SMASH the Stigma: The Unbreakable Guide to Lifting with Osteoarthritis

Osteoarthritis (OA) is often called "wear and tear," but that name suggests you should stop using the joint altogether. That couldn't be further from the truth. Inactivity is one of the worst things for an arthritic joint, as the cartilage relies on movement for nutrition.

However, you can’t just jump back into heavy lifting without a strategy. You need a way to build muscle—the ultimate long-term support for your joints—without aggravating the pain.

Here is your smart guide to building strength and confidence, even with knee, hip, or shoulder OA.

The Goal: Maximizing Muscle Gain While Minimizing Joint Stress

For clients with OA, the objective shifts from simply "lifting heavy" to finding the maximum effective load that remains pain-free. We want to strengthen the muscles that stabilize the joint, improve functional independence, and keep you active, all without causing a flare-up.

This requires a systematic approach to adjusting the type and speed of the load.

Your 6-Step Hierarchy for Pain-Free Loading

When starting or returning to strength training with OA, we use a specific progression to ensure your joints are protected while your muscles are challenged. You should always start at the lowest effective level that is pain-free and only progress when you are completely comfortable.

Here is the ideal progression, moving from the least joint-stressing load to the most advanced load:

Rank	Loading Method	Why It Works for OA
1. Isometric Training	Static holds (e.g., wall sit, plank, holding a dumbbell mid-rep)	Lowest Joint Stress. Produces significant muscle tension without any joint movement or friction. Perfect for painful joints and building initial confidence.
2. Resistance Bands	Using rubber loops or tubing.	Provides variable resistance (less tension at the start of the movement and more at the end). This makes the typically painful bottom portion of the movement much easier.
3. Cable Machines	Using a pulley system.	Allows for constant tension throughout the entire range of motion, but—crucially—the load is always horizontal or at a fixed angle, not pulling straight down. This often feels much easier on joints than free weights.
4. Bodyweight	Squats, push-ups, lunges using only your own weight.	This is the baseline for functional movement. However, it requires good mobility and is sometimes too much for severe OA, which is why we often use bands or cables first.
5. Dumbbells	Hand-held free weights.	Allows for independent control of each limb, which is excellent for addressing imbalances that might contribute to OA pain.
6. Barbell	Using a fixed barbell for exercises like squats or deadlifts.	Highest Joint Stress. The load is fixed across the back/shoulders, demanding the most core stability and symmetrical movement. This is the most effective for systemic strength but is often reserved for when your mobility and muscle base are fully rebuilt.

The takeaway: A barbell is the most effective tool for strength building, but for someone with OA, isometric training and resistance bands are often the safest and most joint pain-free starting points.

The best advice I can give you for the widest range of success is to start with what doesn’t hurt, that you can load with the most amount of weight that doesn’t hurt.  If it hurts, start working your way up the table.

For example, I can still get away with Barbell Bench Press (some days)!  Somedays however, my elbow is in such bad shape that it hurts to even hold onto the barbell.  So, I’ll shift to Dumbbell bench press.  If that still doesn’t feel great, I’ll work up to bodyweight or cables!  (And by feel great I mean a scale of pain from 1-10, 10 being I want to cut my arm off completely and 1 being no pain at all, we’re looking for about a 2-3, since dealing with arthritis it’s quite impossible to ever be completely pain free).

I hope this helps a few people out and if you love it, give it a share!