Hip osteoarthritis exercises: a practical home program

If you have been told you have arthritis in your hip, exercise may be the last thing you feel like doing. Yet hip osteoarthritis exercises are one of the core treatments recommended by major guidelines, because stronger muscles and regular movement help reduce pain and keep you doing the things you want to do.

This guide explains why exercise comes first for hip osteoarthritis, gives you a practical home program with step-by-step instructions, and covers how to handle pain along the way. It is general information only, not medical advice. Please see your GP or physiotherapist before starting, especially if your pain is severe or new.

The short answer

• The UK’s National Institute for Health and Care Excellence (NICE) says the core treatments for osteoarthritis are therapeutic exercise and weight management (if appropriate), along with information and support.
• A Cochrane review of 10 trials found land-based therapeutic exercise can reduce pain and improve physical function in people with hip osteoarthritis.
• Good programs combine muscle strengthening with general fitness, such as walking, cycling or water exercise.
• Joint pain may increase a little when you start. Regular, consistent exercise still benefits your joints.
• Hands-on treatment can help alongside exercise, but not on its own.

What hip osteoarthritis feels like

Hip osteoarthritis often causes pain in the groin or the front of the hip, sometimes spreading to the thigh or knee. Many people notice stiffness after sitting or first thing in the morning, and trouble with jobs like putting on socks and shoes, getting in and out of the car, or climbing stairs.

Not all hip pain is osteoarthritis. Pain on the outside of the hip, or pain that starts in the lower back, is treated differently. Our article on hip pain in older adults explains the common causes and how to tell them apart.

Why exercise comes first

The NICE osteoarthritis guideline recommends offering therapeutic exercise tailored to each person, such as local muscle strengthening and general aerobic fitness, and considering supervised exercise sessions. It also advises telling people that joint pain may increase when they start exercising, but that regular and consistent exercise will benefit their joints, and that sticking with it long term increases the benefits.

This is backed by a Cochrane review, which pooled 10 randomised trials and concluded that land-based therapeutic exercise programs can reduce pain and improve physical function among people with symptomatic hip osteoarthritis.

NICE adds that manual therapy should only be considered alongside exercise, as there is not enough evidence for it on its own. It also suggests considering walking aids, such as a walking stick, for people with lower limb osteoarthritis, and notes that for people living with overweight, any amount of weight loss is likely to help.

A home exercise program for hip osteoarthritis

These are common examples. Your physio will adjust the choice, the number and the difficulty for you. Warm up with a few minutes of gentle walking around the house. Hold a stable surface such as a kitchen bench for standing exercises, move slowly, and stop if pain becomes sharp or you feel unsteady.

1. Bridge

1. Lie on your back on the bed with your knees bent and feet flat.
2. Squeeze your buttocks and lift your hips a little way off the bed.
3. Hold for a couple of seconds, then lower slowly.

2. Sit to stand

1. Sit near the front of a firm chair, feet hip-width apart and slightly behind your knees.
2. Lean forward and stand up, pushing evenly through both feet. Use the armrests at first if you need to.
3. Sit down slowly with control. As it gets easier, try without using your hands.

3. Standing side leg raise

1. Stand side-on to the bench, holding it with one hand.
2. Keeping your body upright and toes pointing forward, lift your outside leg out to the side a short way.
3. Lower slowly. Swap sides.

4. Standing leg swing back

1. Face the bench, holding on with both hands.
2. Keeping your knee straight and your back still, take one leg a little way behind you.
3. Return slowly. Swap sides.

5. Step-ups

1. Stand at the bottom of your stairs, holding the handrail.
2. Step up onto the first step with one foot, then bring the other foot up.
3. Step back down, leading with the first foot. Repeat, then lead with the other leg.

6. Seated knee lifts

1. Sit tall in a firm chair.
2. Lift one knee a few centimetres, keeping your foot relaxed.
3. Lower slowly. Alternate legs.

7. Lying knee rolls

1. Lie on your back on the bed with your knees bent and together.
2. Gently let both knees roll to one side as far as is comfortable, then to the other side.
3. Keep the movement smooth and easy.

Adding general fitness

Alongside strengthening, aim for regular activity that raises your heart rate a little. Options include:

• Walking, built up gradually, with a stick if it helps.
• An exercise bike, with the seat high enough that your hip is not bent sharply.
• Water exercise. Warm water supports your body weight, which many people with hip pain find comfortable. See our hydrotherapy service.

How to handle pain while exercising

Some discomfort during or after exercise is common, especially early on. A practical guide many physios use:

• Mild discomfort that settles within a few hours, or by the next morning, is usually acceptable.
• Pain that is sharp, keeps building, or leaves you worse the next day is a sign to reduce the amount or difficulty, not to stop exercising altogether.
• Flare-ups happen. On a bad day, do gentler exercises or fewer repetitions, then build back up.

If you also have knee arthritis, many of the same principles apply. See knee osteoarthritis home exercises.

When to see your doctor

See your GP promptly, or seek urgent care, if you have:

• Hip or groin pain after a fall, especially if you cannot put weight on the leg. This needs urgent assessment for a fracture.
• A hot, red or swollen joint, or hip pain with fever or feeling unwell.
• Sudden severe hip pain without an obvious cause.
• Pain at night that does not ease with rest or position, or unexplained weight loss.
• New numbness or weakness in the leg.

Frequently asked questions

Will exercise wear out my hip faster?

Guidelines recommend exercise precisely because it benefits people with osteoarthritis. NICE advises that regular, consistent exercise will benefit your joints, even if it causes some discomfort at first.

How long before I notice a difference?

It varies. Exercise is a long-term treatment, and the benefits build with consistency. Your physio can set simple measures, such as how many sit to stands you can do or how far you can walk, so you can see your progress.

What if I end up needing a hip replacement?

Getting stronger before surgery is still worthwhile, and exercise is central to recovery afterwards. Our guide to physiotherapy after hip replacement explains what to expect.

Get your hip moving again

Our physiotherapists visit homes across Melbourne and the Geelong region to build hip osteoarthritis programs around your goals, your home and your day. Make a referral or contact our team on 03 8824 0712.

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