If you've ever been told you have “bone on bone” arthritis, chances are it sounded like a life sentence for joint pain, stiffness, and limitations. The phrase often sparks fear, making people think their only options are to suffer through the pain or undergo surgery. But what does “bone on bone” really mean? And more importantly—what can you do about it?
Before you assume going the route of injections and surgery are your only option, let’s break down what’s actually happening in your body and how performance physical therapy can help keep you strong, mobile, and doing what you love while avoiding invasive procedures.
What Does “Bone on Bone” Really Mean?
When people hear "bone on bone," they often think of two bones grinding together with no cushion in between. While severe osteoarthritis (OA) can lead to a loss of cartilage in a joint, it’s rarely as extreme as it sounds.
Cartilage Wear & Tear – Over time, the smooth cartilage that cushions your joints can thin due to aging, previous injuries, or repetitive stress.
Joint Space Narrowing – X-rays may show a decreased space between bones, but this doesn’t always correlate with pain or dysfunction. Many people with “bone on bone” findings on imaging have little to no pain!
Inflammation & Stiffness – When arthritis flares up, swelling and stiffness can make movement uncomfortable, but that doesn’t mean your joint is beyond repair.
How Can Performance Physical Therapy Help?
Instead of focusing on the X-ray findings, we focus on what you can do to improve strength, mobility, and function. Here’s how performance physical therapy can help you move better—without jumping straight to surgery:
Strength Training for Joint Support
Muscles stabilize and protect your joints. By strengthening the muscles around the
affected joint, we reduce stress on the cartilage and improve overall function. Whether it’s your knees, hips, shoulders, or spine, targeted strength work makes a huge difference.
Mobility & Joint Health Optimization
Just because cartilage has thinned doesn’t mean your joint is “done.” Improving joint
mobility through controlled movement, stretching, and specific drills can help maintain or
even improve range of motion. When we do manual therapy and the proper exercises, we
actually encourage the release of synovial fluid into the joint. This fluid nourishes the joint
space, which acts like an anti-inflammatory medication, without the side effects.
Pain Management Without Surgery
Many people think pain = damage, but that’s not always true. Our goal is to help you move
better with less pain through hands-on therapy, mobility work, dry needling, and
progressive exercise programming.
Load Management & Movement Mechanics
The way you move impacts joint stress. We analyze movement patterns and help you adjust
how you walk, squat, lift, or run to reduce unnecessary strain and keep your joints working
efficiently.
You Have More Options Than You Think
Hearing “bone on bone” doesn’t mean you have to stop lifting, running, or staying active. Your body is resilient, and with the right approach, you can keep doing what you love without unnecessary surgeries or medications.
If you’re dealing with joint pain, stiffness, or movement limitations, let’s build a plan that works for you. Book a session with The Impact Initiative - Woodstock Physical Therapy today and take control of your movement!
Fitness-Forward. Evidence-Based. Impact-Driven.
Woodstock Physical Therapy
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