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® Canada

GLA:D® Canada: Reduce Joint Pain & Improve Mobility

Can the GLA:D® Canada Program Reduce Joint Pain and Improve Mobility?

If knee or hip pain is making everyday activities harder, you may have wondered whether exercise can actually help — or whether exercising with arthritis is simply asking for trouble. The GLA:D® Canada Program takes a different approach: instead of telling people with osteoarthritis to stop moving, it combines education, supervised exercise, and physiotherapy to help them move with greater confidence, manage symptoms, and improve everyday function.

At Sync Move Rehab Centre, the GLA:D® Canada Program is designed for people living with knee or hip osteoarthritis who want a structured, evidence-based way to stay active and manage their symptoms. The program combines education with supervised neuromuscular exercise, strengthening, balance and movement training, and functional exercises. (Sync Move Rehab Centre)

But can GLA:D® Canada really reduce joint pain and improve mobility?

The short answer is yes, many people can experience meaningful improvements in pain and physical function, although results vary from person to person. Research involving tens of thousands of GLA:D® participants has found improvements in pain, walking ability, chair-stand performance, and quality of life. Broader research on osteoarthritis also continues to support exercise as one of the central parts of non-surgical care.

So, let’s take a closer look at what the program does, what the research says, and what someone living with knee or hip osteoarthritis can realistically expect.

What Is the GLA:D® Canada Program?

GLA:D® stands for Good Life with OsteoArthritis in Denmark. It was originally developed in Denmark as a structured program for people with knee and hip osteoarthritis.

The program was later adapted for Canada. Its basic philosophy is refreshingly practical: people with osteoarthritis need information about their condition, but information alone is not enough. They also need guidance on how to move, strengthen their muscles, manage symptoms, and stay active.

The Canadian program combines education and supervised exercise and is delivered by trained healthcare professionals. Research examining its implementation in Canada found that the program could be successfully adapted to the Canadian healthcare setting for people with mild to severe knee and hip osteoarthritis. (Osteoarthritis and Cartilage)

At Sync Move Rehab Centre, the program begins with a physiotherapy assessment to determine whether GLA:D® is appropriate for you. The clinic’s current program structure includes education sessions and 12 supervised neuromuscular exercise sessions.

The exercise sessions are held twice per week for six weeks, with each session lasting about 60 minutes. (GLA:D® Canada Program at Sync Move Rehab Centre)

That may sound like a fairly simple recipe:

Learn → Move → Strengthen → Practice → Repeat.

And sometimes the simple recipes are the ones that actually make it into everyday life.

Why Does Osteoarthritis Cause Joint Pain and Stiffness?

Before looking at whether GLA:D® can help, it is useful to understand what osteoarthritis actually is.

Osteoarthritis is a condition that affects the whole joint. It can involve cartilage, bone, muscles, ligaments, and other tissues around the joint.

The knee and hip are particularly important because we use them constantly.

Walking to the kitchen? Knees and hips.

Getting out of the car? Knees and hips.

Climbing stairs? Definitely knees and hips.

Trying to stand up gracefully after sitting for an hour? Your knees may have an opinion about that too.

The World Health Organization estimates that around 528 million people worldwide were living with osteoarthritis in 2019, representing a 113% increase since 1990. Around 73% of people living with osteoarthritis were older than 55, and approximately 60% were women. The knee is the most commonly affected joint. (World Health Organization)

Importantly, osteoarthritis is not simply an unavoidable consequence of getting older.

Age is one risk factor, but previous joint injuries, genetics, body weight, repetitive joint loading, and other factors can also play a role.

This is one reason modern osteoarthritis care has moved away from the old idea that the only options are “put up with it” or “have surgery.”

There is a lot that can be done in between.

Can Exercise Really Reduce Osteoarthritis Pain?

This is probably the biggest question people have.

After all, if your knee hurts when you walk, why would deliberately exercising it make things better?

It sounds almost like telling someone with a sunburn to spend more time in the sun.

But joints are not quite that simple.

Exercise can help improve muscle strength, movement control, physical function, and confidence. It can also help people become more physically active.

Major clinical guidelines support exercise as a core part of knee and hip osteoarthritis management.

The American College of Rheumatology and Arthritis Foundation strongly recommend exercise for people with knee and hip osteoarthritis. They also note that exercise programs tend to produce better outcomes when they are supervised, particularly by physical therapists or other trained professionals. (American College of Rheumatology/Arthritis Foundation guideline)

Similarly, NICE guidance recommends therapeutic exercise tailored to the individual’s needs and says supervised exercise sessions should be considered. NICE also recommends combining exercise with education or behaviour-change support as part of structured osteoarthritis care. (NICE)

The important word here is tailored.

The goal isn’t to force every person with arthritis to perform the same workout.

It is to find appropriate movements and gradually build capacity.

What Does the Research Say About GLA:D® and Joint Pain?

One of the strongest reasons to consider GLA:D® is that the program has been evaluated on a large scale.

A 2021 study published in Osteoarthritis and Cartilage examined outcomes from 28,370 people with symptomatic knee or hip osteoarthritis who participated in GLA:D® programs in Denmark, Canada, and Australia.

The results were encouraging.

Across the three countries, participants experienced:

  • A 26–33% improvement in mean pain intensity
  • An 8–12% improvement in walking speed
  • An 18–30% improvement in chair-stand ability
  • A 12–26% improvement in joint-related quality of life
  • Clinically relevant pain reductions in approximately 43–47% of participants

The researchers concluded that around half or more of participants were classified as responders for pain and objective physical function following the program. (Roos et al., 2021)

That is an impressive amount of data.

But there is an important detail worth remembering: this was a longitudinal program evaluation rather than a simple randomized trial comparing GLA:D® directly against no treatment. So the results show meaningful improvements associated with participation, but they should not be interpreted as proof that every participant will experience the same level of improvement.

Healthcare rarely comes with a “results guaranteed” sticker.

And that’s a good thing to acknowledge.

What Happened When GLA:D® Was Introduced in Canada?

The Canadian experience provides another interesting piece of the puzzle.

An early Canadian implementation study included 72 participants. Of those, 59 started the program and 58 provided follow-up information.

The researchers reported a 40% improvement in pain, with 59% of participants achieving a clinically important improvement of at least two points on the Numeric Pain Rating Scale.

Other improvements were also seen in knee- and hip-related outcome measures. About 24% reported becoming more physically active.

Perhaps even more interestingly, 99% of participants said they benefited from and were satisfied with the program, while 90% said they used what they learned in daily life. (Davis et al., 2018)

Of course, this was a relatively small early implementation study, so it should not be treated as proof that 99% of everyone who tries GLA:D® will have the same experience.

But it does show that the program was feasible in Canada and that participants reported meaningful benefits.

What Do We Know About GLA:D® Canada on a Larger Scale?

The program did not remain a small Canadian pilot.

A 2023 study examined the GLA:D® Canada registry from its beginning through the end of 2022.

By that point, 15,193 participants had been registered:

  • 11,228 with knee osteoarthritis
  • 3,965 with hip osteoarthritis

Participants were approximately 66 years old on average and were predominantly women. Many had been dealing with their knee or hip problems for several years before starting the program.

The registry also showed that participation increased again in 2022 after declining during the COVID-19 pandemic and clinic closures. (PLOS ONE)

This large Canadian registry is important because it allows researchers and healthcare providers to monitor how the program is being delivered and how participants are doing over time.

The program’s Canadian outcomes registry collects information at baseline and follow-up, including patient-reported measures and physical function tests. (PubMed)

In other words, GLA:D® isn’t simply:

“Here are some exercises. Good luck!”

There is a system for measuring outcomes and learning from the data.

How Can GLA:D® Canada Improve Mobility?

Pain is only one piece of the osteoarthritis puzzle.

Many people are more frustrated by what the pain stops them from doing.

Maybe you can no longer:

  • Walk as far as you used to
  • Climb stairs comfortably
  • Stand from a chair without using your hands
  • Walk around a shopping centre
  • Play recreational sports
  • Garden
  • Travel comfortably
  • Keep up with friends or family

This is where mobility becomes especially important.

The GLA:D® Canada Program focuses on neuromuscular exercise, which means exercises designed to improve the way your muscles and joints work together.

Participants learn how to control their movements, improve posture, build strength, and apply these skills to everyday activities. (Sync Move Rehab Centre)

Better movement doesn’t necessarily mean faster movement.

Sometimes better movement simply means:

“I can do that without worrying about my knee.”

That is a meaningful improvement.

Strength Matters More Than Many People Realize

When knee or hip pain begins, people often reduce activity.

Understandably.

If walking hurts, you walk less.

If stairs hurt, you avoid stairs.

If standing hurts, you sit more.

The problem is that reduced activity can contribute to reduced muscle strength and physical capacity.

Then everyday activities become even harder.

This can create a frustrating cycle:

Pain → less activity → weakness → reduced confidence → even less activity.

GLA:D® aims to interrupt that cycle through supervised exercise.

Strengthening exercises can help the muscles around the hip and knee perform their jobs more effectively.

The goal isn’t to build enormous muscles.

You don’t need to leave physiotherapy looking like you are preparing for the Olympics.

You need enough strength and control to make daily movement easier.

Why Neuromuscular Exercise Is Part of GLA:D®

You may have heard the phrase “strength training” many times.

Neuromuscular exercise is slightly different.

It focuses not only on how strong a muscle is, but also on how well you control movement.

Imagine having a strong engine but poor steering.

That’s not exactly the driving experience you want.

Your muscles, joints, balance, and nervous system need to work together.

Neuromuscular exercises can help people practice controlled movement, balance, alignment, and functional tasks.

This is especially relevant for knee osteoarthritis because movement patterns can change when people are experiencing pain.

The GLA:D® approach therefore doesn’t simply say:

“Make your legs stronger.”

It also asks:

“How can you move better?”

What Does a Typical GLA:D® Canada Program Include?

At Sync Move Rehab Centre, the GLA:D® Canada Program includes three main components.

1. Education Sessions

Participants typically complete two or three education sessions.

These sessions cover topics such as:

  • What osteoarthritis is
  • Symptoms and risk factors
  • Available treatment options
  • How exercise can help
  • Self-management strategies
  • How to cope with challenging daily activities

This education is important because osteoarthritis comes with plenty of myths.

For years, people were often told that arthritis was simply “wear and tear.”

Modern understanding is more complicated.

Learning what osteoarthritis is — and what it is not — can help people make better decisions about activity.

2. Twelve Exercise Sessions

The Sync Move Rehab Centre program includes 12 supervised neuromuscular exercise sessions, with sessions held twice a week for six weeks.

During these sessions, participants work on:

  • Movement control
  • Posture
  • Strength
  • Balance
  • Functional movement
  • Everyday activities

Exercises can be adjusted according to individual ability, fitness level, and symptoms. (Sync Move Rehab Centre)

3. Progress Monitoring

The program also collects outcome information.

At Sync Move Rehab Centre, progress is monitored at the initial visit and at later follow-ups, including three and 12 months after starting the program. (Sync Move Rehab Centre)

This provides useful information about how people are doing beyond the first few weeks.

Can GLA:D® Canada Help With Stairs and Getting Out of a Chair?

Yes, these are exactly the kinds of everyday activities that rehabilitation programs should care about.

A person might not care whether their quadriceps strength has increased by a certain percentage.

They may care very deeply about whether they can stand up from the sofa without pushing themselves up with both hands.

Research on GLA:D® has included objective tests such as chair stands and walking performance.

The large international study found improvements of 18–30% in chair-stand ability and 8–12% in walking speed across Denmark, Canada, and Australia. (Osteoarthritis and Cartilage)

These types of measures are valuable because they connect rehabilitation with real-world function.

What Does Newer Exercise Research Tell Us?

The evidence supporting exercise for knee osteoarthritis continues to evolve.

A major systematic review and network meta-analysis published in The BMJ in 2025 examined 217 randomized controlled trials involving 15,684 participants with knee osteoarthritis.

The researchers compared different types of exercise, including aerobic, strengthening, flexibility, neuromotor, mind-body, and mixed exercise.

They found that exercise improved pain, physical function, walking performance, and quality of life compared with control conditions.

Aerobic exercise showed particularly strong results across several outcomes, while strengthening and mixed exercise also produced meaningful improvements in function. Neuromotor exercise was particularly beneficial for gait performance in the short term. (The BMJ, 2025)

This research does not mean that everyone with knee osteoarthritis should suddenly start running five kilometres every morning.

In fact, it highlights an important point:

The best exercise is the exercise that is appropriate for the person and can be done consistently.

That is one reason individualized physiotherapy matters.

What If Exercise Hurts?

This is probably one of the most common concerns.

“Won’t exercise make my arthritis worse?”

Not necessarily.

Some people experience temporary increases in discomfort when beginning a new exercise program. NICE specifically notes that joint pain may increase when therapeutic exercise is first started, while also emphasizing that regular and consistent exercise can benefit pain, function, and quality of life over the longer term. (NICE)

That doesn’t mean you should simply ignore severe pain.

Pain is information.

A physiotherapist can help distinguish between expected exercise-related discomfort and symptoms that suggest an exercise needs to be changed.

This is another advantage of supervised rehabilitation.

If you are exercising alone at home and something feels wrong, your first thought may be:

“Should I keep going?”

During supervised exercise, you can ask the person who is actually watching your movement.

That is considerably more useful than asking Google at 11:47 p.m.

Is GLA:D® Canada Suitable for Severe Osteoarthritis?

According to Sync Move Rehab Centre, the program can be appropriate for people with mild, moderate, and severe knee or hip osteoarthritis, with suitability determined during the physiotherapy assessment. (GLA:D® Canada at Sync Move Rehab Centre)

This is important because people sometimes assume that exercise is only useful during the early stages of arthritis.

That is not the case.

People with more advanced osteoarthritis may still benefit from improving strength, balance, physical function, and confidence.

However, severe symptoms should be assessed professionally.

GLA:D® is not a promise that joint replacement will never be necessary.

For some people, surgery eventually becomes the most appropriate option.

The purpose of conservative management is to help people function as well as possible and make informed treatment decisions.

Could GLA:D® Canada Help Delay Joint Replacement?

Potentially — but this needs careful wording.

The program is not a guaranteed surgery-prevention treatment.

However, if exercise, education, and symptom management improve your function and quality of life enough, you may be able to postpone surgery.

For someone already considering joint replacement, physiotherapy can also help prepare the body for surgery by improving strength and physical capacity.

The decision about surgery should always be made with appropriate healthcare professionals based on symptoms, function, imaging when relevant, overall health, and personal goals.

Think of GLA:D® as another tool in the toolbox, not a magical wrench that fixes every knee.

Is GLA:D® Canada Better Than Exercising at Home?

Home exercise can absolutely be useful.

In fact, continuing to exercise outside the clinic is an important part of long-term osteoarthritis management.

The difference is that supervised exercise gives you:

  • Professional guidance
  • Exercise progression
  • Movement feedback
  • Individual modifications
  • Accountability
  • Education
  • A structured program

The American College of Rheumatology and Arthritis Foundation specifically note that supervised exercise tends to be associated with better outcomes than unsupervised exercise. (ACR/Arthritis Foundation)

That doesn’t make home exercise “bad.”

It simply means that many people benefit from learning what to do — and how to do it — before continuing independently.

How Is GLA:D® Canada Different From Simply “Going to the Gym”?

A gym gives you access to equipment.

GLA:D® gives you a structured osteoarthritis management program.

Those are not the same thing.

You could walk into a gym and find:

  • Treadmills
  • Exercise bikes
  • Weight machines
  • Dumbbells
  • Resistance bands

But which exercises are appropriate for your knee?

How much resistance should you use?

How often should you train?

What should you do if pain increases?

How should you progress?

Those are the questions that make professional rehabilitation valuable.

GLA:D® combines exercise with education and clinical guidance specifically for knee and hip osteoarthritis.

Who May Benefit From GLA:D® Canada?

The program may be appropriate for people experiencing:

  • Knee osteoarthritis
  • Hip osteoarthritis
  • Pain when walking
  • Pain when climbing stairs
  • Morning stiffness
  • Difficulty standing from a chair
  • Reduced balance
  • Reduced mobility
  • Reduced confidence with movement
  • Mild to severe osteoarthritis
  • Concerns about joint replacement

At Sync Move Rehab Centre, the program begins with a comprehensive physiotherapy assessment to determine whether it is suitable for you. (Sync Move Rehab Centre)

A doctor’s referral or X-ray is often not required to begin the program, according to the clinic’s current information.

Why Choose Sync Move Rehab Centre for GLA:D® Canada?

For people in Thornhill and surrounding communities, finding a convenient provider can make it easier to follow through with a rehabilitation program.

Sync Move Rehab Centre provides the GLA:D® Canada Program with physiotherapy care and individualized exercise progression.

The clinic serves communities including:

  • Thornhill
  • Markham
  • Richmond Hill
  • Vaughan
  • North York

Its GLA:D® Canada service combines the standardized program framework with individualized exercise modifications based on each participant’s abilities, fitness level, symptoms, and goals. (Sync Move Rehab Centre)

The clinic’s approach is not simply about getting through 12 exercise sessions.

It is about helping participants understand osteoarthritis and develop skills they can continue using in everyday life.

What Can You Realistically Expect From GLA:D® Canada?

It is important to have realistic expectations.

GLA:D® Canada is not a cure for osteoarthritis.

It does not rebuild damaged cartilage overnight.

It does not guarantee that your knee or hip will never hurt again.

And it certainly cannot promise that everyone will avoid surgery.

What it can do is provide a structured opportunity to work on things that are within your control.

These include:

  • Strength
  • Movement
  • Balance
  • Physical activity
  • Confidence
  • Self-management
  • Functional ability

Research suggests that many participants experience improvements in pain and physical function.

But individual responses vary.

Some people may notice changes quickly.

Others may need more time.

Some may experience large improvements.

Others may experience smaller but still meaningful changes.

In rehabilitation, “meaningful” doesn’t always mean dramatic.

Being able to walk another ten minutes without stopping can be a huge victory if you previously couldn’t walk for five.

The Importance of Staying Active After the Program

One of the biggest mistakes people can make is thinking:

“I finished physiotherapy, so I’m done exercising.”

Unfortunately, joints don’t hand out graduation certificates.

Osteoarthritis is a long-term condition, so maintaining physical activity matters.

The goal of GLA:D® is not simply to help you during the supervised sessions.

The education and exercises are intended to help you develop skills that can continue beyond the formal program.

That may mean walking regularly, continuing strengthening exercises, participating in recreational activities, or following an individualized exercise plan.

Consistency usually matters more than perfection.

Missing one workout doesn’t erase your progress.

Think of it like brushing your teeth. You don’t decide that because you missed Tuesday, the whole concept of dental hygiene is cancelled.

GLA:D® Canada and the Bigger Picture of Osteoarthritis Care

Modern osteoarthritis management is becoming more active and more personalized.

The World Health Organization identifies rehabilitation as an important part of managing osteoarthritis and notes that hundreds of millions of people worldwide could benefit from rehabilitation services. (WHO)

The OARSI guidelines for non-surgical management identify structured land-based exercise and education as core treatments for knee osteoarthritis. (OARSI)

The American College of Rheumatology and Arthritis Foundation also strongly recommend exercise for knee and hip osteoarthritis. (ACR/Arthritis Foundation)

And NICE recommends tailored therapeutic exercise and considers supervised exercise an important option. (NICE)

GLA:D® fits naturally into this broader evidence-based approach.

It takes principles that can sometimes sound abstract in a clinical guideline — “exercise,” “education,” “self-management” — and turns them into a structured program that people can actually participate in.

Frequently Asked Questions About GLA:D® Canada

Can GLA:D® Canada completely eliminate joint pain?

No program can guarantee complete pain relief.

Research shows that many GLA:D® participants experience meaningful reductions in pain, but individual results vary.

Is GLA:D® only for older adults?

No. Osteoarthritis can affect younger adults too, particularly after previous joint injuries or other risk factors.

The program is designed around the person’s symptoms and physical abilities rather than simply their age.

Can I participate if I have severe arthritis?

Sync Move Rehab Centre states that GLA:D® may be suitable for mild, moderate, and severe knee or hip osteoarthritis. A physiotherapy assessment helps determine whether the program is appropriate. (Sync Move Rehab Centre)

Does GLA:D® Canada involve surgery?

No. GLA:D® is an education and exercise-based program.

It is designed as a non-surgical management approach, although people who eventually require surgery may also benefit from physiotherapy before or after joint replacement.

Do I need a doctor’s referral?

According to Sync Move Rehab Centre, a referral is generally not required to participate.

However, individual circumstances can vary.

How long does the program take?

At Sync Move Rehab Centre, the program includes education and 12 supervised exercise sessions over approximately six weeks.

Is GLA:D® Canada covered by insurance?

Coverage depends on your extended health insurance plan. Sync Move Rehab Centre notes that many plans cover physiotherapy services associated with GLA:D®, but patients should confirm their individual coverage before starting. (Sync Move Rehab Centre)

So, Can GLA:D® Canada Reduce Joint Pain and Improve Mobility?

The available evidence gives us good reason to say it can help many people.

Large-scale GLA:D® research involving 28,370 people with symptomatic knee or hip osteoarthritis found improvements in pain, walking speed, chair-stand performance, and quality of life after the program. A Canadian implementation study also found meaningful improvements in pain and osteoarthritis-related outcomes.

At the same time, newer exercise research continues to reinforce the value of exercise for people with knee osteoarthritis. A 2025 BMJ systematic review of 217 randomized controlled trials found that exercise can improve pain, function, gait performance, and quality of life. (The BMJ)

So the question may not be:

“Can exercise cure my arthritis?”

A better question is:

“Can the right exercise program help me live better with arthritis?”

The evidence suggests the answer can be yes.

For people living with knee or hip osteoarthritis, GLA:D® Canada offers a structured way to combine education, supervised exercise, strengthening, movement training, and self-management. If pain or stiffness is making walking, stairs, recreational activities, or everyday tasks more difficult, Sync Move Rehab Centre can help you explore whether the GLA:D® Canada Program is appropriate for your needs. Visit the Sync Move Rehab Centre website or learn more about the GLA:D® Canada Program for Knee & Hip Osteoarthritis to take the next step toward reducing pain, improving mobility, and staying active.

References

  1. World Health Organization – Osteoarthritis
    WHO Osteoarthritis Fact Sheet
  2. Roos EM, Grønne DT, Skou ST, et al. (2021). Immediate outcomes following the GLA:D® program in Denmark, Canada and Australia.
    PubMed – GLA:D® Outcomes Study
  3. Young JJ, Perruccio AV, Veillette CJH, et al. (2023). The GLA:D® Canada program for knee and hip osteoarthritis: A comprehensive profile of program participants from 2017 to 2022.
    PLOS ONE – GLA:D® Canada Registry Study
  4. Zywiel MG, Ellis K, Veillette CJH, Skou ST, McGlasson R. (2021). Implementation of the GLA:D® Program across Canada.
    PubMed – GLA:D® Canada Implementation
  5. Davis AM, Kennedy D, Wong R, et al. (2018). Cross-cultural adaptation and implementation of GLA:D® in Canada.
    Osteoarthritis and Cartilage – Canadian GLA:D® Study
  6. Yan L, Li D, Xing D, et al. (2025). Comparative efficacy and safety of exercise modalities in knee osteoarthritis.
    The BMJ – 2025 Exercise Meta-analysis
  7. Kolasinski SL, Neogi T, Hochberg MC, et al. (2020). 2019 ACR/Arthritis Foundation Guideline for the Management of Osteoarthritis.
    American College of Rheumatology / Arthritis Foundation Guideline
  8. Bannuru RR, Osani MC, Vaysbrot EE, et al. (2019). OARSI Guidelines for the Non-Surgical Management of Knee, Hip and Polyarticular Osteoarthritis.
    OARSI Guidelines
  9. NICE Guideline NG226 – Osteoarthritis in over 16s: diagnosis and management.
    NICE Osteoarthritis Recommendations
  10. GLA:D® Canada – Osteoarthritis Information
    Official GLA:D® Canada Osteoarthritis Resources
  11. GLA:D® International – Key Research Publications
    GLA:D® International Research Publications
  12. Sync Move Rehab Centre – GLA:D® Canada Program for Knee & Hip Osteoarthritis
    Official GLA:D® Canada Service Page