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Balance rarely gets a second thought — until a stumble on an uneven footpath or a wobble getting out of the shower brings it sharply into focus. For older adults, that split-second loss of stability is more than an inconvenience. Falls are among the leading causes of injury-related hospitalisation in people over 65, and roughly one in three adults aged 65 and over falls at least once a year, with half of those falling repeatedly [1]. The great news is that balance is trainable at any age, and a well-designed exercise program can make a measurable difference.

Why balance declines with age

Balance depends on three systems working together: vision, the inner ear (vestibular system), and sensation in the feet and joints (proprioception). With age, these systems naturally become less responsive, and this is often compounded by reduced muscle strength, slower reaction times, and medical conditions or medications that affect coordination. The result is a smaller margin for error when the body is challenged — stepping off a kerb, turning quickly, or reacting to a slip.

What the research shows

This is where targeted exercise has been shown to make a genuine difference. A recent systematic review in 2025 showed that structured balance and strength programs consistently reduced falls in older adults from 20–58% [2]. Programs that include practising how to recover from an unexpected slip or trip (perturbation-based training) showed even larger reductions in laboratory-simulated falls.

Broader reviews echo these findings, showing that balance exercise improves static, dynamic, and reactive stability, lower-limb strength, and mobility, while also reducing injurious falls and related emergency presentations [1]. These benefits aren’t limited to people who have already fallen, they apply just as strongly to active older adults wanting to stay that way.

Is it ever too early, or too late to start?

The evidence points to a clear answer, earlier is better, but later is still worthwhile. Age-related declines in balance and muscle strength are often already detectable from around age 50, becoming more pronounced through the 60s and 70s rather than progressing at a steady, predictable pace [3]. This means the longer training is delayed, the more ground there is to make up, and the harder that ground becomes to recover.

That said, it’s genuinely never too late to start. One study found that after 16 weeks of guided exercise, many older adults who were becoming weaker or less steady improved their strength, confidence and independence. Almost half improved enough to move into a healthier category. This shows it is never too late to benefit from the right exercise program [4]. Long-term training has also been shown to help maintain strength and mobility even in adults already in their late 70s and 80s [5]. In short: the earlier someone starts, the more function they protect but starting later still delivers real and meaningful gains.

What this looks like in practice

Effective balance training is progressive and varied. It might include single-leg stance work, tandem walking, stepping and weight-shifting drills, Tai Chi-based movement, and controlled challenges to a person’s stability under supervision. The key is gradual progression, consistency, and exercises tailored to individual strength, mobility, and fall-risk factors. This is exactly where a physiotherapist or exercise physiologist adds value, both in assessment and in program design.

The takeaway

Balance isn’t something to simply accept as declining with age, it’s a physical capacity that responds to training, much like strength or cardiovascular fitness. Investing a little time each week can support independence, confidence in daily movement, and a genuinely active lifestyle for years to come.

Ready to take the first step?

Our physiotherapy and exercise physiology team can assess your balance and falls risk, and build a program suited to your goals and lifestyle. Get in touch with your local clinic to book an assessment today.

This article is general health information, not a substitute for individualised clinical advice. Please consult a qualified physiotherapist or exercise physiologist for guidance specific to your circumstances.

References

  1. Sadaqa M, Németh Z, Makai A, Prémusz V, Hock M. Effectiveness of exercise interventions on fall prevention in ambulatory community-dwelling older adults: a systematic review with narrative synthesis. Front Public Health. 2023;11:1209319.
  2. Choudhary PK, Choudhary S, Saha S, Katanić B, İlbak İ, Tornóczky GJ. Effectiveness of balance- and strength-based exercise interventions for fall prevention in community-dwelling older adults: a systematic review of randomized controlled trials. Life (Basel). 2025;16(1):41.
  3. Bergquist R, Weber M, Schwenk M, Ulseth S, Helbostad JL, Vereijken B, Taraldsen K. Performance-based clinical tests of balance and muscle strength used in young seniors: a systematic literature review. BMC Geriatr. 2019;19:9.
  4. Mulasso A, Roppolo M, Rainoldi A, Rabaglietti E. Effects of a multicomponent exercise program on prevalence and severity of the frailty syndrome in a sample of Italian community-dwelling older adults. Healthcare (Basel). 2022;10(5):911.
  5. Aartolahti E, Lönnroos E, Hartikainen S, Häkkinen A. Long-term strength and balance training in prevention of decline in muscle strength and mobility in older adults. Aging Clin Exp Res. 2020;32(1):59-66.

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Every September, thousands of Australians join STEPtember¹  – a simple 30-day challenge that encourages people to move more and walk every day. It’s built around the idea of hitting a daily goal (like 10,000 steps or an equivalent amount of activity), but the real power lies not just in the numbers – it’s in feeling better physically² and mentally³ because of it.

Why walking works

Walking is one of the most accessible and effective forms of exercise we have. You don’t need fancy gear, a gym membership, or special skills – just comfortable shoes and a little motivation. Research shows that even moderate physical activity like brisk walking can have real health benefits³ that matter:

  • Mental health benefits: A large review showed that exercise reduces symptoms of depression and anxiety compared with being inactive and is comparable to medications and psychotherapy4. That means everyday walking isn’t just good for your body – it’s good for your mind too.
  • Ongoing mental health protection: Higher levels of regular physical activity – including walking – are linked with a lower chance of developing depression and anxiety disorders over time5. Movement isn’t just a quick mood booster – it’s a protective lifestyle habit.
  • Physical health benefits: Higher daily step counts have been associated with lower risk of all-cause mortality and cardiovascular disease6. In other words, it’s good for both your heart and your body.

According to Australia’s Physical Activity and Sedentary Behaviour Guidelines, adults should accumulate 150 to 300 minutes of moderate intensity physical activity (like brisk walking) each week8. This makes walking an ideal way to meet these recommendations – and STEPtember helps turn that target into achievable daily movement.

More than steps – it’s about wellbeing

Unlike intense fitness programs that can feel intimidating, walking is inclusive and manageable for people at all fitness levels. That means:

  • You can squeeze in steps during a lunch break.
  • Take short walking breaks between meetings.
  • Use the stairs instead of the lift.
  • Go for a walk with a friend or colleague.

Beyond physical benefits, walking also significantly supports mental wellbeing. Research from the Centres for Disease Control and Prevention (CDC) shows that regular physical activity can reduce symptoms of anxiety and depression, improve sleep quality, and enhance cognitive performance. Small, consistent amounts of movement can build into habits that stick long after September is over.

Walk with purpose

STEPtember also gives people a chance to support meaningful causes. Many participants choose to fundraise for organisations supporting Australians living with disabilities, adding another layer of motivation – your daily steps can make a difference in someone else’s life too. But even if you’re just walking for your own health and wellbeing, that’s a great reason to start. At the heart of STEPtember is its charitable mission. In Australia, funds raised through STEPtember support individuals living with cerebral palsy and other disabilities through organisations such as Cerebral Palsy Alliance.

Cerebral palsy is the most common physical disability in childhood in Australia7. Cerebral palsy results from changes to the developing brain and primarily affects movement, muscle tone, and posture. Although it is a lifelong condition, early intervention, therapy, assistive technology, and research can greatly enhance quality of life. The impact of research has contributed to a 40% reduction in the rate of cerebral palsy in Australia, as well as a decrease in severity7.

Funds raised through STEPtember help support7:

  • Early diagnosis and intervention programs
  • World-leading research into prevention and treatment
  • Assistive technology and mobility equipment
  • Community inclusion initiatives
  • Therapy services for children and adults

For participants, this connection to impact is powerful. Each step taken contributes not only to personal health but also to tangible support for Australians living with disability. The challenge transforms everyday movement into meaningful action.

Take the First Step

Movement doesn’t have to be complicated to be powerful. Walking – something most of us can do – is one of the most evidence-based ways to boost your physical and mental health. This September, give yourself a meaningful reason to move more, feel better, and make each step count.

References

  1. https://www.steptember.org.au/
  2. Centres for Disease Control and Prevention. (n.d.). Benefits of physical activity. U.S. Department of Health & Human Services. https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
  3. World Health Organization. (n.d.). Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity
  4. Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209.
  5. Wanjau, M. N., Möller, H., Haigh, F., Milat, A., Hayek, R., Lucas, P., & Veerman, J. L. (2023). Physical Activity and Depression and Anxiety Disorders: A Systematic Review of Reviews and Assessment of Causality. AJPM focus, 2(2), 100074.
  6. Hall, K. S., Hyde, E. T., Bassett, D. R., Carlson, S. A., Carnethon, M. R., Ekelund, U., Evenson, K. R., Galuska, D. A., Kraus, W. E., Lee, I. M., Matthews, C. E., Omura, J. D., Paluch, A. E., Thomas, W. I., & Fulton, J. E. (2020). Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. The international journal of behavioral nutrition and physical activity, 17(1), 78.
  7. Cerebral Palsy Alliance. (n.d.). About cerebral palsy. https://cerebralpalsy.org.au/our-research/about-cerebral-palsy/
  8. Australian Government Department of Health and Aged Care. (n.d.). Physical activity and exercise guidelines for all Australians. https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians

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Osteoporosis is when the structure of bone is compromised, making it weaker and less dense, and the bone has an increased risk of breaking (1). You may have heard of this condition before, but what does osteoporosis look like practically, and what does low bone density mean?

Prevalence and Diagnosis

Healthy Bones Australia estimate that as of 2024, 1.2 million Australians are diagnosed with Osteoporosis while a further 6.3 million live with lower-than-normal bone density (osteopenia) (1). It is also known as a silent condition as it does not necessarily present with pain or any outward symptoms. Osteoporosis is diagnosed with a DEXA scan, and as a result, it is expected that there are many more undiagnosed cases of osteoporosis.

Osteoporosis can affect anyone, but some people are at higher risk than others. This includes post-menopausal women, older adults, smokers, and people with low calcium or vitamin D levels (1, 2). Our bones are at their strongest between about ages 20 and 30. After this point, bone strength slowly starts to decline as part of the natural ageing process. For women, this decline can speed up after menopause. This is mainly due to lower levels of oestrogen, a hormone that helps keep bones strong. Oestrogen plays an important role in bone health by helping to balance the process of bone renewal. It supports the activity of cells that build new bone, helps control cells that break bone down, and also helps maintain healthy, mature bone tissue. When oestrogen levels drop, this balance is disrupted, and bone loss can happen more quickly.

The good news is that there are ways to support bone health and reduce the risk of fractures. Lifestyle choices such as regular weight-bearing exercise, getting enough calcium and vitamin D, not smoking, and staying active can all help slow bone loss and support stronger bones over time.

How does exercise work?

Incorporating high-intensity resistance and impact-based exercises is an essential part of managing low bone density (2-4). These types of exercises help by creating both compressive and tensile stresses at the bone site, which is the stimulus that our body needs to adapt and build more bone tissue.

Some examples of resistance and impact exercises that your Exercise Physiologist or Physiotherapist might prescribe for you include:

  • Squats
  • Deadlifts
  • Rows
  • Overhead press
  • Jumping
  • Hopping

These are a small selection of exercises that may be included in a comprehensive program tailored to you based on your medical history or exercise participation in the past. More importantly, the chosen exercises need to be performed under adequate loading and frequency for the bones to recognise that they need to adapt (2-4). Two or more sessions per week of high-intensity (heavy weight) and low-repetition resistance exercise is advised to create enough stress for the bones to respond and rebuild (3). The best part about it? It has been proven to be very safe under supervision and guidance, even if you have osteoporosis or have had a fracture before (3)!

To some, this may sound like something they are fearful of as they may feel frail, or maybe it is not a type of exercise they have participated in before. However, under professional supervision from an Exercise Physiologist or Physiotherapist with appropriate progression, you should be exercising optimally for your current level of ability and feel safe and confident in doing so.

Expectations and outcomes

Many people might feel upset if their follow-up DEXA scan doesn’t show their bones getting stronger. Remember, the main goal is to slow age-related changes and bone loss early on. Even small improvements are important. The most important thing is to stick with regular exercise and keep working at it over time to help your bones stay healthy.

What can I do to prevent osteoporosis or take action?

Start early!

Having a higher peak bone mass when you are younger might allow for the effects of age-related bone resorption to be minimised. If you are a younger individual, get involved in a social impact-based sport and lift some weights with a partner to promote higher peak bone mass. Spread the word! Promoting impact or resistance exercise/sports to members of our families (particularly the young ones) can help to set them up for life.

See an Exercise Physiologist or Physiotherapist

Involve yourself in an individualised high-intensity resistance exercise program 2-3x weekly to promote bone remodelling (2, 3). Age does not exclude you from lifting weights and it is never too late to get started.

Engage your GP and/or endocrinologist

Discuss the suitability of pharmacological management for your bone and hormone health (2). You may require some additional assistance to get the most improvement out of your bones .

Balance training

Work on your static and dynamic balance to reduce the risk of falling over. If you can stay on your feet, then you reduce your risk of fracture (2).

If you’re concerned about osteoporosis or your bone health, an Exercise Physiologist or Physiotherapist can help you with a safe, individualised exercise program to improve strength, balance, and reduce fracture risk. Early intervention makes a big difference in protecting long-term mobility and independence. Contact your local Allsports clinic to book an appointment today.

References (APA 6)

  1. https://healthybonesaustralia.org.au/your-bone-health/about-osteoporosis/
  2. Healthy Bones Australia. (2024). Bone health explained: Consumer guide (4th ed.). https://healthybonesaustralia.org.au/wp-content/uploads/2024/12/hba-consumer-guide-04-12-24.pdf
  3. Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2018). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research, 33(2), 211–220. https://doi.org/10.1002/jbmr.3284
  4. Kerr, D., Morton, A., Dick, I., & Prince, R. (1996). Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. Journal of Bone and Mineral Research, 11(2), 218–225. https://doi.org/10.1002/jbmr.5650110211

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Living With Persistent Pain and How Physiotherapy Can Help

Knee replacement surgery can be life-changing for people with severe knee osteoarthritis, relieving pain and improving mobility when other treatments have not been effective. However, for some Australians, significant pain may persist even after surgery, or chronic knee pain may limit function before surgery occurs. Persistent pain does not necessarily indicate that the surgery has failed; rather, it reflects the complex nature of pain and highlights the important role physiotherapy can play in supporting recovery and long-term function.

What Is Persistent Pain?

Persistent pain, sometimes referred to as chronic pain, is pain that lasts longer than three months and does not always correspond directly to the degree of physical tissue damage. Pain is influenced by a combination of biological, psychological, and social factors rather than structural changes alone (Mills et al., 2019).

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (Raja et al., 2020, p. 1977). This definition highlights the role of the nervous system and the brain in the experience of pain. As a result, even after surgical procedures such as knee replacement, persistent pain may arise from increased nervous system sensitivity or learned protective responses rather than ongoing tissue damage.

Persistent Pain After Knee Replacement

Total knee replacement (TKR) is considered an effective treatment for advanced osteoarthritis, yet some patients continue to experience ongoing pain following surgery. Research suggests that approximately 15–20% of patients report moderate to severe long-term pain after knee or hip replacement surgery (Beswick et al., 2012).

Persistent post-surgical pain may be influenced by several factors, including:

  • Nervous system sensitisation
  • Muscle weakness or altered biomechanics
  • Long-standing protective movement patterns
  • Psychological factors such as fear of movement or reduced confidence in the joint

These factors highlight that successful recovery involves more than addressing joint structure alone and emphasise the importance of rehabilitation and pain education.

Australian Clinical Guidance: First-Line Management

In Australia, best-practice management of knee osteoarthritis and persistent joint pain is guided by evidence-based clinical standards. The Australian Commission on Safety and Quality in Health Care (ACSQHC) recommends that core treatments for osteoarthritis include patient education, exercise therapy, weight management where appropriate, and support for self-management (Australian Commission on Safety and Quality in Health Care, 2024).

These conservative management strategies should be optimised before surgical intervention is considered and remain important components of rehabilitation following knee replacement. The ACSQHC clinical care standard also emphasises that imaging and surgical referral should occur only after appropriate non-surgical treatments, including physiotherapy, have been explored (ACSQHC, 2024).

How Physiotherapy Can Help

Education About Pain and Recovery

Physiotherapists help individuals understand that pain does not always reflect structural damage and that gradual movement and rehabilitation are safe and beneficial. Improving a person’s understanding of pain can reduce fear of movement and improve participation in rehabilitation (Mills et al., 2019).

Education is also recognised as a core component of high-quality osteoarthritis care within Australian clinical guidelines (ACSQHC, 2024).

Graded Exercise and Strength Training

Exercise is widely recognised as a cornerstone treatment for knee osteoarthritis and post-surgical rehabilitation. Land-based exercise programs, including strengthening and aerobic activity, have been shown to reduce pain and improve physical function (The Royal Australian College of General Practitioners, 2018).

Physiotherapists typically prescribe exercises that progressively increase strength and function. These programs often focus on strengthening the quadriceps, hip muscles, and core, which help support the knee joint and improve movement efficiency.

Following surgery, exercise programs begin with low-intensity movements and gradually progress as strength, confidence, and joint tolerance improve.

Movement Retraining and Functional Skills

Individuals who have experienced long-term knee pain often develop compensatory movement patterns designed to protect the painful joint. These altered patterns may persist even after surgery. Physiotherapy aims to retrain functional movements such as walking, stair climbing, and sit-to-stand transitions. Improving movement mechanics and balance helps redistribute joint loads and encourages safe, confident movement.

Pacing and Flare-Up Management

Persistent pain often fluctuates over time. Physiotherapists commonly teach pacing strategies to help patients manage periods of increased pain without avoiding activity altogether. Pacing may involve breaking tasks into manageable segments, adjusting activity intensity, and gradually building tolerance to movement.

A Multidisciplinary Approach

Physiotherapy is one component of a broader multidisciplinary approach to persistent pain management. Depending on individual needs, care may also involve general practitioners, orthopaedic surgeons, dietitians, or pain specialists. This collaborative approach addresses the physical, psychological, and social aspects of persistent pain.

Living Well With Persistent Pain

Persistent pain does not necessarily mean that recovery has failed or that improvement is impossible. Instead, it reflects the complex interaction between the body, nervous system, and lifestyle factors. Through education, graded exercise, movement retraining, and pacing strategies, physiotherapy can help individuals regain confidence in their knee, improve function, and participate more fully in everyday activities.

References

Australian Commission on Safety and Quality in Health Care. (2024). Osteoarthritis of the knee clinical care standard. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/osteoarthritis-knee-clinical-care-standard-2024

Beswick, A. D., Wylde, V., Gooberman-Hill, R., Blom, A., & Dieppe, P. (2012). What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies. BMJ Open, 2(1), e000435. https://doi.org/10.1136/bmjopen-2011-000435

Mills, S. E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: A review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia, 123(2), e273–e283. https://doi.org/10.1016/j.bja.2019.03.023

Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., Song, X. J., Stevens, B., Sullivan, M. D., Tutelman, P. R., Ushida, T., & Vader, K. (2020). The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain, 161(9), 1976–1982. https://doi.org/10.1097/j.pain.0000000000001939

Royal Australian College of General Practitioners. (2018). Guideline for the management of knee and hip osteoarthritis (2nd ed.). https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/knee-and-hip-osteoarthritis

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When winter arrives, people living with arthritis may notice their joints feel stiffer, sorer, or harder to get moving. If that sounds familiar, you’re not imagining it. 

While research hasn’t identified a single direct cause linking cold weather to arthritis flares, studies suggest that factors such as temperature changes, shifts in barometric pressure, reduced physical activity, and changes in sleep patterns may influence pain sensitivity and joint stiffness (Arthritis Australia, 2023; Kolasinski et al., 2020). 

The good news? There are practical, evidence-based strategies that can help you stay mobile and comfortable through winter – and physiotherapy plays a key role in that plan. 

Why Do Joints Feel Worse in Winter? 

Winter often changes our daily habits. We may tend to move less, spend more time indoors, and sit for longer periods. Colder temperatures can also make muscles and soft tissues feel tighter, while reduced sunlight may affect mood and energy levels (Arthritis Australia, 2023). For people living with osteoarthritis (OA), these changes may worsen symptoms. 

Osteoarthritis involves degeneration of joint cartilage and changes in surrounding tissues, which can lead to stiffness, particularly after periods of rest or inactivity (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2024). That’s why many people with arthritis notice their joints feel stiff first thing in the morning or after sitting for long periods. When winter reduces activity levels, stiffness can increase – creating a cycle of moving less and feeling worse. 

Movement Is Medicine (Even in Winter) 

One of the most important messages in arthritis care is simple: 

 – Movement helps joints. 

Australian clinical guidelines consistently recommend exercise as a first-line treatment for knee and hip osteoarthritis, ahead of many passive treatments (The Royal Australian College of General Practitioners, 2018; Kolasinski et al., 2020). 

Regular movement helps by: 

  • Reducing joint stiffness 
  • Strengthening muscles that support joints 
  • Improving mobility and balance 
  • Supporting long-term joint function 

A physiotherapist or exercise physiologist may recommend a tailored program that includes: 

  • Low-impact aerobic exercise such as walking, cycling, or swimming 
  • Strength training targeting key muscle groups like the quadriceps and glutes 
  • Range-of-motion exercises to maintain joint mobility 
  • Balance exercises to reduce fall risk 

Research consistently shows that structured exercise programs can reduce pain and improve function for people with osteoarthritis (Kolasinski et al., 2020). The key is finding exercises that are appropriate for your body and sustainable long-term. 

Warmth Helps – Use It Strategically 

Cold muscles and joints can feel stiffer, especially first thing in the morning. Heat therapy can help ease this stiffness by: 

  • Increasing blood flow 
  • Reducing muscle guarding 
  • Improving comfort before movement 

Clinical guidelines suggest that heat can be a helpful adjunct strategy for symptom relief alongside exercise and activity (RACGP, 2018). 

Simple winter strategies include: 

  • Taking a warm shower before activity
  • Using a heat pack on stiff joints before exercise
  • Wearing layered clothing to keep joints warm
  • Gradually warming up before longer walks or activity

Heat doesn’t treat the underlying arthritis itself – but it can make movement more comfortable, which supports better long-term outcomes. 

Strength Protects Joints 

Muscle strength plays a crucial role in protecting joints. When muscles are weak, joints are exposed to higher mechanical loads during everyday activities like walking, standing, and climbing stairs. This is particularly important for knee osteoarthritis, where weakness in the quadriceps muscles is strongly linked to worse pain and functional limitations (ACSQHC, 2024). Australian care standards emphasise the importance of individualised strengthening programs guided by trained clinicians (ACSQHC, 2024). 

Examples of helpful strengthening exercises include: 

  • Sit-to-stand practice 
  • Step-ups 
  • Resistance band exercises 
  • Controlled squats 

Winter can actually be an ideal time to focus on structured indoor strength training, helping build resilience around affected joints. 

Weight Management and Joint Load 

For people with knee osteoarthritis, body weight can significantly influence joint loading. Research suggests that for every ~0.45 kg (1 lb) of weight lost, knee joint load during walking decreases by approximately 1.8 kg (4 lb) per step (Messier et al., 2005). Over the course of thousands of daily steps, this reduction can meaningfully decrease stress on the joint. 

Winter routines, such as reduced activity or comfort eating, can sometimes lead to weight gain, which may worsen symptoms. If weight management is relevant, physiotherapists can often work collaboratively with GPs and dietitians to support a sustainable approach. 

Pacing and Managing Flare-Ups 

Arthritis symptoms naturally fluctuate, and winter may increase the likelihood of temporary flare-ups. When pain increases, the instinct can be to stop activity completely. However, long periods of rest can worsen stiffness and deconditioning. 

Instead, clinicians often recommend pacing strategies, such as: 

  • Temporarily reducing activity intensity 
  • Continuing gentle movement 
  • Gradually building activity back up as symptoms settle 

Guidelines strongly emphasise ongoing activity and self-management, rather than prolonged rest or over-reliance on medication (ACSQHC, 2024). 

When Should You See a Physiotherapist? 

It may be helpful to seek physiotherapy advice if: 

  • Winter stiffness is lasting longer than usual 
  • Pain is limiting your daily activity 
  • Your mobility is declining 
  • You’re unsure what exercises are safe 

Early support can help you maintain activity levels, reduce pain, and prevent long-term decline in function. 

The Winter Takeaway 

Cold weather may increase joint stiffness, but it doesn’t have to stop you from staying active. 

The most effective winter strategy isn’t complete rest. It’s: 

✔ Staying active 

✔ Keeping joints warm 

✔ Strengthening muscles regularly 

✔ Managing flare-ups with confidence 

  With the right physiotherapy guidance, winter can be a season of maintaining strength and independence, not losing it. Contact your local physiotherapist today to get started. 

References 

Arthritis Australia. (2023). How cold weather impacts arthritis. https://www.arthritis.org.au/arthritis/arthritis-insights/living-well-with-arthritis/how-cold-weather-impacts-arthritis/ 

Australian Commission on Safety and Quality in Health Care. (2024). Osteoarthritis of the knee clinical care standard. https://www.safetyandquality.gov.au

Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L. F., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., & Altman, R. (2020). 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 72(2), 149–162. https://doi.org/10.1002/acr.24131

Messier, S. P., Gutekunst, D. J., Davis, C., & DeVita, P. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism, 52(7), 2026–2032. https://doi.org/10.1002/art.21139

The Royal Australian College of General Practitioners. (2018). Guideline for the management of knee and hip osteoarthritis (2nd ed.). https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/knee-and-hip-osteoarthritis 

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COVID Safety Notice

First published March 26, 2020 12:40pm. Updated 29th June 12:30pm AEST 2021

We are still operating as normal and abiding by Covid safe guidelines from the Department of Health.

There are current contact tracing alerts and related public health advice for people who have been in the Australian Capital Territory, New South Wales, Victoria and New Zealand.

Read the latest advice from Queensland Health – HERE

At Entirely Health, we’re focused on the well-being of every person who steps through our clinic doors. This includes the health and safety of our local communities, which is you, our patients, as well as our team members.

Read more

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Physiotherapist

Alex works from our Yeppoon practice and has a special interest in dance related injuries and preventative management along with Pilates, she also enjoys treating foot/ankle, hip/pelvic injuries. Prior to moving to Central Queensland she worked  in Sydney as a physiotherapist with professional dancers and dance students for preventative and dance related injuries. During this time she also treated workplace injuries, acquired brain injuries and chronic pain.

In her spare time Alex enjoys a wide range of outdoor activities such as stand up paddling, kite surging, surfing and ballet. Read more

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There is a good chance that many of you know someone who has had a long lasting tendon injury, or has had one yourself. The runner with the nagging Achille’s pain, the footballer with the recurrent groin issue, the tennis player who can’t hit a backhand because of their sore elbow. It is only in the last couple of years that we have begun to develop a better understanding of tendon injuries and why they are so frustrating (to both patient and therapist). Read more

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Exercise Physiologist

Shireen holds a Bachelor of Exercise Science, a Graduate Diploma of Exercise Science and a Bachelor of Business Management. She is an ESSA accredited exercise physiologist working from both our Rockhampton and Yeppoon practices. Shireen has always worked the the fitness industry and before completing her exercise physiology studies worked at various health clubs and gyms. She enjoys working with her clients and helping to break down barriers and eliminating fears of exercising, educating why exercise is medicine and noticing improvements in their strengths and confidence. In her spare time Shireen enjoys cooking hiking, keeping fit outdoors and occasionally binge watching TV series. Read more

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