Arthritis and Exercise
Cardiovascular, resistance and flexibility guidelines for clients with arthritis.

Arthritis is a major health concern. According to the Centers for Disease Control and Prevention, 23% of all adults in the U.S., more than 54 million people, have arthritis. “It is a leading cause of work disability, with annual costs for medical care and lost earnings of $303.5 billion” (CDC 2020).
As a fitness professional, you can make a difference. Both the CDC and the Arthritis Foundation (arthritis.org) agree that exercise is an important tool in arthritis pain management and prevention.
Here are some guidelines to get you started with program design for clients with arthritis.
Exercise Guidelines for Persons With Arthritis
Cardiovascular Exercise Guidelines
- Obtain medical clearance from the client’s physician prior to beginning an exercise program.
- Incorporate smooth, rhythmic activities that use the large muscle groups.
- Avoid high-impact exercises that might stress the affected joints.
- Establish a frequency of 3–5 days per week.
- Set an intensity of 60%–80% of maximum heart rate.
- Depending on the initial fitness level of the client, you might begin with as little as 5 minutes of cardiovascular activity and gradually progress to 30 minutes.
- When progressing, increase duration before intensity.
- Modes of exercise may include walking, rowing, swimming, cycling and water workouts.
- Avoid exercise during periods of peak pain and joint inflammation.
Resistance Exercise Guidelines
- Obtain medical clearance from the client’s physician prior to beginning an exercise program.
- Begin each session with an adequate joint-range-of-motion warmup.
- Avoid exercises that cause increased joint pain.
- Establish a frequency of 2–3 days per week. Allow 24 hours between sessions for recovery.
- With deconditioned clients, begin with just two to three repetitions, and gradually progress to 10–12.
- Consider various modes of exercise. Options may include free weights, weight machines, isometrics and elastic bands.
- Avoid high-repetition, high-resistance exercises that cause a greater force impact on affected joints.
- Avoid exercise during periods of peak pain and joint inflammation.
Flexibility Exercise Guidelines
- Obtain medical clearance from the client’s physician prior to beginning an exercise program.
- Precede sessions with a thorough warmup to increase internal body temperature and circulation.
- Incorporate flexibility work as often as every day.
- Give special attention to the lower back, hamstrings, calves and fronts of the shoulders.
- Include static stretches, holding for 10–30 seconds. Stretches may be repeated one to four times.
Your colleagues can offer some creative ideas for putting these ideas into action.
References
CDC (Centers for Disease Control and Prevention). 2020. Arthritis. Accessed July 7, 2021: cdc.govchronicdisease/resources/publications/factsheets/arthritis.htm.