How can you exercise when your weight makes your joints hurt?

Why do joints hurt more with higher body weight?

The knees, hips, ankles and lower back carry body weight with every step. Higher body weight increases the load on these joints and is a risk factor for osteoarthritis. Fat tissue also produces inflammatory substances that may contribute to joint pain.

Pain can make people less active, which weakens muscles, increases stiffness and makes weight management harder. Breaking this cycle with suitable exercise is important.

Which exercises are gentle on the joints?

Water-based exercise, swimming, stationary cycling, rowing machines, seated exercises and elliptical trainers load the joints less than running or jumping. Walking is still valuable and can be done in shorter bouts on flat surfaces.

A Cochrane review of 13 trials with 1,190 people with knee or hip osteoarthritis found that aquatic exercise, on average over 12 weeks, produced small short-term improvements in pain and disability, equivalent to about five points on a 100-point scale, and no serious adverse events were reported 1.

How much exercise is recommended?

The World Health Organization recommends that adults do 150 to 300 minutes of moderate-intensity aerobic activity a week, or equivalent vigorous activity, plus muscle-strengthening activities on two or more days a week. It also recommends reducing sedentary time, and notes that some activity is better than none 2.

People starting from low activity levels can begin with short sessions and gradually build up.

Why is strength training important?

Stronger thigh, hip and core muscles support and protect the joints, improve balance and make everyday tasks easier. Strength training also helps preserve muscle mass during weight loss.

Exercises can start with sit-to-stand from a raised chair, wall push-ups, resistance bands and seated leg extensions, progressing as comfort allows.

Does combining diet and exercise help more?

In the IDEA trial of 454 older adults with overweight or obesity and knee osteoarthritis, participants were assigned to intensive diet plus exercise, diet alone or exercise alone for 18 months. The diet plus exercise group lost an average of 10.6 kilograms (11.4 per cent) and had less pain and better function than both the diet-only and exercise-only groups 3.

Knee compressive forces were lower in participants who lost weight through diet than in those who only exercised 3. This supports combining physical activity with dietary changes.

How can pain during exercise be managed?

Mild discomfort during exercise is acceptable if it settles soon afterwards. If pain increases the next day, reduce the intensity or duration rather than stopping completely. Supportive footwear, warming up and using pain relief as advised can help.

A physiotherapist can recommend exercises that suit specific joints and help with any fears about exercise.

How can I stay motivated when progress feels slow?

Changes in weight and joint pain can take time, so focusing on other signs of progress helps. These include being able to walk further, climbing stairs more easily, sleeping better, having more energy or needing fewer rest breaks.

Setting small weekly goals, exercising with a friend or group, and recording activity in a diary or app provide encouragement. Setbacks such as illness or a painful week are common; restarting at a lower level rather than giving up keeps long-term progress on track.

When should I check with a doctor before starting?

Speak with a doctor before starting a new programme if you have heart disease, chest pain, severe breathlessness, dizziness, uncontrolled blood pressure or diabetes, or recent joint injury.

Stop exercising and seek medical help for chest pain, severe breathlessness or fainting.

Frequently asked questions