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The pain in your knee used to come and go. Now it's there most mornings. Stairs have become something you think about before you start. The dog walk has shortened. Your GP has sent you for an X-ray, told you it's osteoarthritis, and mentioned that surgery is something to think about down the track, but not yet.
Then someone has said the word GLA:D. A friend, your GP, maybe a physiotherapist. You don't know what it is, whether it works, or whether six weeks is worth your time. GLA:D is an evidence-based exercise and education program for hip and knee osteoarthritis, delivered at Inform Physio's Fairfield clinic by GLA:D-certified physiotherapists. The aim of this article is to get you from 'what is this' to 'what would my six weeks look like' so you can decide whether to book an initial assessment.
What is GLA:D, in plain terms?
GLA:D stands for Good Living with osteoArthritis: Denmark. The program was developed by researchers at the University of Southern Denmark and first ran in 2013. It was brought to Australia in 2016 and runs nationally through La Trobe University in Melbourne, which holds the outcomes registry and oversees clinician training.
The program is a structured course of patient education and neuromuscular exercise for adults with symptomatic hip or knee osteoarthritis. Neuromuscular exercise targets the coordination between nerves and muscles around a joint, not just raw strength. A few features separate it from generic gym-based exercise:
- One protocol, used internationally. The same education content and exercise framework runs in Denmark, Canada, Australia, and other GLA:D countries. Outcomes are comparable across them.
- Certified physiotherapists only. Delivery requires a specific GLA:D training course. Not every physiotherapy practice offers the program.
- Outcomes tracked nationally. Every participant's pain, function, and quality-of-life scores are logged in the GLA:D Australia registry, hosted at La Trobe.
If you want the upstream context on osteoarthritis and how exercise affects the joint, the Inform Physio blog post on physiotherapy for osteoarthritis covers that ground. This article assumes you have the diagnosis and want to know what GLA:D would look like.
Who is GLA:D for?
The eligibility criteria are broader than many people assume.
- People diagnosed with knee or hip osteoarthritis. A formal X-ray diagnosis is not always required. Eligibility is based on symptoms consistent with osteoarthritis, not just imaging.
- People at any stage of the condition. GLA:D is not only for people facing surgery. It runs for early-stage osteoarthritis where pain is starting to interfere with activity, mid-stage osteoarthritis where pain is daily, and late-stage osteoarthritis where surgery is being weighed.
- People who want to try non-surgical management first. Australian and international guidelines list education, exercise, and weight management as first-line care for knee and hip osteoarthritis. GLA:D delivers two of those three in a structured form.
- People between joint replacements, or recovering from one and managing the other side.
Not everyone should start with GLA:D. People with red-flag symptoms, such as an acute injury, suspected fracture, joint infection, or unexplained weight loss with bone pain, need urgent medical assessment first. People with unmanaged cardiac issues or uncontrolled blood pressure will need clearance before they start. The initial assessment session picks these up, so you do not need to self-screen before booking.
What will my six weeks of GLA:D look like?
The program runs across roughly eight weeks in total: two assessment and education sessions at the start, then twice-weekly group exercise sessions for six weeks, with follow-up scheduled afterwards. Group sessions are held at Inform Physio's group exercise space in Fairfield.
Here is the structure at a glance.
| Phase | When | What happens |
|---|---|---|
| Assessment | Sessions 1–2 | Individual appointment with a GLA:D-certified physiotherapist. Baseline functional tests. Two education sessions. |
| Exercise | Sessions 3–12 (six weeks) | Two group sessions per week. Neuromuscular exercises, progressed across the program. |
| Follow-up | After session 12 | Functional tests repeated. Plan for continuing exercise. Registry follow-up at three and twelve months. |
Sessions 1 to 2 – Assessment and education
The first appointment is an individual session with the GLA:D-trained physiotherapist. The physiotherapist takes a history, examines the affected joint, and runs a short battery of functional tests to set a baseline.
The tests are practical, not heroic. The current GLA:D Australia battery typically includes a 40-metre walk test, a 30-second sit-to-stand test, and a knee-bend strength test. None of them require equipment more elaborate than a chair and a stopwatch.
The education sessions cover what osteoarthritis is at a joint and tissue level, how exercise affects an osteoarthritic joint, how to manage pain and pain flares, and what self-management looks like beyond the six weeks.
Sessions 3 to 12 – Neuromuscular exercise
This is the bulk of the program: two group sessions per week, for six weeks. Each session runs about 60 minutes and follows a consistent structure of warm-up followed by a sequence of neuromuscular exercises. The focus is movement control, lower limb strength, and confidence using the joint.
A few features matter:
- Exercises are progressed. What you do in session three is not the load you do in session ten. The physiotherapist adjusts each exercise to your current capacity.
- Small group size. The group is kept small enough for the physiotherapist to watch each participant's technique.
- Designed to transfer to home. By the end of the program, you have a routine you can keep doing on your own.
Follow-up – Re-test and ongoing
At the end of the six weeks, the functional tests from the first session are repeated. The numbers, not the physiotherapist's impression, tell you whether you walk faster, stand from a chair more times, and have stronger leg control than when you started.
The physiotherapist will then talk through how to continue. Participants are followed up at three months and twelve months as part of the GLA:D Australia national registry. This is how the Australian outcomes data is gathered, and it means every participant's progress contributes to the public evidence on the program.
What does the evidence show?
The program has been studied in Australia and internationally. Average results are meaningful for many participants, but the averages are not guarantees for any individual.
From the figures published by GLA:D Australia (gladaustralia.com.au) and peer-reviewed implementation studies at La Trobe University:
- Pain reduction averages around 36 per cent across the Australian registry, with similar effect sizes for hip and knee participants. (GLA:D Australia, program information.)
- Many participants reduce their pain medication use during and after the program.
- Around 74 per cent of participants who wanted surgery before starting GLA:D had not undergone surgery and no longer desired it at 12-month follow-up, per a La Trobe University implementation evaluation led by Barton and colleagues.
- Functional measures improve on average, including walking speed, the number of sit-to-stand repetitions in 30 seconds, and joint-related quality of life. (Skou and Roos, longitudinal analysis of more than 28,000 GLA:D participants across Denmark, Canada, and Australia.)
A few honest caveats:
- These are averages across thousands of participants. Some people improve more than the average. Some improve less. A small proportion do not improve.
- GLA:D is not surgery. For people with severe structural damage and pain that is not responding to first-line care, joint replacement remains the right choice.
- The point of GLA:D is to give you and your treating team better information about whether non-surgical management is achieving enough. If it is, surgery may be deferred or no longer needed. If not, surgery becomes an informed decision rather than a default one.
How much does GLA:D cost, and what about rebates?
GLA:D is delivered by a qualified physiotherapist, so standard physiotherapy fees apply. Sessions are charged individually, not as a flat program fee. Several rebate pathways can reduce out-of-pocket costs.
| Pathway | Who can use it | What to ask about |
|---|---|---|
| Medicare CDM plan | Participants with a GP-issued Chronic Disease Management plan and allied health referral | How many subsidised allied health visits your plan includes |
| Private health extras | Members with physiotherapy cover | Per-session rebate and your annual limit |
| DVA | Eligible Department of Veterans' Affairs participants | Whether GLA:D sessions sit under your existing entitlements |
| NDIS | Participants with physiotherapy on an approved plan | Whether your plan covers group-based physiotherapy |
Confirm specific dollar figures with the Inform Physio reception team or your GP, as rebate amounts change and depend on your circumstances.
Who delivers GLA:D at Inform Physio?
GLA:D-certified physiotherapists at Inform Physio deliver the program. Certification is not transferable between clinicians; each physiotherapist completes the GLA:D training course themselves. Group sessions run at the practice's group exercise space.
Frequently asked questions
No. You can self-refer. A GP referral with a Chronic Disease Management plan may attract a Medicare rebate, which is a separate question to whether you can book in the first place.
You do not need a baseline fitness level. The program is designed for people with osteoarthritis pain, and the exercises are progressed from your starting point.
The six-week sequence is structured, but a missed group session can usually be picked up at the next scheduled group. Talk to your physiotherapist about how to catch up.
Many participants delay or decide against surgery after completing GLA:D. The decision is between you and your surgeon. GLA:D gives both of you real data on whether non-surgical management is achieving enough.
Some discomfort during exercise is expected when a joint already hurts at rest. The physiotherapist will help you tell the difference between productive discomfort and pain that signals you need to modify. Pain flares during the program are common and usually settle as you progress.
About the author
GLA:D-certified physiotherapist at Inform Physio who reviewed this article. APA credentials or equivalent. Two-to-three sentence bio covering osteoarthritis and exercise rehabilitation experience. the clinician's team-page profile on the Inform Physio website.
Ready to start? Here is what the first appointment looks like
The first step is one appointment, not a six-week commitment. Before the group sessions begin, you have an individual assessment with the GLA:D-certified physiotherapist. That appointment is a standalone booking, and attending it does not commit you to the program. It is the session where eligibility, baseline function, and your goals are mapped out, and you decide from there whether to enrol.
Please bring three things to that first appointment, if you have them:
- Any GP referral or Chronic Disease Management plan
- Your most recent imaging report (X-ray, MRI, or other scan)
- A list of pain medications you currently use
Phone numbers, online booking, and clinic addresses are on the Inform Physio booking page.