Hip Osteoarthritis Exercises: What Actually Helps

Why does exercise help hip osteoarthritis?

Hip osteoarthritis involves gradual loss of the cartilage that cushions the joint. Exercise does not restore that cartilage, but it addresses nearly everything around the joint: weak muscles load the hip unevenly, stiff soft tissue reduces range of motion, and physical inactivity lets the cycle worsen. Strengthening the hip abductors, extensors, and core reduces the compressive forces placed on the joint with every step. Aerobic conditioning helps with weight management, which further unloads the hip 1Ref 1Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE (2019).OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Exercise — land-based and aquatic — is a core recommended treatment for hip and knee OA2Ref 2Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL (2015).Exercise for osteoarthritis of the knee.Systematic review demonstrating exercise reduces pain and improves physical function in lower-limb OA.

International guidelines for the non-surgical management of osteoarthritis strongly recommend exercise — both land-based and aquatic — as a core treatment, not an optional add-on 1Ref 1Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE (2019).OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Exercise — land-based and aquatic — is a core recommended treatment for hip and knee OA.

What types of exercise are recommended for hip OA?

Three categories of movement are consistently supported by evidence 1Ref 1Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE (2019).OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Exercise — land-based and aquatic — is a core recommended treatment for hip and knee OA2Ref 2Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL (2015).Exercise for osteoarthritis of the knee.Systematic review demonstrating exercise reduces pain and improves physical function in lower-limb OA:

Strengthening exercises - Clamshells / hip abduction: Lying on your side with knees bent, rotate the top knee upward without letting your pelvis roll. This targets the gluteus medius, which stabilizes the hip during walking. - Bridges: Lying on your back, feet flat, lift your hips off the floor. Strengthens gluteus maximus and hamstrings. - Seated hip flexion and extension: Useful if floor work is difficult. March slowly in a chair, raising each knee. - Mini-squats / chair stands: Stand up from a chair slowly and sit back down with control. One of the most functional strengthening movements available.

Range-of-motion and flexibility - Hip flexor stretch (kneeling lunge position): Gently extends the front of the hip, which tends to tighten with prolonged sitting. - Supine knee-to-chest: Gentle mobilization of the hip in flexion. - Standing hip circles: Slow, controlled circles within a pain-free range.

Low-impact aerobic activity - Walking, cycling (stationary or outdoor), swimming, and water aerobics are all well-tolerated. Even short daily walks accumulate meaningful benefit. - Aquatic exercise reduces joint load while still allowing resistance training against water.

How much exercise, and how often?

General physical activity guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity for adults 3Ref 3Bull FC, Al-Ansari SS, Biddle S, et al. (2020).World Health Organization 2020 guidelines on physical activity and sedentary behaviour.Recommendation of at least 150 minutes per week of moderate-intensity aerobic activity for adults. For hip OA, this target is appropriate to work toward gradually — starting with whatever duration is tolerable and adding five to ten minutes each week.

Strengthening exercises two to three days per week, with rest days in between, gives muscles time to adapt. It is normal to feel mild muscle soreness after a new exercise routine; sharp joint pain during or after activity is a signal to modify the movement or reduce intensity and discuss with a clinician.

Is it safe to exercise when the hip is painful?

Mild discomfort during movement is common with hip OA and is generally acceptable. A widely used rule of thumb: exercise should not raise pain above a 3 or 4 on a 10-point scale, and any increase should settle back to baseline within 30 minutes of stopping.

Sharp, catching, or worsening pain — especially if accompanied by swelling or giving-way — warrants evaluation before continuing. Similarly, if your hip has become significantly worse recently, rule out a new injury or other cause before resuming a vigorous routine.

What does a physical therapist do for hip OA?

A physical therapist assesses which muscles are weak or tight, identifies movement patterns that load the hip inefficiently, and designs an individualized program. PT for hip OA typically includes manual joint mobilization, gait training, and progressive exercise. This is different from a generic exercise video: the therapist can modify the program as you improve and address flare-ups along the way.

OARSI guidelines specifically recommend that exercise programs be supervised, at least initially, for better outcomes 1Ref 1Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE (2019).OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Exercise — land-based and aquatic — is a core recommended treatment for hip and knee OA.

Can exercise prevent the need for hip replacement?

There is no exercise program proven to halt cartilage loss, but consistently active patients with hip OA often manage pain and function well for years — sometimes indefinitely — without surgery. Exercise is also recommended after hip replacement to restore strength and mobility, so it is not a one-time strategy but a lifelong approach.

Weight management alongside exercise matters: each pound of body weight translates to several pounds of force across the hip with each step. A clinician can help you set realistic goals.

Where does Gale fit in?

Hip OA is typically managed by an orthopedic surgeon, rheumatologist, or physical therapist — specialists Gale does not directly provide. Gale can help you prepare for those visits: organizing your symptom history, generating questions, and tracking how your pain responds to activity over time. If you are unsure where to start, a Gale primary care clinician can assess your hip and refer you to the right specialist.