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How people talk about osteoarthritis may impact outcomes, including uptake of guideline recommendations related to activity-based lifestyles and interventions. In this editorial, we describe 2 key ways of talking, based on findings from our systematic review of 62 qualitative studies exploring the perceptions of people with knee osteoarthritis (n = 1208), their carers (n = 28), and clinicians (n = 2403). Among raw quotes extracted from the studies, we observed a dominant impairment-based way of talking and a participatory based way of talking. These ways of talking form a novel framework to help clinicians understand what people think and do about osteoarthritis. J Orthop Sports Phys Ther 2023;53(6):325–330. doi:10.2519/jospt.2023.11880