GLA:D Canada exercise program for knee and hip osteoarthritis

GLA:D® Canada vs Traditional Osteoarthritis Treatment

GLA:D® Canada vs. Traditional Osteoarthritis Treatment: What’s the Difference?

If knee or hip osteoarthritis has started making everyday activities harder, you may have heard the same advice many times: take medication, rest when it hurts, lose some weight, and consider surgery if things get bad enough. But there is another approach that puts education, movement, and active self-management at the centre of care. This is where GLA:D® Canada for knee and hip osteoarthritis comes in.

Osteoarthritis, or OA, is extremely common in Canada. In fact, GLA:D® Canada research has described the program as an evidence-based approach developed to make guideline-recommended care available to the millions of Canadians living with knee and hip osteoarthritis.

So, what makes GLA:D® different from traditional osteoarthritis treatment?

The short answer is that it does not necessarily replace medication, injections, weight management, physiotherapy, or surgery. Instead, it gives people a structured way to use education and supervised exercise as an important part of their overall treatment plan.

And that difference matters.

Because when your knee hurts every time you climb the stairs, “just exercise more” is not exactly the world’s most helpful instruction.

What is GLA:D® Canada?

GLA:D® stands for Good Life with osteoArthritis in Denmark. The program was originally developed in Denmark and has since been implemented in several countries, including Canada.

The Canadian program is designed specifically for people with knee and hip osteoarthritis. It combines education with supervised exercise and is delivered by trained healthcare professionals.

The goal is not to promise a miracle cure. Osteoarthritis currently has no simple cure that makes the condition disappear. Instead, the goal is to help people understand their condition, manage symptoms, move more confidently, improve physical function and stay active.

According to the official GLA:D® Canada program, participants receive education about osteoarthritis, self-management and exercise, followed by supervised neuromuscular exercise sessions.

At Sync Move Rehab Centre, the GLA:D® Canada Program is offered for people dealing with knee and hip osteoarthritis in Thornhill and surrounding communities.

You can learn more about the program directly on the GLA:D® Canada Program page at Sync Move Rehab Centre.

Traditional Osteoarthritis Treatment: What Does It Usually Mean?

There is no single “traditional” treatment for osteoarthritis.

In reality, osteoarthritis care often involves several different strategies depending on the severity of symptoms, the affected joint, the person’s health, lifestyle, goals and response to treatment.

Common approaches may include:

  • Pain-relieving medication
  • Anti-inflammatory medication
  • Therapeutic exercise
  • General physical activity
  • Weight management
  • Physiotherapy
  • Braces or walking aids
  • Injections
  • Lifestyle changes
  • Joint replacement surgery for severe cases

Some people use only one or two of these options. Others move through several stages over time.

The important point is that GLA:D® Canada is not simply “exercise instead of medical treatment.” It is better understood as a structured, evidence-based way of putting education and exercise into the treatment plan.

This distinction is important because modern osteoarthritis care increasingly focuses on active management rather than simply trying to make the pain disappear temporarily.

Arthritis Society Canada also emphasizes physical activity, therapeutic exercise, self-management and weight management as important parts of osteoarthritis care.

GLA:D® Canada vs. Traditional Treatment: The Main Difference

The biggest difference is how the person is involved in their own treatment.

A traditional approach may sometimes feel like this:

“Here is your prescription. Take this when it hurts. Come back if it gets worse.”

A structured program such as GLA:D® takes a different approach:

“Let’s help you understand what is happening, teach you how to move safely, build your strength and give you practical tools that you can continue using in everyday life.”

That does not mean medication has no place.

It does not mean injections are always wrong.

And it certainly does not mean surgery is never necessary.

Instead, GLA:D® focuses on giving people more tools before they reach the point where their only perceived option is surgery.

1. Education Is Part of the Treatment

One of the most important differences with GLA:D® Canada is that education is not treated as an optional extra.

Participants learn about osteoarthritis, symptoms, risk factors, available treatment options and ways to manage their symptoms.

They also learn why exercise can help and how to deal with everyday activities that have become difficult.

This may sound simple, but understanding osteoarthritis can change how a person responds to pain.

For example, many people instinctively believe that pain means the joint is being damaged every time they move.

That fear can lead to less movement.

Less movement can lead to weaker muscles.

Weaker muscles can make everyday activities harder.

And suddenly the person is caught in a frustrating cycle of pain, inactivity and reduced confidence.

Education can help break that cycle.

The official GLA:D® Canada program specifically includes education about osteoarthritis, self-management and the role of exercise.

2. Exercise Is Structured Rather Than Random

Another important difference is that GLA:D® is not simply a list of exercises downloaded from the internet.

The program uses supervised exercise sessions led by trained professionals.

At Sync Move Rehab Centre, the program includes an initial physiotherapy assessment followed by education and supervised neuromuscular exercise. Exercises can be modified according to the individual’s abilities, fitness level and symptoms.

This matters because two people with “knee arthritis” can have completely different needs.

One person may struggle mainly with stairs.

Another may have difficulty getting up from a chair.

Someone else may have reduced balance or feel nervous about walking outdoors.

A good exercise program should take those differences into account.

3. GLA:D® Focuses on Neuromuscular Control

You may have heard that people with osteoarthritis simply need to “strengthen their muscles.”

Strength is certainly important, but movement quality matters too.

GLA:D® includes neuromuscular exercises designed to help people improve movement control, stability and the way they use their joints during everyday activities.

The official Canadian program describes exercises that help participants improve joint stability and apply better movement strategies to daily life.

In practical terms, this can mean learning how to move more confidently when:

  • Walking
  • Climbing stairs
  • Standing from a chair
  • Getting in and out of a car
  • Carrying everyday items
  • Performing household activities
  • Returning to recreational activities

The objective isn’t to turn everyone into an Olympic athlete.

For most people with osteoarthritis, being able to get through Tuesday without negotiating with their knee is already a pretty excellent achievement.

4. Supervision Can Make Exercise More Effective

One of the challenges with home exercise is knowing what to do, how much to do and whether you are doing it correctly.

It is also surprisingly easy to start enthusiastically on Monday and forget the whole plan by Thursday.

Research-based osteoarthritis guidelines support exercise as a central part of treatment, and evidence suggests supervised exercise can be particularly useful. The American College of Rheumatology/Arthritis Foundation guideline strongly recommends exercise for people with knee and hip osteoarthritis and notes that exercise programs tend to be more effective when supervised.

That is one reason structured programs can be appealing.

You have a schedule.

You have guidance.

You can ask questions.

And your exercises can be adjusted as your ability changes.

5. GLA:D® Is Designed to Build Confidence, Not Just Strength

Pain is only one part of osteoarthritis.

Confidence is another.

A person may technically be capable of walking farther but avoid doing so because they are afraid their knee will suddenly hurt.

Someone may stop taking the stairs because they expect pain.

Another person may avoid recreational activities they used to enjoy.

This is where education, supervised exercise and gradual progression can make a meaningful difference.

The aim is not simply:

“Your pain score went from 6 to 4.”

It is also:

“I can walk to the store again.”

“I can get out of my chair more easily.”

“I can go for a walk with my family.”

“I am less worried about moving.”

Those improvements can have a surprisingly large effect on quality of life.

What Does the Research Say About GLA:D®?

This is where things become particularly interesting.

A large study published in Osteoarthritis and Cartilage looked at 28,370 people with symptomatic knee or hip osteoarthritis who participated in GLA:D® programs in Denmark, Canada and Australia.

The program included education and 12 supervised exercise sessions.

Following the program, participants experienced:

  • 26–33% improvement in average pain intensity
  • 8–12% improvement in walking speed
  • 18–30% improvement in chair-stand performance
  • 12–26% improvement in joint-related quality of life
  • About 43–47% of participants experienced clinically relevant pain reductions

The researchers concluded that the results supported positive outcomes following implementation of guideline-based education and exercise therapy.

That is a substantial number of people.

And it is one reason GLA:D® has attracted attention beyond Denmark.

What Do Canadian GLA:D® Results Show?

Canadian data are also encouraging.

The official GLA:D® Canada 2023 results reported that:

  • 58.3% of knee participants reported improved pain
  • 55.8% of hip participants reported improved pain
  • 56.4% of knee participants reported improved function
  • 51% of hip participants reported improved function
  • 64.4% of knee participants reported improved quality of life
  • 57.6% of hip participants reported improved quality of life

The same report noted that by that point, the program had trained 2,015 clinicians and had launched at 402 sites across 9 provinces and 2 territories.

These numbers are important because they reflect implementation of the program in Canada rather than results from a small laboratory experiment.

What About the People Who Have More Severe Osteoarthritis?

This is a common question.

Many people assume that exercise-based treatment is only useful when osteoarthritis is mild.

That is not necessarily true.

The GLA:D® Canada program is intended for people with a range of knee and hip osteoarthritis symptoms. A person’s suitability should be assessed by a qualified healthcare professional.

At Sync Move Rehab Centre, the program page notes that the program can be appropriate for mild, moderate and severe knee or hip osteoarthritis, with the physiotherapist determining whether it is suitable after assessment.

Exercise also does not automatically disappear from the treatment plan just because someone has advanced osteoarthritis.

In some cases, improving strength, balance, movement confidence and daily function can be particularly valuable while a person is considering other treatment options.

Can GLA:D® Replace Medication?

Not necessarily.

This is one of the biggest misconceptions about exercise-based osteoarthritis programs.

GLA:D® is not a promise that you will never need medication.

Pain medication and anti-inflammatory treatments may be appropriate for some people. Other treatments may also be useful depending on the individual.

The difference is that GLA:D® focuses on strategies that help people actively manage their condition rather than relying only on passive treatments.

Arthritis Society Canada notes that osteoarthritis treatment can include a combination of self-management, therapeutic exercise, physical activity, weight management, medication and, when necessary, surgery.

In other words, it does not have to be an “either/or” decision.

For some people, the best approach may be:

exercise + education + lifestyle changes + medication when appropriate

rather than:

medication alone

What About Cortisone or Other Injections?

Injections can be useful for some people with osteoarthritis, depending on their situation.

They may provide temporary symptom relief, but they do not teach you how to move better or strengthen the muscles supporting the joint.

This is another area where GLA:D® takes a different approach.

The program is focused on skills that participants can continue using outside the clinic.

Think of it as the difference between borrowing an umbrella during a rainstorm and learning where the weather forecast is on your phone.

Both can be useful.

But one gives you a tool you can use again tomorrow.

What About Joint Replacement Surgery?

Knee or hip replacement can be an important and highly effective treatment for people with severe osteoarthritis when other approaches are no longer providing enough relief.

GLA:D® does not claim to eliminate the need for surgery.

However, an exercise and education program may be useful for people who want to improve function, manage symptoms or potentially postpone surgery while working with their healthcare team.

Pre-surgery rehabilitation can also be valuable for improving strength and physical capacity.

Ultimately, the decision about surgery should be made with an appropriate healthcare professional based on symptoms, function, imaging when needed, overall health and personal goals.

GLA:D® Canada Is Not “Just Physiotherapy”

There is some overlap between GLA:D® and physiotherapy, but the program is more structured.

A physiotherapist may provide many different forms of treatment depending on the patient’s needs.

GLA:D® Canada follows a standardized framework built around:

  1. Education
  2. Supervised neuromuscular exercise
  3. Ongoing outcome monitoring

The standardized nature of the program is important because it helps ensure that participants receive an evidence-based approach rather than a completely different treatment depending on which clinic they visit.

GLA:D® Canada also uses a national data collection system to monitor outcomes at baseline, around three months and again at 12 months.

Why Does Outcome Tracking Matter?

Imagine buying a pair of running shoes and never checking whether they actually helped you run.

You would probably want to know.

Healthcare is no different.

GLA:D® Canada collects information about pain, quality of life and physical activity, allowing outcomes to be monitored over time.

The Canadian program’s published participant data also show the scale of the program.

By the end of 2022, the registry included 15,193 participants, including 11,228 people with knee OA and 3,965 with hip OA. The average participant was 66 years old, and many participants had been living with symptoms for several years before entering the program.

Interestingly, about two-thirds of participants reported using pain medication before starting the program, while approximately one-third reported wanting joint surgery.

This tells us something important: GLA:D® participants are not necessarily people with minor aches and pains.

Many are people whose osteoarthritis is already affecting their lives.

So, Which Is Better: GLA:D® or Traditional Treatment?

There is no single answer for everyone.

It may be more useful to think of GLA:D® as part of modern osteoarthritis management rather than a competitor trying to defeat every other treatment.

Traditional treatments such as medication, injections, braces and surgery can have an appropriate role.

At the same time, current evidence strongly supports exercise and self-management for knee and hip osteoarthritis.

The real question is therefore:

Are you receiving a treatment plan that helps you manage your osteoarthritis today and gives you skills for tomorrow?

For many people, that means combining several approaches.

GLA:D® Canada vs. Traditional Osteoarthritis Treatment at a Glance

GLA:D® Canada Traditional or Conventional Approach
Structured education Education may vary
Supervised exercise Exercise may or may not be supervised
Neuromuscular training May focus mainly on general strengthening
Self-management strategies Depends on the treatment plan
Progress monitoring Varies between providers
Group-based sessions Often individual treatment
Focus on long-term active management May focus more heavily on symptom relief
Designed specifically for knee and hip OA Treatment depends on the individual
Can work alongside other treatments May include medication, injections or surgery

This does not mean one column is automatically “good” and the other is “bad.”

Modern osteoarthritis care can include elements from both.

Who Might Consider GLA:D® Canada?

You may want to ask a healthcare professional about the program if you have:

  • Knee osteoarthritis
  • Hip osteoarthritis
  • Pain when walking
  • Difficulty climbing stairs
  • Morning stiffness
  • Difficulty standing from a chair
  • Reduced mobility
  • Reduced balance
  • Fear or lack of confidence with movement
  • Difficulty participating in activities you enjoy
  • A desire to become more active
  • An interest in delaying or preparing for joint replacement surgery

At Sync Move Rehab Centre, the GLA:D® journey starts with an assessment to determine whether the program is appropriate for you. Exercises are adjusted according to individual ability and symptoms.

Do You Need a Doctor’s Referral?

Requirements can vary by clinic and insurance provider.

At Sync Move Rehab Centre, a doctor’s referral is generally not required to participate in the GLA:D® Canada program. However, insurance coverage can depend on your individual extended health plan.

If you have insurance coverage for physiotherapy, it is worth checking with your provider before starting.

What Happens During the GLA:D® Canada Program?

The program at Sync Move Rehab Centre includes a comprehensive assessment followed by education and supervised exercise.

The standard program includes education sessions and 12 supervised neuromuscular exercise sessions. The exercise sessions are generally 60 minutes and take place twice a week over six weeks.

Participants learn about:

  • Osteoarthritis
  • Pain and symptom management
  • Movement strategies
  • Muscle strength
  • Joint stability
  • Balance
  • Functional movement
  • Everyday activity

The goal is to make exercise useful outside the clinic.

After all, the real test isn’t whether you can perform an exercise perfectly inside a physiotherapy clinic.

It’s whether you can use what you learned when you’re standing in your kitchen, walking through a grocery store or trying to get up from your favourite chair.

Why Choose a Certified GLA:D® Provider?

Standardization is one of the strengths of the GLA:D® model.

Healthcare professionals who deliver the Canadian program receive specific GLA:D® training. The official GLA:D® Canada certification program is designed to train providers in evidence-based osteoarthritis management, neuromuscular exercise and implementation of the program.

This helps create consistency across participating locations.

At Sync Move Rehab Centre, the program is delivered by physiotherapists with a focus on individualized progression and evidence-based care.

The clinic serves communities including Thornhill, Markham, Richmond Hill, Vaughan and North York.

The Bigger Picture: Treat the Person, Not Just the X-Ray

One of the most useful ways to think about osteoarthritis is to remember that an X-ray is only one piece of the puzzle.

Two people can have similar-looking joint changes but very different levels of pain and disability.

One person may have significant changes on an X-ray but remain active.

Another may have less obvious changes but experience substantial pain and difficulty walking.

That is why modern osteoarthritis management looks beyond imaging.

Pain, strength, mobility, confidence, physical activity, sleep, weight, lifestyle and personal goals all matter.

GLA:D® fits well into this broader approach because it gives people practical tools rather than focusing only on what the joint looks like.

What the Evidence Really Means

It is important not to overpromise.

Research showing that many people improve does not mean every participant will experience the same results.

GLA:D® is not a cure for osteoarthritis.

It cannot guarantee that someone will avoid surgery.

It cannot guarantee that pain will disappear.

And it does not mean medication will never be necessary.

What the research does suggest is that a structured program combining education and exercise can improve pain, physical function and quality of life for many people with knee and hip osteoarthritis.

That is a much more useful promise than a miracle cure.

The Bottom Line

The biggest difference between GLA:D® Canada and traditional osteoarthritis treatment is not that one uses exercise while the other uses medication. The real difference is the emphasis on active, structured self-management. GLA:D® combines education, supervised neuromuscular exercise and ongoing progress monitoring to help people with knee and hip osteoarthritis understand their condition and become more confident in managing it. Medication, injections, weight management, physiotherapy and surgery may still have an appropriate place in an individual’s care. The best treatment is the one that matches the person’s symptoms, health, goals and lifestyle. If knee or hip osteoarthritis is limiting your ability to walk, exercise, work or enjoy everyday activities, the GLA:D® Canada Program at Sync Move Rehab Centre offers a structured, evidence-based approach designed to help you move better, reduce symptoms and stay active.

Frequently Asked Questions

Is GLA:D® Canada a cure for osteoarthritis?

No. There is currently no simple cure for osteoarthritis. GLA:D® is designed to help people manage symptoms, improve physical function and stay active.

Is GLA:D® better than medication?

It is not necessarily an either/or choice. Medication may be appropriate for some people, while exercise and self-management are also important parts of osteoarthritis care.

Can people with severe knee or hip osteoarthritis participate?

Potentially, yes. Suitability depends on the individual. A physiotherapist should assess your condition and determine whether the program is appropriate.

How long does GLA:D® Canada take?

The standard program includes education sessions and 12 supervised exercise sessions. At Sync Move Rehab Centre, the exercise sessions are generally delivered twice a week over six weeks.

Do I need an X-ray before starting?

Not necessarily. At Sync Move Rehab Centre, a doctor’s referral or X-ray is often not required to begin the program. An assessment is used to determine whether GLA:D® is appropriate.

Can GLA:D® help me delay joint replacement?

It may help improve symptoms and function and can be useful for people who want to remain active while considering their treatment options. However, no program can guarantee that surgery will be avoided.

Is GLA:D® covered by insurance in Canada?

Coverage depends on your individual extended health insurance plan. Many plans provide some coverage for physiotherapy services, but patients should confirm their benefits directly with their insurer.

Sources & Further Reading

  1. GLA:D® Canada – Results in Canada – Canadian program outcomes, implementation data and participant results. GLA:D® Canada Results
  2. GLA:D® Canada – Education and Exercise – Official explanation of the program structure and evidence-based approach. GLA:D® Canada Education and Exercise
  3. GLA:D® Canada – Data Collection – Information about outcome monitoring at baseline, three months and 12 months. GLA:D® Canada Data Collection
  4. Young JJ, et al. The GLA:D® Canada program for knee and hip osteoarthritis: A comprehensive profile of program participants from 2017 to 2022. PLOS ONE. Read the PLOS ONE study
  5. Skou ST, et al. Immediate outcomes following the GLA:D® program in Denmark, Canada and Australia. Osteoarthritis and Cartilage. Read the research study
  6. Arthritis Society Canada – Osteoarthritis – Canadian information on osteoarthritis, exercise, weight management and treatment. Arthritis Society Canada – Osteoarthritis
  7. Arthritis Society Canada – Exercises for Osteoarthritis of the Hip & Knee – Practical information about exercise and osteoarthritis. Exercises for Hip & Knee Osteoarthritis
  8. Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Read the ACR/Arthritis Foundation Guideline
  9. GLA:D® Canada – Certification Course – Information about training and standardized delivery of the program. GLA:D® Canada Certification Course
  10. Arthritis Society Canada – Pain Management Guide – Canadian guidance on physical activity, exercise and osteoarthritis pain management. Arthritis Pain Management Guide
  11. Sync Move Rehab Centre – GLA:D® Canada Program – Program information, assessment, sessions and local service details. GLA:D® Canada at Sync Move Rehab Centre
GLA:D® Canada

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

  1. GLA:D® Canada – Education and Exercise — Program structure and education/exercise approach.
  2. GLA:D® Canada – What Is GLA:D® Canada? — Program components and Canadian implementation.
  3. GLA:D® Canada – Results in Canada — Canadian program outcomes and participation data.
  4. GLA:D® Canada Annual Report 2023 — Detailed Canadian outcomes.
  5. GLA:D® Canada Data Collection — Outcome monitoring at baseline, three months and 12 months.
  6. Getting Started with the GLA:D® Canada Program Guide, 2026 — Current program structure and guidance.
  7. GLA:D® Canada – Exercise Program — Neuromuscular exercise principles and exercise stations.
  8. GLA:D® Canada – Treatment for Osteoarthritis — Education, exercise and self-management principles.
  9. 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.
  10. BMJ 2025 – Exercise for People Living with Knee Osteoarthritis — Clinical perspective on exercise and long-term engagement.
  11. GLA:D® Canada – Learning About Osteoarthritis — Education topics including physical activity, weight management and pain.
  12. GLA:D® Canada – Virtual GLA:D® Information — Information about virtual and hybrid delivery.
  13. Sync Move Rehab Centre – GLA:D® Canada Program — Local program information and physiotherapy services.