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Hip Pain Physical Therapy: Exercises and What to Expect

Physical therapy for hip pain identifies the specific cause — bursitis, gluteal tendinopathy, hip flexor strain, femoroacetabular impingement, labral issues, or arthritis — and designs a targeted program of strengthening and mobility exercises. OARSI guidelines strongly recommend exercise therapy as core non-surgical management for hip osteoarthritis; PT addresses the muscle imbalances that load the joint unevenly and sustain pain.

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Why does the hip hurt, and why does it matter for treatment?

The hip joint is a deep ball-and-socket joint bearing the full weight of the upper body during walking, running, and stair climbing. Pain in and around the hip arises from several distinct structures, and physical therapy is most effective when the right structure is targeted:

  • Greater trochanteric pain syndrome (lateral hip pain): Often called hip bursitis, this is pain on the outer side of the hip, frequently worse lying on that side or after prolonged sitting. The tendons of the gluteus medius and minimus — not just the bursa — are usually involved. A 2024 systematic review found exercise to be superior to corticosteroid injection for long-term global improvement in this condition 2.
  • Hip flexor strain or tendinopathy: Pain in the front of the hip or groin, often aggravated by stairs, running, or hip flexion. The iliopsoas and rectus femoris are the most common culprits.
  • Femoroacetabular impingement (FAI): The ball and socket make abnormal contact during certain positions, causing deep groin pain with prolonged sitting or squatting.
  • Hip labral tear: The cartilage ring around the socket is damaged. Often accompanies FAI.
  • Hip osteoarthritis: Cartilage loss causing stiffness, aching, and reduced range of motion — typically in adults over 50 1.

Identifying which structure is involved guides the entire PT program.

What does physical therapy for hip pain involve?

A PT will assess your range of motion, strength, walking pattern (gait), and provocative tests to narrow down the cause. Treatment typically includes:

Strengthening the hip stabilizers: Weak gluteal muscles — particularly the gluteus medius — are a common thread across many hip pain conditions. They cause the hip to drop and the thigh to rotate inward during walking, loading the joint and surrounding structures unequally. Key exercises include: - Clamshells and side-lying hip abduction - Single-leg bridges - Step-ups and lateral band walks - Single-leg squats (progressed gradually)

Hip flexor flexibility: Tight hip flexors from prolonged sitting shorten the iliopsoas and alter pelvic tilt, compressing the front of the joint. The kneeling hip flexor stretch (low lunge) and Thomas stretch are commonly prescribed.

Mobility work: Gentle hip circles, 90/90 hip mobility exercises, and controlled range-of-motion movements help restore full motion — particularly important in osteoarthritis and FAI 1.

Gait and movement training: For runners and active individuals, the PT will assess running form and correct compensatory patterns that generate excessive hip load.

Manual therapy: Joint mobilization of the hip or lumbar spine can be helpful when restricted mobility contributes to pain.

Which hip exercises are most commonly prescribed?

Clamshells: Lie on your side with knees bent. Keeping feet together, rotate the top knee toward the ceiling. Targets the gluteus medius without loading the hip joint.

Glute bridge: Lie on your back, feet flat, knees bent. Press through your heels to lift the hips, squeezing the glutes at the top. Progress to single-leg bridges once strength allows.

Side-lying hip abduction: Lie on your side, top leg straight. Lift the top leg to about 30 degrees, hold briefly, lower. Keep the pelvis stable.

Hip flexor stretch (kneeling lunge): Kneel on one knee, the other foot forward. Shift forward gently until you feel a stretch in the front of the kneeling hip. Hold 30–45 seconds.

Monster walks (lateral band walks): Place a resistance band around the ankles. Step sideways in a half-squat position. This mimics real gait demands on hip stabilizers.

Standing hip hinge: Hinge at the hips with a neutral spine, loading the glutes and hamstrings. Fundamental for learning to offload the hip joint during daily activities.

Exercise for hip pain: what does the evidence say?

For hip osteoarthritis, the Osteoarthritis Research Society International (OARSI) guidelines unconditionally recommend land-based exercise — including strengthening and neuromuscular training — as a core non-surgical intervention 1. Exercise reduces pain and improves physical function without significant risk of joint harm.

For gluteal tendinopathy and greater trochanteric pain syndrome, a 2024 systematic review and meta-analysis found exercise-based interventions produced meaningful reductions in pain and disease severity, with exercise outperforming corticosteroid injection for sustained global improvement 2.

The underlying principle across conditions is progressive loading: gradually increasing the demands placed on the hip stabilizers so they adapt to support the joint better over time.

What if PT does not resolve hip pain?

Most hip pain from tendinopathy, bursitis, and muscle imbalance responds well to PT over 6 to 12 weeks. When significant arthritis is present, PT can reduce pain and improve function but cannot reverse structural joint changes 1. If pain persists despite adequate conservative treatment, an orthopedic physician may consider:

  • Corticosteroid or platelet-rich plasma injection for tendinopathy or bursitis
  • Hip arthroscopy for labral tears or FAI
  • Hip replacement for severe, end-stage osteoarthritis

The right specialist for hip pain rehabilitation is a physical therapist; an orthopedic hip specialist if surgical evaluation becomes needed. Gale can help you find a PT and prepare questions for your appointment.

Common questions

How long does physical therapy for hip pain take to work?

Most people notice improvement within 4 to 8 weeks of consistent PT and home exercise. Longer-standing conditions like hip osteoarthritis may require ongoing maintenance exercise to manage symptoms.

Can hip pain from bursitis be treated with PT alone?

Yes, for most cases. Gluteal tendinopathy (often called hip bursitis) typically responds well to a targeted PT program focused on progressive loading of the gluteal tendons. A corticosteroid injection may be added if pain is too severe to participate in exercise initially.

Is it safe to walk with hip pain?

For most causes of hip pain, walking at a comfortable pace is beneficial. Prolonged walking that produces significant pain during or after the activity should be scaled back until the underlying problem is being addressed.

Should I stretch or strengthen for hip pain?

Both, but the emphasis depends on the cause. Gluteal tendinopathy generally responds better to progressive strengthening than aggressive stretching. Hip flexor pain often needs both flexibility work and core strengthening. Your PT will determine the right balance.

Does hip pain always mean the hip joint itself is the problem?

No. Pain felt in the hip region can originate from the lumbar spine, sacroiliac joint, or hip flexor tendons rather than the hip joint itself. A thorough PT evaluation will help identify the true source.

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When hip pain needs urgent or specialist evaluation

  • —Hip pain after a fall or impact, especially in an older adult — may indicate a hip fracture requiring emergency evaluation
  • —Inability to bear weight after a fall
  • —Severe hip pain with fever or warmth — possible septic arthritis, which requires immediate medical attention
  • —Groin pain with numbness, tingling, or weakness in the leg — may have a spinal or nerve cause

If an older adult falls and cannot bear weight, or there is severe hip pain with fever, call 911 or go to an emergency room immediately.

This article provides general health education only and is not a substitute for evaluation by a licensed physical therapist or physician. A physical therapist is the right specialist for hip pain rehabilitation. Gale does not directly provide physical therapy services; it can help you find a PT and prepare for your visit.

References

  1. 1.Bannuru RR, Osani MC, Vaysbrot EE, et al. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage. doi:10.1016/j.joca.2019.06.011 ✓OARSI unconditional recommendation of land-based exercise (strengthening, neuromuscular, aerobic) as first-line non-surgical management for hip osteoarthritis and related hip pain
  2. 2.Cordeiro TTP, Rocha EAB, Silva RS (2024). Effects of exercise-based interventions on gluteal tendinopathy. Systematic review with meta-analysis. Scientific Reports. doi:10.1038/s41598-024-53283-x ✓Systematic review with meta-analysis showing exercise-based interventions reduce pain and improve function in gluteal tendinopathy (greater trochanteric pain syndrome), outperforming corticosteroid injection for sustained global improvement
  3. 3.Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH (2017). Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD011279.pub3 ✓Cochrane overview of 21 reviews (37,143 participants) supporting physical activity and exercise as effective for chronic musculoskeletal pain conditions in adults

3 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.