If a doctor has told you that you may eventually need a knee or hip replacement, it can feel like a countdown has started. The joint hurts. Stairs are harder than they used to be. And the plan, as far as you have been told, is to wait until it gets bad enough for surgery.
Here is what often gets left out of that conversation. For most people with knee or hip osteoarthritis, surgery is not the only option, and it is rarely the first one that should be tried. There is a structured, evidence-based program built specifically for this stage, and many people who complete it feel better, move better, and put off or avoid surgery altogether.
It is called GLA:D, and this is what it is.
What GLA:D actually is
GLA:D stands for Good Life with osteoArthritis: Denmark. It began at the University of Southern Denmark as a way to take what the research clearly shows works for arthritic joints, structured education and the right kind of exercise, and deliver it the same way every time, so that results could be measured across thousands of people.
It has since been brought to Canada, and it is now offered at clinics across the country, including here at Atlas Spine Clinic in Scarborough.
The core idea is simple, and it runs against a common assumption. When a joint hurts, the instinct is to protect it and move it less. But for osteoarthritis, carefully guided movement is one of the most effective things you can do. The right exercise strengthens the muscles that support and control the joint, which reduces the load going through the worn surfaces and, for many people, reduces the pain.
GLA:D is not a generic exercise class. It is a specific program built on three pillars.
The three parts of the program
Education. Before any exercise begins, you learn what osteoarthritis actually is, and, just as importantly, what it is not. Many people believe that arthritis means their joint is wearing out and that every step causes more damage, so movement feels frightening. The education sessions replace that fear with an accurate picture: what is happening in the joint, why appropriate loading is safe and helpful, and how to manage symptoms day to day.
Neuromuscular exercise. This is the heart of the program. It is not random cardio or heavy lifting. It is a set of exercises designed to retrain how you control and stabilize the joint, improving strength, balance, and confidence in movement. Every exercise is supervised and adjusted to your ability, and it progresses as you get stronger.
Self-management. The goal is not for you to depend on the clinic forever. It is to give you the knowledge and the specific exercises to keep managing the condition on your own, long after the program ends.
What the results actually show
This is the part that matters most, and it is worth being precise about, because the numbers are real and they come from tracking actual participants.
GLA:D Canada keeps a registry of outcomes from people who complete the program across the country. Among those participants, function improved for about 51 percent of people with hip osteoarthritis and 56 percent of people with knee osteoarthritis. Quality of life improved for roughly 58 percent of hip participants and 64 percent of knee participants. And pain improved for about 56 percent of hip participants and 58 percent of knee participants.
Beyond those measures, research on the program has consistently found that participants tend to rely on less pain medication afterward, and that a meaningful share are able to delay or avoid joint replacement surgery. Results vary from person to person, and no program can promise a specific outcome, but the overall pattern across thousands of participants is clear: for a lot of people, this genuinely helps.
That is the case for trying it before surgery. It is low risk, it is evidence based, and if it works for you, you may have avoided or postponed a major operation. If it does not fully resolve things, you have lost nothing and you are stronger going into any surgery you do end up having.
Who it is for
GLA:D is designed for people with knee or hip osteoarthritis, at almost any stage. You do not need to be at the point of considering surgery to benefit. In fact, the earlier you start, the more you have to gain.
It is a good fit if you have joint pain that limits your daily activities, if you have been told you have arthritis in a knee or hip, or if you are weighing a possible joint replacement and want to try the evidence-based conservative route first.
It is also worth knowing that you do not need a doctor’s referral to start. You can refer yourself simply by contacting the clinic.
What taking part looks like
The GLA:D program follows a consistent structure wherever it is offered. It typically begins with an initial assessment of your joint, your movement, and your goals. From there, the program generally includes a pair of education sessions and around twelve supervised neuromuscular exercise sessions, usually run about twice a week over roughly six weeks.
At Atlas Spine Clinic, the program is delivered by a certified GLA:D practitioner, and it is available either in a small group or one on one, depending on what suits you. The group setting has its own advantage: you are working alongside other people dealing with the same thing, which many participants find motivating.
Dr. Arvin Sepahdoost, a certified GLA:D practitioner at the clinic, leads the program in Scarborough.
It starts with a conversation, not a commitment
If any of this sounds like your situation, the first step is not signing up for anything. It is a short conversation to find out whether the program is a sensible fit for you.
Atlas Spine Clinic offers a free 10-minute phone consultation about the GLA:D program. You can ask your questions, describe what you are dealing with, and get an honest answer about whether GLA:D makes sense for your knee or hip before you decide anything.
Learn more about the GLA:D program at Atlas Spine Clinic and book your free phone consultation.
General information, not medical advice. An assessment is needed to determine whether the GLA:D program is appropriate for your specific condition.
Frequently asked questions
Do I need a referral from my doctor to join GLA:D?
No. You can refer yourself to the program by contacting the clinic directly. If you are already under the care of a physician for your joint, it is always worth keeping them informed, but a referral is not required to start.
Will exercise not make my arthritis worse?
It is a completely understandable worry, and it is one of the first things the program addresses. For osteoarthritis, appropriate, guided exercise does not wear the joint out. It strengthens the muscles that support the joint and, for many people, reduces pain over time. Every exercise in GLA:D is supervised and matched to your ability.
How long is the program?
The GLA:D program is typically structured around an initial assessment, two education sessions, and about twelve supervised exercise sessions, usually run roughly twice a week over about six weeks. The exact schedule is confirmed at your assessment.
Can GLA:D help me avoid surgery?
It may. Research on the program has found that many participants use less pain medication and that a meaningful number are able to delay or avoid joint replacement. It cannot be guaranteed for any one person, but for a lot of people it makes a real difference, which is exactly why it is worth trying before surgery.
Is it done in a group or one on one?
Both options are available at Atlas Spine Clinic. Some people prefer the motivation of a small group working through the same challenges, while others prefer individual attention. You can choose what suits you.
