The best exercises for hip arthritis strengthen the BUTTOCK and thigh muscles, keep the hip moving through as much of its range as it has, and include regular low-impact activity like walking, cycling or swimming.
Move the hip every day.
Strengthen it two to three times a week.
Most people feel a difference after about 6 to 12 weeks: less stiffness, a longer walk before the ache starts, and an easier time with socks and car seats.
Exercise won’t wear the joint out faster. Resting it makes the hip stiffer and the muscles around it weaker.
Why these exercises help
- Buttock muscles steady the pelvis: the muscles on the side of the hip stop the pelvis dropping with each step. Strong ones reduce limping and take strain off the joint
- Stiffness breeds stiffness: a hip that isn’t moved loses range, especially bending up and turning in. That lost range is what makes putting on socks so hard
- Movement feeds cartilage: cartilage takes in nutrients from the joint fluid as the hip is loaded and unloaded
- It’s first-line treatment: the NHS calls exercise one of the most important treatments for osteoarthritis, at any age
Every bit of range you use, you keep. Every bit you avoid, the hip slowly gives away.
Phase 1: weeks 1 to 4, keep it moving
Gentle enough for most days. The numbers are starting points, not targets.
- Knee toward chest: lying on your back, bring one knee toward your chest as far as is comfortable, hold for 10 seconds, then lower. Start with 5 each side
- Leg rolls: lying on your back with legs straight, roll the whole sore leg inward so your toes point in, then outward. Start with 10 to 15, slowly
- Bridge: lying on your back with knees bent, squeeze your buttocks and lift your hips, hold for 3 seconds. Start with 2 sets of 10
- Clamshells: lie on your good side with knees bent and feet together, then lift the top knee without rolling your pelvis back. Start with 2 sets of 10
- Sit-to-stand from a high seat: stand up and sit down slowly. Use a firm, higher chair or add a cushion. Start with 2 sets of 8 to 10
- Exercise bike: about 10 minutes at an easy pace. Set the seat high so the hip doesn’t have to bend sharply at the top of each turn
Phase 2: weeks 4 to 8, build strength
Two to three times a week with a rest day between. The last few reps should feel like work.
- Side-lying leg lifts: lie on your good side with the bottom knee bent, lift the top leg up and slightly back, then lower slowly. Start with 3 sets of 10
- Standing hip extension: standing at a kitchen counter for balance, take the sore leg straight back without arching your lower back, squeezing the buttock. Start with 3 sets of 10
- Lower sit-to-stands: work down toward a normal chair height. Start with 3 sets of 10
- Step-ups: step up onto a low step with the sore leg first, then step down slowly. Start with a 4 to 6 inch (10 to 15 cm) step, 2 to 3 sets of 10
- Hip flexor stretch: stand in a split stance with the sore leg behind, tuck your tailbone under and shift your weight forward until you feel a stretch at the front of the hip. Hold 30 seconds, 3 times
Phase 3: week 8 onward, make it part of life
- More load: a resistance band looped around the ankles for side steps, bridges on one leg, higher steps, or a leg press at the gym
- Balance: stand on the sore leg for 30 seconds next to a counter, then try it with your eyes closed
- Walking: shorter, more frequent walks beat one long painful one. Add a few minutes at a time, not a whole extra mile
- Cycling and water exercise: both are kind to stiff hips. If the breaststroke kick bothers the hip, switch to a front crawl kick
- Weekly total: build toward the general adult target of about 150 minutes of moderate activity a week, in any size chunks
The pain rules
- During exercise: a mild to moderate ache is fine, up to about 5 out of 10
- Afterward: it should settle within an hour or two
- The next-morning test: if the hip is sorer or stiffer than usual the next morning, cut back the reps, load or walking distance for a few days, then build again
- After a flare: go back to the Phase 1 exercises for a few days rather than stopping completely
How to progress
- Move up when you can do 3 sets of 10 to 15 with good control and pass the next-morning test
- Change one thing at a time: reps, then load, then how often
- Give it time: 12 weeks of steady work is a fair trial. Don’t judge it at week three
What to stop or avoid
- Forcing stretches that give a sharp pinch deep in the groin. Stretch to firm tension, not pain
- Deep squats and very low seats early on
- A long walk on a bad day: split it into shorter ones instead
- Side-lying leg lifts if your pain is on the OUTSIDE of the hip and worse lying on that side. That’s more often a tendon problem, and this exercise can irritate it. See gluteal tendinopathy
For symptoms, injections and the other treatments, see hip arthritis. If you’ve done the work for three months and the hip is still shrinking your life, see when is it time for a hip replacement. Getting stronger before surgery makes the early weeks after it easier.
Get seen urgently if
- You fell and can’t put weight on the leg, or it looks shorter or turned out
- The hip is suddenly very painful, hot or swollen and you have a fever
- Your calf is swollen, warm or painful
Get it checked if
- Pain is getting quickly worse over weeks, not months
- Pain is keeping you awake most nights
- You have unexplained weight loss, night sweats or a history of cancer
- Nothing has changed after 12 weeks of regular, progressing exercise
Move it daily, strengthen it weekly, and let the next morning tell you how much is enough.