What if you could keep your joints strong and pain-free for decades—without endless cardio or risky workouts?

Amy Hudson and Dr. James Fisher continue their series on the benefits of strength training, breaking down the connection between osteoarthritis and strength training. They reveal how targeted strength work can reduce joint stress, slow degeneration, and even improve quality of life. 

Tune in to learn how strength training can protect your joints and keep you moving pain-free.

• Dr. Fisher starts by explaining what osteoarthritis really is–a degenerative joint disease where cartilage and bone break down over time. 
• That damage triggers pain, stiffness, and reduced mobility, often creating a vicious cycle where inactivity leads to weight gain, and extra weight adds even more stress to already struggling joints.
• Dr. Fisher highlights that every case is personal. No two people with osteoarthritis have the same symptoms, challenges, or lifestyle impact. 
• How to reduce your risk before it starts. Dr. Fisher points out that obesity is one of the strongest risk factors for knee osteoarthritis—and losing weight can dramatically lower that risk.
• Dr. Fisher explains how building muscle around the knee stabilizes it, making injuries less likely. Preventing that initial injury can mean delaying, or even avoiding, the onset of osteoarthritis.
• According to Dr. Fisher, strength training offloads the joints. By strengthening the muscles, you shift the workload from the skeletal system to the muscular system. This means less wear and tear on your joints and more support for pain-free movement.
• Amy and Dr. Fisher agree—our bodies aren’t meant to carry all the load on our skeletons. Skipping strength training leaves your joints taking on more stress than they should. 
• Dr. Fisher reveals research showing resistance exercise works. Studies confirm it can decrease pain, improve joint mechanics, and restore physical function. It’s a proven way to reclaim strength and confidence in movement, even with osteoarthritis.
• Learn why strength training beats repetitive cardio for joint safety. High-impact, repetitive movements—like running—can aggravate joint pain.
• Amy shares how people can stay active despite joint pain. 
• Many people write themselves off from activities of daily life, but working with an exercise coach using slow, controlled muscle loading can fortify joints without causing irritation. 
• Dr. Fisher breaks down a study showing long-term benefits of strength training. 
• Amy and Dr. Fisher explain how resistance training has been shown to improve strength while reducing self-reported pain levels in osteoarthritis patients. The physical improvements often lead to greater confidence and quality of life.
• Dr. Fisher warns that degenerative conditions won’t resolve on their own. Without action, osteoarthritis like prediabetes or prehypertension, often progresses. Taking steps to improve strength and joint health now can slow or even stop that downward spiral.

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SHOW TRANSCRIPT

Why Strength Training Is the Best Exercise For Your Arthritis

I think that’s hard for us sometimes to wrap our mind around potential possibilities and scenarios that are unfavorable in the future.

If I hadn’t done the strength training that I’ve done through my time as a basketball player, I might have had much more significant knee injuries and that might have led to the onset of osteoarthritis at this time.

Welcome to the Strength Changes Everything podcast, where we introduce you to the information, latest research, and tools that will enable you to live a strong, healthy life. On this podcast, we will also answer your questions about strength, health, and well -being. I’m Amy Hudson. I own and operate three exercise coach studios. My co -hosts are Brian Sagan, co -founder and CEO of The Exercise Coach, and Dr. James Fisher, leading researcher in evidence -based strength training. And now for today’s episode.

Hi, everybody. We are continuing a series today taking deep dives into specific health benefits of strength training. Dr. Fisher is going to break down the connection between osteoarthritis today and strength training and how this area of our health can be improved. We’re going to talk about what it is. a little bit more about sort of how it works and what causes it. And then we’ll break down the connection between participating in strength training and one’s risk for this and how we can improve our quality of life around this area. So I’m super excited to dive in.

Dr. Fisher, let’s get started with just describing what’s osteoarthritis for those of us that don’t know what this condition is.

Yeah, absolutely. So osteoarthritis, first of all, it’s worth clarifying, differs significantly from sort of rheumatoid arthritis. So osteoarthritis is a degenerative joint disease characterized by breakdown of cartilage and bone. It leads to pain, stiffness, and reduced joint function and often leads people down a path of kind of poor mobility. then weight gain and then that weight gain can be extra weight through their joints and so forth, so leading to a bit of a vicious cycle. Osteoarthritis can be a number of factors.

So there can be some degree of genetic predisposition to it. There can be a product of kind of high repetitive movements if we’ve done kind of a working job where there’s been the same movement over and over and over again. We know that it’s higher following menopause, so that elevated estrogen can impact it. And obviously, it can follow on from injury. So if there’s been fracture or trauma to a site, that can result in osteoarthritis down the line. And then we’ve talked about adding weight and obesity, and obesity can add wear or tear to a joint.

So osteoarthritis can be really quite debilitating for some people, but certainly make exercise very off -putting. It sounds very uncomfortable. what you’re describing.

Yeah, so we’ve got a number of studies that we’re going to move through, and previously we’ve talked through meta -analyses around different medical conditions. When it comes to osteoarthritis, it’s a very individual condition, and we should recognize really that all medical conditions are individual to a person. No two people are suffering in the same way, experiencing the same things. There’s very much kind of a lived experience of medical conditions, so that’s worth highlighting. So the studies that we’re going to look at here are all kind of individual studies or review articles, but they’re not necessarily meta -analyses where they’ve kind of combined lots of studies to pluck out a single value. They’re more kind of individual studies where they’re just talking about the benefits and the outcomes.

One of the key papers here, and again, I’ve got some slides together on YouTube, if you’re interested to come and have a look at the slides that we’ve put together, is a review article from 2050. So it’s a few years old now, and it’s completely strategies for the Prevention of Knee Osteoarthritis. Now, one of the things that the authors in this paper talk about is that obesity, as we said at the start, is a major risk factor for osteoarthritis, and weight loss is affecting and reducing that risk of osteoarthritis. So one of the key things that these authors looked at was the impact of strength training programs as being successful. in kind of preventing major knee injuries, first of all.

So as a basketball player who’s had a major knee injury, they’re not avoidable, they’re not completely avoidable. Then I also like to think that if I hadn’t done the strength training that I’ve done through my time as a basketball player, I might have had much greater, much more significant knee injuries. And that might have led to the onset of osteoarthritis at this time. So strength training, first of all, can stabilize the knee and prevent that injury to begin with. and preventing that injury can lead us down a path of hopefully avoiding or certainly delaying osteoarthritis. They also talked about weight loss and they said that reducing weight through strength training can also help reduce the risk of osteoarthritis.

And they talked about impaired muscle function. So strength training serves to offload our skeletal structures. So when we engage in strength training, we’re strengthening the muscles around the joints and we’re using those muscles rather than loading the joint itself. Oftentimes you’ll see people stood and they might be in a slouched posture or they might have their knees completely locked out or one knee bent and one knee locked out. And what they’re doing is they’re loading their skeletal structure. They’re not loading their muscular system.

If for example you’ve ever done a leg press or a chest press exercise, you’ve always been encouraged not to reach that full end point in the range of movement where you lock out the joint. But when you lock out the joint, you effectively transfer all load onto the skeleton and take it off the muscle. So one of the things that these authors talk about is that engagement in strength training helps us be aware of that and helps to load our muscular system, not load our skeletal system, and therefore we are strengthening our muscles and maintaining the mobility of the joints themselves.

Dr. Fisher, would it be a fair statement to say that we, our body is actually designed not to have our skeletal system loaded a lot, like not participating in strength training is doing our body a disservice by putting unnecessary strain on our skeletal system.

Yeah, actually, it’s a really interesting discussion because lots of people will think that when they engage in strength training, they’re improving their bone mineral density, and they’re 100 % right in doing that. And they’re loading their bones, they’re not loading their joints. So, when you engage in strength training, you are certainly increasing your muscular strength and you’re certainly increasing your bone mineral density. But yes, by not engaging in strength training, you are really doing your body a disservice and potentially loading the skeletal system rather than the muscular system. Okay, the next study that we want to look at is again another study that specifically looked at knee osteoarthritis. This one is a little bit earlier study.

This is from 2012. But there’s some really interesting statements. So for example, one of the conclusions that these authors draw is that resistance exercise has been shown to be an effective intervention for both decreasing pain and improving physical function and self -efficacy. Resistance exercise may restore muscle strength and joint mechanics while improving physical function. Now, if this sounds to you like I’m reading directly from the research paper, then I am. The text is on the screen if you’re watching on YouTube, of course, or if you’re listening on the podcast, please go to the screen and you can see the paper itself.

The authors continue, resistance exercise also may normalize muscle firing patterns and joint biomechanics, leading to reductions in joint pain and cartilage degradation. These physical adaptations could lead to improved self -efficacy, decreased anxiety and depression, and resistance exercise can be prescribed and performed by patients across the spectrum of osteoarthritis severity. So there’s a couple of key things in all this. I really love that these authors have included within their review the discussion of joint pain. Many people with osteoarthritis will be experiencing pain and that will be very off -putting to go and do exercise.

Certainly going for a run, going for a walk, doing anything that’s a repetitive movement which is typical cardiovascular exercise. Strength training, of course, doesn’t load the joints in the same way because it’s non -impact and it doesn’t load the joints in the same way because it’s not high repetition. It’s simply a handful of very slow, very controlled repetitions. You know, most people who go to the exercise coach when they get on a leg press probably do between six and eight repetitions at the most because of how slow they’re actually moving through that. By moving slowly through that, they’re loading the muscular system, not the skeletal system, which is what we’ve already talked about. And therefore, it doesn’t have the same pain implication during the exercise itself.

One of the authors are then saying is it can then serve to reduce joint pain by reducing cartilage degradation and by improving kind of physical function and muscle firing rate and some of the joint biomechanics themselves. And of course, they then go on to talk about quality of life factors like self -efficacy, decreased anxiety and depression, which of course if you’re prescribed with a medical condition where you can’t go out and engage in normal activities, then you would lose confidence in yourself, you’d lose identity in who you are, and you might start to lose that social interaction as well, and so forth. So we can see how many of these conditions can have kind of a longer -term negative effect to other lifestyle factors. And of course what the authors are effectively saying here is that resistance exercise can be prescribed in a number of ways from heavy loads to lighter loads, from high repetitions to low repetitions, from high cadence or high repetition duration to low repetition duration and it can be prescribed for anybody on the spectrum with osteoarthritis.

I really liked your description on how strength training safely can improve and not necessarily bother or exacerbate pain in a joint and in fact help us long term. I think it’s easy for people who have pain in any joints, like their knees, for example, to sort of like count themselves out of other activities of daily life. Oh, my family and I, you know, are walking around the lake. I’m not going to go or visit the amusement park. You know, it’s just easier to to to count yourself out. But then that’s kind of depressing.

Right. And and a little bit sad. And I really just appreciate the explanation you gave and the encouragement that No, we can we can serve to fortify that musculature around that joint in a safe way without irritating the joint itself by slow controlled muscular loading that in fact will help us long term. So thank you for that.

But yeah, so the next study that we’re going to look at, and again, I’ve got this on the screen here, affects the strength training on the incidence and progression of knee osteoarthritis. Now many studies, as you’ll now begin to see, have looked at the knee as a specific joint. Osteoarthritis is not limited to just the knee joint, but that certainly is the highest sort of prevalence. And so it’s the one where most research has been done. So in this study, was 221 older adults with a mean age of 69 years and they were randomized to either a strength training or a range of motion training group where they participated three times a week for 12 weeks.

So the range of motion training group is effectively passively moving your joint through a range of motion, almost to a stretch factor. So it can be thought of as a mobility exercise rather than specifically loading the muscle. And then all participants transitioned to home -based exercise and were reassessed after 30 months. And this is something that I love, this idea of reassessing further down the line. And in this case, we’re looking at two and a half years. So they’ve engaged in 12 weeks of strength training, of supervised strength training. and then they’ve gone away to do home -based exercise and then they were reassessed two and a half years later to find out what the outcome was and whether there were longer term benefits. So the authors concluded, the strength training group retained more strength and exhibited less frequent progressive joint space narrowing over 30 months than the range of motion group. So one of the things that we’re seeing with osteoarthritis with the breakdown of cartilage and the breakdown of bone is that there is a joint space narrowing. There’s effectively a compression within the joint where it might be bone on bone or the cartilage is worn away and hence we’re experiencing pain. So anything that we can do to have less joint space narrowing is absolutely key if there is progression of osteoarthritis. And in this case, what they’re saying is the strength training group actually exhibited less progressive joint space narrowing over 30 months compared to the range of motion group.

Wow, that’s awesome.

So our final one here is another reviewer. is a review of 18 studies, 2 ,800 participants aged 55 to 74 years and again it’s probably worth clarifying most of these studies are in older adults simply because they are the ones that typically experience osteoarthritis. Now you can have earlier onset osteoarthritis and of course that doesn’t mean that strength training is not beneficial for those population groups as well. but the studies typically will have looked at where it’s most prevalent. So in this case, this was a series of studies where strength training was prescribed to people with osteoarthritis and the conclusions from these authors were that resistance training improves muscle strength and self -reported measures of pain and physical function in 50 to 75 percent of the cohort. Now one of the main reasons I wanted to bring up this paper is because many people will go away and they will engage in strength training and they will say, oh I got stronger but I didn’t reduce my pain or I reduced my pain but I didn’t feel like I improved my mobility.

Okay, so I think that one of the things that we can be aware of in all this is there is a wealth of research that shows the benefits of strength training in multiple facets of our well -being, whether that’s less progressive joint space narrowing as we had in the previous study, whether that’s weight loss, whether that’s improved strength, whether that’s improved mobility or reductions in pain and so forth. But we might not experience the specific one that we’re interested in. So somebody that obviously has a higher degree of pain with their osteoarthritis would primarily be looking to reduce that pain. Well, if they don’t reduce their pain, but they do improve their physical function, and they do improve their kind of the joint space narrowing, then they’re effectively delaying that onset of osteoarthritis. So they might not be acutely reducing pain, but they might be reducing direction that that pain might be going.

They might be reducing or showing a reduction in increased pain over the lifespan. So it’s worth just kind of clarifying that. But one of the things that I love about that statement is self -reported measures of pain. Pain, as we said before, is a very individual factor. So how people experience different medical conditions is a really individual thing. But in this case, it was people self -reporting their pain.

And as it says, resistance training improved muscle strength. and showed reductions in self -reported measures of pain.

Really cool. Yeah, it’s kind of mind -blowing to think about that statement you were talking about is the future pain or the worst pain you may have in the future that you’re avoiding, even if you’re not completely eliminating your pain at this time. I think that’s hard for us sometimes to wrap our mind around potential possibilities for the future and scenarios that are unfavorable in the future. We don’t want to think about that. We don’t want to spend time thinking about that. But it can be pretty powerful to actually just spend five minutes and imagine what life would be like if not for the healthy behaviors that I’m participating in right now. because it can feel your fire when you don’t feel like doing that or you’re not sure if you’re making enough progress.

Yeah, anybody who’s lost weight can look back at themselves in their previous body weight and say, hey, 10 years ago I weighed this and now I weigh this. Anybody who’s engaged in strength training and improved their muscle strength and their physical function can say, you know, 10 years ago, I couldn’t function as well, and I wasn’t strong, and now I feel better, and I sleep better, and I’m stronger, and so forth. And it’s the same, unfortunately, with some of the negative implications of some of these conditions. You know, you might say, well, 10 years ago, I didn’t have osteoarthritis, and now I have it, and it’s very painful. Five years ago, it wasn’t as painful as it is today, which means that in five years’ time, it might be even worse.

And these are typically degenerative conditions. In previous podcasts, we’ve talked about high blood pressure, we’ve talked about diabetes, we’ve talked about cholesterol levels. these are not things that typically resolve themselves. So if you’re if you are pre -hypertensive and you don’t do anything, you’re really on a pathway to hypertension. If you’re pre -diabetic and you don’t do anything, you’re on a pathway to being diabetic and so forth. So if you’re experiencing osteoarthritis or if a loved one or a family member or friend has osteoarthritis but they’re not doing anything to try to improve their quality of life, improve their strength, improve their joint health, then that they might be on, you know, hopefully slow, but they might be on a downward spiral.

So it’s certainly worth passing this information on to friends, family members, loved ones, or of course, if you as a listener have osteoarthritis, then now’s the time to engage in strength training.

A hundred percent. Thank you for speaking directly to that person at the end here, because that was what I was going to ask you. Do you have any final thoughts on this?

No, I think that as we’ve gone through these theories, it’s been a real pleasure to kind of talk through these health benefits. And everybody on the podcast, everybody who listens knows that strength training is, of course, my life. It’s something I’ve devoted my research to. But it’s so important to pass on this information to you as a listener, but also to your friends, families, loved ones, and so forth, and really create good habits for children as well.

Right.

Yes, we can we can fall back on what the research has shown. This is not a possibility or a guess or a pop. You know, it sounds like it might be true. The research is showing that there is evidence for this. And so that’s something that we can. encouraged with.

Thank you for breaking this down for us, Dr. Fisher, and all of these other things in this series, too, all of these other benefits that we’ve broken down with the science. We will see you next week on the podcast for some of our concluding remarks on this topic. Until then, have a wonderful week, and we hope you remember, strength changes everything. Thanks for listening. If you enjoyed today’s episode, please share it with a friend. You can submit a question or connect with the show at strengthchangeseverything .com. Join us next week for another episode and be sure to follow the show on Apple Podcasts, YouTube, or wherever you get your podcasts so that you never miss another episode. Here’s to you and your best health.