exercise and bone health guide. To book, head to the bookings directory and pick the location that suits you. If you are a referrer, our referrers hub has the intake details.
