How Exercise and Education in GLA:D® Canada Support Joint Health
Living with knee or hip osteoarthritis can sometimes feel like your joints are setting their own rules. One day you can walk comfortably, and the next day a flight of stairs suddenly feels like a mountain. You may start avoiding certain activities because you are worried that movement will make the pain worse.
But here is an important point: movement is often part of the solution, not the problem.
The GLA:D® Canada Program takes this idea one step further. Instead of simply telling people with osteoarthritis to “exercise more,” the program combines education and supervised exercise to help people understand their condition, move with greater confidence, strengthen the muscles around the joint, and develop practical strategies for managing symptoms.
GLA:D® stands for “Good Life with osteoArthritis in Denmark.” The program was originally developed in Denmark and is now available in Canada through trained healthcare professionals. The Canadian program focuses on people experiencing symptoms related to knee or hip osteoarthritis.
For people looking for an evidence-based approach to managing osteoarthritis, the combination of education and exercise is one of the most important features of GLA:D® Canada.
Why Does Exercise Matter When You Have Osteoarthritis?
One of the most common misunderstandings about osteoarthritis is that painful joints need complete rest.
It is understandable why someone might think this way.
If your knee hurts when you walk, your first instinct may be to walk less. If stairs hurt, you may start taking the elevator. If standing up from a chair is uncomfortable, you may avoid getting up unnecessarily.
The problem is that avoiding movement for too long can create another problem: your muscles may become weaker and everyday movements can become more difficult.
GLA:D® Canada focuses on helping people stay active in a safe and practical way rather than simply avoiding movement. The program uses exercises designed to improve strength, movement control and everyday function.
This approach is also supported by broader research.
A major systematic review published in The BMJ in 2025 examined 217 randomized controlled trials involving 15,684 people with knee osteoarthritis. The researchers found that exercise could improve pain, physical function, walking ability and quality of life. Different forms of exercise offered different benefits, with aerobic exercise showing particularly strong overall results, while strengthening and mixed exercise were also helpful for function.
In other words, exercise is not simply about “getting fit.”
For someone with osteoarthritis, exercise can be about making everyday life easier.
Education Is Just as Important as Exercise
Imagine being handed a set of exercises without being told why you are doing them.
You might do them for a week.
Maybe two.
Then one morning your knee feels sore and you think, “Well, apparently this isn’t working.”
That is where education becomes important.
GLA:D® Canada does not treat exercise as a mysterious list of movements. Participants learn about osteoarthritis, physical activity, joint stability, pain and ways of managing their condition in daily life.
Understanding your condition can change the way you respond to symptoms.
Instead of thinking:
“My knee hurts, so I must stop moving.”
You may begin to think:
“My knee hurts today. How can I adjust my activity and movement while still staying active?”
That is a very different mindset.
Education can help people make better decisions rather than feeling controlled by their symptoms.
What Does GLA:D® Canada Actually Include?
The current GLA:D® Canada program combines several important elements.
The 2026 GLA:D® Canada program guide describes three main components:
- Group education sessions
- Twelve tailored and supervised neuromuscular exercise sessions
- Collection of outcome information to monitor results and support ongoing quality improvement and research
The exercise component is generally delivered twice a week for six weeks, giving participants repeated opportunities to practise movements and develop confidence.
The goal is not to turn participants into professional athletes.
Thankfully.
The goal is to help people move better and manage everyday activities more comfortably.
What Is Neuromuscular Exercise?
The phrase “neuromuscular exercise” may sound complicated, but the basic idea is relatively simple.
Your muscles and nervous system need to work together to control movement.
When you walk, stand up, climb stairs or change direction, your body is constantly making small adjustments.
GLA:D® exercises focus on helping participants improve the way they control these movements while also building strength.
The official GLA:D® Canada exercise program divides exercises into areas including:
- Leg strength
- Core strength
- Functional exercises
- Positional exercises
Exercises are performed slowly and with attention to movement quality.
This is important because the goal isn’t simply to move more.
The goal is to learn how to move better.
Stronger Muscles Can Make Everyday Activities Easier
Your muscles play an important role in supporting movement.
Consider something as ordinary as getting out of a chair.
You do not normally think about it. You simply stand up.
But if your knees or hips hurt and your leg muscles are weak, that simple movement can become surprisingly difficult.
The same applies to:
- Walking
- Climbing stairs
- Getting into or out of a car
- Standing for longer periods
- Carrying groceries
- Getting up from the floor
- Walking outdoors
- Maintaining balance
Strength training can help improve physical function, which is one reason strengthening exercises are an important part of osteoarthritis management.
The 2025 BMJ review found that strengthening and mixed exercise programs probably improve function in people with knee osteoarthritis.
That means the benefit isn’t only measured inside a clinic.
The real test is what happens when you leave the clinic.
Can you walk a little more comfortably?
Can you stand from a chair more easily?
Can you do something you had started avoiding?
Those are meaningful improvements.
Exercise in GLA:D® Canada Is Designed for Real Life
One of the strengths of the GLA:D® approach is that the exercises are connected to everyday movement.
A person with osteoarthritis does not need stronger muscles just for the sake of having stronger muscles.
They need strength so they can use their body more comfortably in daily life.
This is why functional movements are important.
For example, a rehabilitation professional may work with a participant on movements that relate to:
- Sitting and standing
- Walking
- Balance
- Lower-body control
- Changing positions
- Moving safely during everyday activities
The exact exercises and difficulty can be adjusted according to the person’s abilities.
That matters because osteoarthritis does not look exactly the same in every person.
Two people may both have knee osteoarthritis but have completely different levels of pain, strength, mobility and confidence.
A good exercise program needs to take those differences into account.
The Goal Is Not to “Push Through” Pain
There is a big difference between exercising appropriately and simply forcing yourself through pain.
GLA:D® Canada uses assessment and professional guidance to determine whether the program is appropriate and how exercises should be performed.
This is particularly important for people who are nervous about exercise.
Some people worry:
“If exercise hurts, doesn’t that mean I’m damaging my joint?”
Not necessarily.
Pain is more complicated than a simple damage alarm.
That is one reason education is so valuable. Understanding osteoarthritis can reduce fear and help people respond to symptoms more thoughtfully.
The goal is not to ignore pain.
The goal is to understand it, monitor it and learn how to manage activity appropriately.
Why Combining Education and Exercise Makes Sense
Imagine two different approaches.
Approach One: Exercise Only
Someone gives you exercises and says:
“Do these twice a week.”
You may follow the instructions, but you might not understand:
- Why the exercises matter
- How they relate to osteoarthritis
- What to do when symptoms change
- How to remain active outside the sessions
- How to handle everyday activities
Approach Two: Education + Exercise
Now imagine that you understand what osteoarthritis is, why strength matters, why movement is useful, and how to adapt your daily activities.
Then you practise exercises under professional supervision.
The second approach gives you something more than an exercise routine.
It gives you knowledge and skills that you can continue using after the program ends.
This is one of the central ideas behind GLA:D® Canada.
The education is not supposed to stay inside the classroom. It is reinforced through the exercise sessions and everyday activities.
What Does the Canadian Data Show?
GLA:D® Canada tracks outcomes from participants to understand how the program performs across the country.
Information can be collected at the beginning of the program, around three months later and at 12 months. Measures include pain, quality of life and physical activity.
The 2023 Canadian annual report provides encouraging results.
Among participants, the program reported improvements in:
- Pain
- Physical function
- Quality of life
At three months, the report found pain improvements of 37.7% among hip participants and 43.0% among knee participants. It also reported clinically meaningful improvements in quality of life.
The broader 2023 Canadian results reported that pain improved for 55.8% of hip participants and 58.3% of knee participants, while 51% of hip participants and 56.4% of knee participants reported improved function. Quality of life improved for 57.6% of hip participants and 64.4% of knee participants.
These numbers do not mean everyone will experience the same result.
That is important.
Osteoarthritis is an individual condition, and outcomes can vary.
But the data does show why programs like GLA:D® Canada are attracting attention as part of modern osteoarthritis care.
Education Can Also Build Confidence
Pain is not the only challenge of osteoarthritis.
Fear can be a problem too.
Someone who has experienced repeated pain may gradually become afraid of certain movements.
They may stop exercising.
They may avoid stairs.
They may decline walks with friends.
They may stop travelling because they are worried about how far they will need to walk.
Over time, the joint problem can start affecting much more than the joint.
Education can help break this cycle.
When people understand their condition and learn appropriate ways to move, they may feel more confident about becoming active again.
GLA:D® Canada specifically includes education about osteoarthritis, physical activity and self-management.
And confidence matters.
A person who believes they can manage their symptoms is more likely to keep moving than someone who feels every activity is dangerous.
What Happens After the Six-Week Exercise Program?
This is an important question.
The end of supervised sessions should not mean the end of movement.
In fact, the long-term goal is to help people continue being physically active.
The GLA:D® Canada model includes follow-up outcome measurement, which helps evaluate whether changes are maintained over time.
The program’s broader philosophy is also about independence.
Participants learn exercises and self-management strategies that they can continue using in everyday life.
Some people may also choose ongoing exercise programs after completing GLA:D®. GLA:D® Canada currently supports post-program exercise options designed to help participants continue working on strength, mobility, balance and movement.
Think of the six-week exercise period as a structured starting point rather than a finish line.
Can GLA:D® Canada Help Someone Who Wants to Stay Active?
Yes.
And this is particularly important because physical activity is not only about osteoarthritis.
Regular movement can support overall health, cardiovascular fitness, muscle strength, balance and independence.
The 2025 BMJ evidence review found that exercise can improve multiple outcomes in people with knee osteoarthritis, including pain, function, gait and quality of life.
The challenge is finding a form of exercise that a person can actually maintain.
There is no prize for choosing an exercise routine that you hate.
If you despise it, chances are you will eventually stop doing it.
A better program is one that fits your abilities, goals and lifestyle.
What About People Who Are Nervous About Exercise?
This is very common.
Someone may think:
“I haven’t exercised properly in years.”
“My knee is too painful.”
“I don’t want to make things worse.”
“I am not fit enough.”
“I’ll be the weakest person in the group.”
These concerns are understandable.
The purpose of a supervised rehabilitation program is not to compare participants with one another.
It is to help each person work at an appropriate level.
The exercises can be modified according to ability.
And importantly, the program begins with an assessment by a healthcare professional to determine whether GLA:D® is appropriate.
You don’t have to arrive at your first session already being “good at exercise.”
That would rather defeat the purpose.
GLA:D® Canada Can Also Be Delivered Virtually
Another interesting development is the availability of virtual and hybrid GLA:D® programs.
GLA:D® Canada reports that trained clinicians can deliver the program virtually, allowing some participants to exercise from home.
This can be particularly useful for people who:
- Live far from a clinic
- Have transportation difficulties
- Prefer exercising at home
- Have busy schedules
- Have difficulty travelling because of mobility limitations
The availability of virtual care depends on the clinic and location, so participants should confirm the format directly with their provider.
The important point is that technology can sometimes remove one more barrier between a person and rehabilitation.
Why Local Professional Guidance Still Matters
There is an enormous amount of exercise advice available online.
Search for “knee exercises” and you can easily find hundreds of videos.
Some are excellent.
Some are questionable.
And some seem to believe that everyone with knee pain should immediately perform 400 squats before breakfast.
That is not how individualized rehabilitation works.
A trained professional can assess movement, strength, symptoms and functional ability and then help determine which exercises are appropriate.
The GLA:D® Canada model is built around trained healthcare professionals delivering the education and exercise program.
This professional guidance can be particularly valuable when someone has significant pain, weakness, balance problems or difficulty with everyday movement.
How Sync Move Rehab Centre Can Help
For people in the Thornhill, Markham, Richmond Hill, Vaughan and North York areas, Sync Move Rehab Centre offers the GLA:D® Canada Program for people experiencing knee and hip osteoarthritis.
The program at Sync Move includes an initial physiotherapy assessment, education and supervised exercise sessions. The exercises can be adjusted according to the individual’s needs and abilities.
You can learn more about the program here:
GLA:D® Canada Program at Sync Move Rehab Centre
You can also explore additional osteoarthritis information through the Sync Move Rehab Centre blog.
For someone who has been putting off exercise because of knee or hip pain, getting professional guidance can be a much better starting point than trying to figure everything out alone.
Who Might Benefit From GLA:D® Canada?
The program may be suitable for people experiencing symptoms associated with knee or hip osteoarthritis, including:
- Knee or hip pain
- Morning stiffness
- Difficulty walking
- Difficulty using stairs
- Trouble standing from a chair
- Reduced balance
- Reduced mobility
- Decreased confidence with movement
- Early or more advanced osteoarthritis
It may also be relevant for people who are considering joint replacement or hoping to maintain their function for as long as possible.
However, suitability should be determined through an appropriate assessment rather than simply assuming that every person with joint pain should join the program.
Frequently Asked Questions
Is exercise safe for people with osteoarthritis?
Exercise is widely recommended as part of osteoarthritis management, but the type and amount should be appropriate for the individual. GLA:D® Canada uses professional assessment and supervised exercise to help participants exercise appropriately.
Will exercise cure osteoarthritis?
No. There is currently no known cure that reverses cartilage loss caused by osteoarthritis. The goal of management is to reduce symptoms, improve function and help people remain active.
How often are GLA:D® exercises performed?
The standard Canadian program includes 12 supervised exercise sessions, generally delivered twice a week over six weeks.
Is GLA:D® Canada only for people with severe arthritis?
No. The program is intended for people with symptoms of knee or hip osteoarthritis, and an assessment helps determine whether it is appropriate for an individual.
Does education really make a difference?
Education can help people understand osteoarthritis, physical activity, pain and self-management. GLA:D® Canada combines education with exercise so that participants can apply what they learn during movement and daily activities.
Can I participate virtually?
Virtual and hybrid GLA:D® services are available in some settings. Availability varies by provider, so it is best to check with the clinic directly.
What if I have not exercised in a long time?
That does not automatically mean GLA:D® is unsuitable for you. The program begins with assessment, and exercises can be adapted to your current ability. The purpose is to help you improve—not to test whether you can already exercise like an athlete.
The Bigger Picture: Helping People Live With Their Joints, Not Around Them
Osteoarthritis can gradually change the way a person lives.
A short walk becomes a shorter walk.
The stairs become the elevator.
A weekend outing becomes a decision based on how much walking is involved.
Eventually, someone may find themselves organizing life around their joints.
The purpose of education and exercise in GLA:D® Canada is to help change that pattern.
The program does not promise a magic cure. It does something more realistic: it teaches people about osteoarthritis, gives them structured opportunities to exercise, develops strength and movement control, and encourages long-term self-management.
The latest research continues to support exercise as an important part of osteoarthritis care. A 2025 review involving more than 15,000 participants found meaningful benefits across pain, function, walking ability and quality of life.
Canadian GLA:D® data also shows encouraging improvements in pain, function and quality of life among many participants.
Most importantly, the goal is not simply to make someone better at completing exercises.
The goal is to help them get back to living their life.
For people in the Greater Toronto Area who want professional support with knee or hip osteoarthritis, Sync Move Rehab Centre offers the GLA:D® Canada Program as an evidence-based approach combining education, supervised exercise and ongoing support. Learning more about your condition and learning how to move with confidence can be an important step toward staying active and protecting your independence.
References
- GLA:D® Canada – Education and Exercise — Program structure and education/exercise approach.
- GLA:D® Canada – What Is GLA:D® Canada? — Program components and Canadian implementation.
- GLA:D® Canada – Results in Canada — Canadian program outcomes and participation data.
- GLA:D® Canada Annual Report 2023 — Detailed Canadian outcomes.
- GLA:D® Canada Data Collection — Outcome monitoring at baseline, three months and 12 months.
- Getting Started with the GLA:D® Canada Program Guide, 2026 — Current program structure and guidance.
- GLA:D® Canada – Exercise Program — Neuromuscular exercise principles and exercise stations.
- GLA:D® Canada – Treatment for Osteoarthritis — Education, exercise and self-management principles.
- BMJ 2025 – Comparative Efficacy and Safety of Exercise Modalities in Knee Osteoarthritis — Systematic review and network meta-analysis of 217 trials and 15,684 participants.
- BMJ 2025 – Exercise for People Living with Knee Osteoarthritis — Clinical perspective on exercise and long-term engagement.
- GLA:D® Canada – Learning About Osteoarthritis — Education topics including physical activity, weight management and pain.
- GLA:D® Canada – Virtual GLA:D® Information — Information about virtual and hybrid delivery.
- Sync Move Rehab Centre – GLA:D® Canada Program — Local program information and physiotherapy services.
