I recently attended a presentation on osteoarthritis (OA), at which an experienced physiotherapist was speaking to a rather large audience consisting of patients and healthcare professionals. The speaker described knee OA as a degenerative disease characteristic of “wear-and-tear”. When speaking of the importance of exercise in the conservative management of knee OA, the speaker stated that running and other high-impact exercises and activities were not appropriate. These activities were said to be dangerous because of their potential to “create more damage” at the knee and consequently, further progress the disease. Afterward, the speaker advised that all exercise in patients with knee osteoarthritis was to be pain-free, as this was key to not “creating more damage” or “making knee OA worse”.