The best exercises for hip osteoarthritis will depend on your age, current health and mobility levels, the stage of your arthritis and most importantly, what exercise you like to do. If you hate a particular form of exercise, you are unlikely to stick to it, so often the best form of exercise is the one you will do! However, if exercise is aggravating your hip arthritis pain, there are many things that can be done to exercise more comfortably. Read on to find out some great tips on the best exercises for hip osteoarthritis.
What’s in this blog
In this blog, we’ll start off with some great tips on exercising safely with hip osteoarthritis including:
- Finding the right exercise intensity for hip arthritis – How much, how far, how hard to push
- How much pain is ok when exercising with hip arthritis?
Then we’ll take you through the different types of exercises you need to do for hip osteoarthritis:
- Cardio or Aerobic Exercise for hip osteoarthritis (including walking, running, cycling, water/hydro, crosstrainer, rower, stepper)
- Strengthening Exercise for hip osteoarthritis, (including buttock/glute, hip flexor, water/hydro, gym)
- Range-of Motion or Flexibility Exercises for the hip (including hip bend/flexion, hip straightening/extension, hip drop out to the side
For each key exercise, we’ve also provided some advice from expert physical therapist, Dr Alison Grimaldi. We’ll tell you exactly how to modify specific exercises to allow you to exercise safely with hip osteoarthritis: read more in each section of this blog.
At the end of this blog, you’ll also find some bonus information:
- What is hip osteoarthritis and what causes it?
- The role of inflammation in development and progression of arthritis, and
- How you can reduce inflammation to better manage your hip osteoarthritis.
Exercising safely with hip arthritis
Have you stopped exercising because every time you try, you just irritate your hip pain? This is common, with most people unsure what exercise is safe to do with hip arthritis. Stopping exercise may lead to weight gain, which is not ideal for the joints of your legs. A lack of exercise also has other negative impacts on physical and mental health.
Let’s first talk about some general rules for exercising with hip osteoarthritis.
Finding the right exercise intensity for hip arthritis
Avoid Boom-Bust exercise habits
Often when given a diagnosis of hip arthritis, many will jump straight into exercise and go-hard, trying to lose weight, get fit or get strong as quickly as possible. The joint can’t cope with the sudden increase in activity and the pain flares, requiring a period of rest, before trying again and getting the same result – we refer to this as the BOOM-BUST pattern of exercise. Each time you flare your joint, you increase the inflammation in the joint, providing an unhealth environment for your cartilage.
Continually inflaming your joint through poor exercise habits (BOOM-BUST) may lead to more rapid deterioration in your hip cartilage. That’s why it’s so important to find the right exercise and the right exercise intensity for you and your hip.
Start exercise slowly and listen to your body
When you first start to exercise or return to exercise after a pain flare or illness, start slowly – do less than you think you can manage initially and see how your body responds over the next 24-48 hours. Remember, even though your hip might seem to be coping during that first exercise session, the inflammatory response to doing too much might peak 24-48 hours later. A common response is to have a really bad night’s sleep and to wake up stiff the next morning after doing too much. Then you’ll need to rest until it settles (Boom-Bust). By starting slowly, you will avoid the constant aggravation of hip pain and inflammation. Any flare ups then will be mild and not last as long, allowing you to adapt your exercise depending on your response, and keep exercising. Only increase your exercise volume (how much you are doing) by 10% per week as a general rule.1
How much pain is ok when exercising with hip arthritis?
This is one of the most common questions we get asked as health professionals. It’s important to remember that pain is not directly correlated with damage – so some mild discomfort is usually totally fine to exercise through – once you have established that initial baseline i.e., that your hip is coping over the first week or so of exercise. However, pushing through moderate or severe levels of pain may result in a flare of pain and inflammation and can put you back on that Boom-Bust cycle.
The Traffic Light Approach to Exercising with Pain
So, how much pain is ok? If we use the 0-10 pain scale where 0 = No pain and 10 = Worst imaginable pain, a good basic guide is to use the Traffic Light Approach:
- Pain level 0-2/10 (no – minimal pain) – Green Light for Go
- Pain level 3-5/10 (moderate pain) – Amber Light – Modify your activity
- Pain level 6-10/10 (severe pain) – Red Light – STOP and seek advice from your health professional
We have written another whole blog on this topic: Click here to read more
What if my pain is in the Amber or Red Zone (moderate to high pain levels) even before I start exercising?
If you have constantly high levels of pain, even without exercising, seek advice from a health professional before you start. Pain is a complex thing and as we mentioned above, pain levels do not directly match levels of physical damage in your joint or other tissues. Pain is a protective system, and sometimes it becomes a little too protective. You can read further about pain on a page we have written on this topic.
Click here to read more about understanding pain.
If your doctor or other registered health professional had given you clearance to start exercising, they will have likely given you guidelines. Otherwise, as a general rule, aim to avoid increasing your starting level of pain by more than 2 points on the 0-10 scale when exercising. And stick with the start slowly, listen to your response and progress slowly rules.
1. Cardio or aerobic exercise for hip osteoarthritis
Let’s move on to discussing specific forms of exercise, starting with cardio or aerobic exercise. It’s important to try to do some cardio for your physical and mental health and sleep quality, but what is the best cardio exercise for hip osteoarthritis?
Walking and running with hip arthritis
Is it ok to walk or run for exercise with hip arthritis?
Putting weight through a painful joint with arthritis might not seem like a good thing to do, but it really depends on the stage of osteoarthritis and how your joint copes with it. If you use the traffic light approach above and you are in the green zone when exercising, and do not have increased night pain or morning stiffness the next day, your joint would appear to be coping. Many people the joint can cope with walking and even running in early to moderate stages of arthritis and some manage to continue to at least walk for exercise into the advanced stages of the condition. Others will need to swap to a lower impact form of cardio. Listen to your body and if you’re not sure, seek help from a health professional – click here to find a hip pain professional near you.
Strategies to reduce hip pain when walking and running
Before giving up on walking or running as a form of exercise, try these simple strategies to modify your activity and help move you from an Amber Zone on the Traffic Light to the Green Zone.
- Walk/run a shorter distance – find out what distance you can walk/run keeping the pain to a 2/10 max (Green Zone) and stick with this for a while. Slowly increase each week a little further as you are able
- Take shorter strides – this can change the impact force absorbed by the hip joints and the direction of the impact force2
- Reduce hills – going up hills increases the amount of work from your hip muscles – this can irritate the hip joint, particularly in your muscles are weak. Try walking/running on the flat to see if this is less painful
- Use an aid – a walking stick can help to improve how you walk and reduce pressure on the painful areas of the joint. This may include a walking stick (see link to walking stick article) or Nordic walking poles.
Cycling or Stationary Bike
Is a bike or the static bike at the gym a good exercise for hip osteoarthritis?
Yes, it is. As we always say, Motion is Lotion! This type of cyclical action is great for flowing the synovial fluid (normal joint fluid) around the joint, which is important for delivery of nutrients to the cartilage. Cycling is a low impact exercise compared with walking or running, so this can be a great way to keep fit and strong when walking and running have become more limited. You might prefer cycling outdoors, or indoors on a wind-trainer or a stationary exercise bike at the gym or at home.
Strategies to reduce hip pain on a bike
Even though cycling is low-impact exercise, riding a bike can still aggravate hip pain related to hip osteoarthritis. This is usually related to higher forces at the front of the hip when in a position of high hip flexion – knees closer to the chest, or to high muscle forces across the joint when working hard e.g., cycling uphill, or pulling up hard in cleats.
Here are some strategies to reduce hip pain when cycling:
- Try to adopt a more upright body position on the bike, where the hips are less bent. This will open up the front of your hip joint and give the joint some more space, reducing pain related to bony impingement (bones coming together). You can do this by shifting to a mountain bike or hybrid bike rather than a road bike, or by lifting your bike seat and/or handlebars slightly higher. On a road bike, simply spend less time on the drops and more time with your hands on the top handlebar.
- Reduce hills – Hills can be aggravating either due to the amount of bend at the hips, the higher muscle compression across the hip joints due to the hard work, or the side-to-side movement if you come out of the saddle.
- Experiment with and without cleats – cleats (that attach the shoe to the pedal) can hold the foot still and require the leg to stay straighter. With hip osteoarthritis, it is often more comfortable to allow the knee to be slightly turned out, so the normal cleat position may not suit an arthritic hip. Strong pulling up actions can also sometimes aggravate the hip. Having your cleats looser, focusing on the push rather than the pull phase or not using cleats at all, may help reduce pain.
- Have a bike set up assessment – many hip pain professionals will be able to look at your position on your bike and suggest other ways you might be able to reduce your pain. Get your bike set up adjusted for your hip can help you keep cycling comfortably.
- Consider investing in an ebike (electric bike). In some locations it is difficult to avoid hills, but hills might be provoking your hip pain. An electric bike can assist you to get up those provocative hills but still give you the freedom to ride and get that important cardiovascular workout.
- Use an upright rather than the reclined bike in the gym. Reclined or recumbent bikes are often better for back pain, but the increased bend at the hip joint can make it provocative for hip osteoarthritis. It is likely that the upright stationary bike will be better than the reclined alternative.
Other Low Impact Cardio in the Gym
Water Based Cardio Exercise
Is water-based cardio exercise good for hip osteoarthritis?
The water can be a great place for cardiovascular or aerobic fitness exercise when you have hip arthritis. The is because of the reduced impact forces being put through the joints in water compared with on dry land. There are many different options for water-based exercise and things to consider when you have hip osteoarthritis.
Options for water-based cardio exercise:
- Walking in the water
- Water running in a buoyancy vest
- Water cycling – on a pool noodle
- Water aerobics, aqua aerobics or group exercise classes in the water
Strategies to reduce hip pain during water-based exercise
- Start with less than you think you can manage. It is really common for people to push themselves too hard in the pool. Because your bodyweight is supported, it might feel like you’re doing less than you are. Stay on the safe side and do less than you think you can manage initially and monitor your response over the next 24 – 48 hours.
- Swimming: use freestyle or backstroke, rather than breaststroke kick. Breaststroke kick can require a greater range of movement of the hip, and the combination of bending and rotating the hip can be particularly irritating when you have arthritis.
- Swimming: Use less effort, fins, or a pool buoy between the thighs. Sometimes even free or backstroke kick might be painful. Try backing off the effort and just use your legs to balance yourself in the water, rather than kicking really hard. Fins can help you move through the water more easily with less effort, but don’t kick hard with fins. Sometimes removing your legs altogether by using a pool-buoy (buoyancy device) between the thighs can be best.
- Swimming: Drop the tumble-turns. For some people, tumble-turns can be really irritating due to the high degree of bend, which usually occurs quite quickly, and then pushing off the wall in that deep hip bend position. Try dropping the tumble-turn.
- Water walking: Reduce stride length. Even though impact forces are low, large strides can still aggravate you hip because of the range of motion you are pushing your hip through. Keep your strides shorter.
- Water walking: Reduce backwards walking. For the same reason as the large stride walking, backwards walking can often be aggravating. Reduce or avoid backwards walking to keep your hip happier.
- Water running or cycling: Use smaller ranges of motion. Use a cycling action beneath your body is usually more comfortable, rather than using a large striding action or a straight leg scissor action. Also, keep the knee below the level of the hips.
- Water aerobics: Use smaller hip actions. Particularly when you are first starting out, err on the side of caution and start with smaller hip actions. Avoid moving your hip rapidly or forcefully into the end of your range of motion.
- Water aerobics: Minimise twisting actions. Hip arthritis is commonly aggravated by combinations of actions, especially those that involve twisting and even more if they are done in a rapid, uncontrolled manner.
- Water aerobics: Slow down and control your hip actions. Water or aqua-aerobics is often quite fast paced to get the cardio, but ensure you are controlling your hip actions. You might need to slow down your pace, particularly when first starting out.
There are a number of other low-impact cardio exercise options for hip osteoarthritis in the gym – the cross-trainer or elliptical trainer, the stepper, the rowing machine or an arm ergo.
Cross-trainer or elliptical exercise for hip arthritis
Cross-trainer or elliptical machines can be a great exercise option if you have hip osteoarthritis, as there are no impact forces. However, the how you move on the machine and how much you do, will influence how your hip copes.
Here are some top tips for using a cross trainer or elliptical machine with hip osteoarthritis:
- Choose a machine that has a smaller range of motion – the action should be more like upright cycling, rather than like air-walking with large strides.
- Don’t swing your hips side to side – try to keep your pelvis fairly still and perform the standing cycling action with your legs. Hips stay still, legs move underneath.
Start slowly and gradually build – as we have mentioned above, start with a little – even just a few minutes – and see how your hip responds. Gradually build up exercise time if your hip is coping.
Stepper or Step machine for hip osteoarthritis
A stepper or step machine can also be a good choice in the gym for exercising with hip osteoarthritis, as it is a low-impact exercise. However, it can be quite a challenging cardiovascular exercise and can aggravate hip pain depending on how and how much you step.
Here are some top tips for using a stepper or step machine with hip osteoarthritis:
- Perform shallow rather than deep steps – most steppers have a deep step action with high ranges of hip motion when you do the action slowly. Instead, use a shallower action without as much bend at the hips, but this usually means you have to move faster.
- Start with short intervals of stepping – particularly if your cardiovascular fitness is lower, you will need to start with short intervals of even 20-30 seconds, and then take a break for 30-60seconds. The stepper can be a useful choice for High Intensity Interval Training (HIIT) – where you do just 3 lots of 30-60 seconds of stepping. This can be a great stimulus to get your heartrate up. Always check with your medical doctor before engaging in high intensity training.
Don’t swing your hips side to side – As with the ellipticals, try to keep your pelvis fairly still – hips stay still, legs move underneath.
Rower or rowing machine with hip arthritis
As health professionals, we often get asked about the rowing machine by people with hip osteoarthritis. The answer is – it depends … Some people with hip arthritis can manage rowing very comfortably, but this doesn’t suit others. The main issue is the amount of bend at the hips when your body leans forward for the catch. If your hip is easily aggravated by flexion – bringing your knees close to your chest – then your hip may not cope with rowing. However, the bending forward action of rowing is shared with the back, so people who curl from their back may alleviate the pressure on their hips. If your hips are stiff, this will increase the load on your back, so even if your hips cope, you need to be mindful of not overload your back.
Some advice for using a rower or rowing machine with hip osteoarthritis:
- Start slowly and gradually build – As the response is a very individual one, you can try a rower but start with low intensity (effort) and short duration and see how your hip responds.
- Don’t go so deep for the catch – Try to reduce how far you reach forward before you catch and pull back. Reducing your reach will reduce the amount of bend at the hips and back.
- Take care with your back – If you have stiff hips, you are at higher risk of overloading your back, so you will usually be best to choose another form of cardio.
- Get your technique checked by a health or exercise professional – Rowing takes a bit of coordination of all your body parts, so if you’ve never rowed/using a rowing machine before, we recommend you get an experienced health or exercise professional to teach you proper technique first. *Make sure you tell them you have hip arthritis.
2. Strengthening exercise for hip osteoarthritis
Muscle support around a hip joint with osteoarthritis is of critical importance for controlling joint forces and therefore reducing pain, disability and potentially even the rate of joint deterioration. So, there are lots of great reasons to get and stay strong when you have hip osteoarthritis. It can be difficult though to know which are the best strengthening exercises for hip osteoarthritis. We’ll take you through some key considerations here.
Gluteal or buttock strengthening exercises for hip osteoarthritis
Wherever possible, choose a strengthening exercise for the gluteals (buttock muscles) where your foot is attached to the ground. This weightbearing stimulus is particularly important for the gluteal muscles, whose main focus is to push through your foot to hold your body up and move your body against the downward force of gravity. If your gluteals are weak and/or a bit sleepy, weightbearing or ‘closed-chain’ exercise with your foot on the ground is particularly useful for stimulating these muscles.3
Here are a few great ones to start with and how to do them in comfort at the hips, knees and back.
Top tips for squatting comfortably with hip osteoarthritis
Many people find their hips are aggravated with squatting, but others can’t squat because of knee or back pain. Here are some tips for squatting comfortably.
- Don’t squat as deep. Deep squatting repetitively beyond a 90° hip bend may aggravate your hip (and knee) pain.
- Slow down. Rapid actions might mean you move into painful ranges before you are aware. Slow it down, keep it controlled and this is much better for strengthening too. Take 3 seconds to move down and another 3 to come back up.
- Use a sitting down action. Your knees will be much more comfortable, and your hip muscles will get much more stimulus if you move your hips back first, rather than pushing your knees forward. Imagine you are going to sit down and move half-way through that sitting action. Full sit-stands can be provocative, so start with ‘half-sits’.
- Get your tail out but avoid excessive arching. Think tail out (tip of your tailbone), rather than letting your tail drop to point towards the floor. However, avoid overarching your back, as this may give you back pain – relax a little & don’t stick your chest out.
- Keep equal weight between your legs. Don’t let your painfree or less painful side do all the work. Keep your weight even to ensure you are strengthening the weaker side.
- Don’t let your knees drop in. Keep your thighs parallel and knees pointing straight ahead, or if your hips are more comfortable in a turned-out position, that’s fine – just keep your knees pointing in about the same direction as your toes.
Top tips for bridging comfortably with hip osteoarthritis
Some people find their hips are aggravated with squatting, but others can’t squat because of back pain. Here are some tips for bridging (sometimes called a pelvic lift) comfortably.
- Don’t lift as high. Pushing up to the extremes of your hip extension range may aggravate your hips and your back.
- Slow down. You are less likely to aggravate your hips and more likely to stimulate those muscles with a slower action – 3 seconds up and 3 seconds down.
- Dump the bands around the knees. While bands around the knees are commonly recommended to increase gluteal stimulus, it can aggravate some hips and make the muscles stiffer. If you are sore after a hip workout including banded bridges – dump the band.
Top tips for standing on one leg comfortably with hip osteoarthritis
Standing on one leg is a great weightbearing exercise to stimulate the deeper gluteals – the hip abductor muscles, but sometimes this can be very challenging or painful. Here are some tips for practising standing on one leg comfortably.
- Hold on to something. If you are doing this exercise to improve hip strength, remove the balance challenge initially and just get comfortable. Lots of wiggling might irritate your hips.
- Don’t sag on your hip. Sagging on your hip can irritate the joint and tendons around the hip. Grow tall and keep your hip in from the side.
- Start with short holds. Your endurance will probably not be great at first, so start with short holds of even 5-10 seconds.
Hip flexor exercises for hip arthritis
While most people are aware that strengthening the buttock muscles is important for hip arthritis, the hip flexors regularly get forgotten. They get stretched a lot, which might be actually making things worse (read more on this below) but are not often strengthened. However, these muscles are often weak in people with hip arthritis are this might make it more difficult to lift your leg to dress, walk upstairs, get out of the car or out of bed.
Tips for performing a simple exercise for hip flexor strengthening with hip osteoarthritis
- Perch on a high stool or bench. This will mean you can exercise through a range that doesn’t force your hip up into a high degree of hip pain. Make sure you are safe and perching on a stable structure.
- Lift only through a comfortable range. Slowly lift the thigh to the horizontal, or through the comfortable range you have available.
- Don’t twist your thigh. Keep your knee in front of your hip and your ankle under your knee.
- Stay up tall. Grow gently tall through your head and try to reduce bending and rotation of your back and pelvis.
Hydrotherapy – strengthening exercises for hip osteoarthritis in the pool
There is scientific evidence to show that exercise in water can help those with osteoarthritis.4 Also, hydrotherapy performed in warm water, can assist with pain and relaxing muscles. If you are finding it difficult to exercise on land, then in a warm pool might be a great place for you to start.
Strategies to reduce hip pain during hydrotherapy – water-based strengthening
- As with cardio exercise in the pool, some things can still be aggravating when performing strengthening exercises for hip osteoarthritis in water. Here are some strategies to help:
- Reduce backwards walking. Reduce or avoid backwards walking to keep your hip happier.
- Use smaller hip actions. Particularly when you are first starting hydrotherapy, don’t try too hard and push beyond your limits. Avoid moving your hip rapidly or forcefully into the end of your range of motion.
- Minimise twisting actions. Hip arthritis is commonly aggravated by twisting action, particularly if they are done in a rapid, uncontrolled manner.
- Slow down and control your hip actions. Your hips are less likely to be aggravated if you slow down a little, particularly at first until you see how your hip copes. To get more resistance from the water, you will usually need to move a little faster than with land-based strengthening exercises but start slow and always ensure you have good control of your hip actions.
Gym strengthening exercise for hip osteoarthritis
Will joining a gym be useful for hip osteoarthritis?
The gym is full of opportunity to perform some of the best exercises for hip osteoarthritis. There are plenty of strengthening exercises you can do, as well as the variety of cardio options we’ve discussed above. You can progress squatting and bridging exercises demonstrated above by adding some weights at the gym. Start light and get some professional instruction before lifting weights at the gym for hip arthritis.
Strategies to reduce hip pain when exercising at the gym
While weights can be fantastic for building strength around the hips, certain exercises can really aggravate hip pain related to arthritis. We have already covered this topic in detail in 2 previous blogs, so we suggest you head to those blogs in you’d like to read more on this topic.
Which gym exercises should I avoid for hip pain?
Ways to reduce hip pain at the gym
3. Range-of-motion or flexibility exercises for the hip
Apart from pain and weakness, one of the other big issues that stops you doing things when you have hip osteoarthritis is stiffness or lack of mobility.
Why do my hip joints feel stiff?
Loss of range of motion with hip osteoarthritis can be due to a number of factors:
- Postural and movement habits. Often due to pain or fear of pain, many start excessive protecting their hip e.g., standing with weight on the other side and the hip and knee of the painful side bent. The less you straighten that hip, the less you will be able to straighten it! Although forcing extremes of range can be provocative, you must use the painfree range you have to maintain it.
- Thickening and tightening of the joint capsule. As part of the inflammatory process the fibrous capsule around the joint can stiffen up, and a lack of exercise can allow the capsule to tighten further.
- Muscle weakness. The weaker your muscles get, the less range they will be able to move you through – again comes back to use it or lose it.
- Muscle guarding and tightness. Muscle guarding can occur as the body instinctively tries to protect itself. This can reduce your range of motion.
Bony spurs. One of the main restrictions to flexibility in moderate to advanced stages of osteoarthritis, are bony spurs. Extra bone is deposited around the ball and socket joint. This is a part of your body’s attempt to help heal the joint, but unfortunately it can significantly reduce your flexibility. There is nothing that can be done with bony range limitations and forcing the hip into a bony block to joint range will usually just make it very irritated!
Most common range limitations of people with hip arthritis
Most common range limitations that reduce function in people with hip arthritis include:
- Difficulty bringing the knee towards the chest – Limitation of hip flexion
- Difficulty reaching the foot to put shoes and socks on – Limitation of hip flexion -abduction – external rotation
- Difficulty straightening the hip – Limitation of hip extension
Exercise to improve hip flexion (bend of knee to chest) range
Simply lying on your back and forcefully pulling your knee to your chest with your hands is rarely helpful, and often irritating. Try the exercise below for a more gentle and less irritating way to gain flexion range (bend in the hip).
Tips for performing a simple exercise for hip flexor strengthening with hip osteoarthritis
- Rock forward and back slowly
- Only move through a comfortable range
Exercise to improve your ability to relax your knee outwards
The stiffness with getting your knee out to the side to reach your foot with your hand can be a combination of capsular and muscular tightness and bony restriction. While we can’t change this if it’s bony, there is potential to lengthen the soft tissues (muscles and capsule). Unfortunately, forced stretching into end of range may worse pain associated with hip arthritis. Here is a helpful exercise below for helping relax the inner thigh muscles.
Tips for performing this exercise to gain hip opening range
- Keep the pelvis level and very slowly lower the knee out to the side
- Use your hand to help the leg back to the vertical
- Move within a comfortable range
Exercise to improve your ability to straighten your hip
The most common reason for becoming stiff at the front of the hip with hip arthritis is muscle and capsular tightness, and the most common reason for this is simply not using the range. So the simplest way to maintain this range is to use it during everyday postures and movements – within your pain limitation.
Tips for performing this exercise to gain hip straightening range
- When standing, straighten your hip and knee. Lengthen you whole leg and think tall through your head. Hold for 10 seconds, repeat a number of times in a row and repeat a number of times during the day. You are just aiming to achieve a vertical thigh with your body remaining upright.
- When squatting, straighten both hips and knees at the top. Another great way to actively lengthen the front of your hip safely, is to simply lengthen fully through the hips and knees between each repetition of your squats, and when rising from sitting the standing.
If your hip is stuck in a bent position, we recommend you see a health professional to assist you in restoring as much range as possible, as soon as possible. The longer you leave it, the more difficult it is to restore.
Stretches for hip osteoarthritis
Gaining or maintaining as much range as possible with hip osteoarthritis is usually best achieved by ‘active’ range gaining, rather than passive stretching. Active range gaining just means where your muscle is active and controlling the action, as demonstrated in the Bent Knee Fall Out exercise above. Some careful stretching is ok but other types of stretching can increase rather than ease your pain. We have written a whole blog on this topic, so head over there to read more detail.
Can stretching make hip pain worse?
To read more on stretching and if it can help or irritate your hip further, click here.
What is hip osteoarthritis and what causes it?
Understanding a little about hip osteoarthritis can help you understand some of the key advice in this blog. Hip osteoarthritis is a degenerative joint condition, involving gradual deterioration of the smooth cartilage surfaces of the joint – in the hip, this is the cartilage lining the head of the femur (thigh bone) and the acetabulum (hip socket).
Main causes of hip osteoarthritis
Hip osteoarthritis often develops in response to multiple factors such as:
- variations in natural bone shape e.g., as occurs in Femoroacetabular Impingement Syndrome or Acetabular Dysplasia/Hip Dysplasia (shallow hip sockets)
- past joint injury e.g., a fall or injury at work or during sport
- genetic factors
You can read more background information about hip osteoarthritis, OA, cartilage damage and the ageing hip by clicking here.
The role of inflammation in development and progression of osteoarthritis
Researchers have more recently found a common factor that appears to be linked with the development and worsening of osteoarthritis – inflammation!5 Inflammation can be systemic – in the blood stream, and local – in the joint.
Factors that increase systemic inflammation:
- poor general health, such as obesity or diabetes
- poor diets with high intake of sugar and bad fats
- poor sleep
Factors that may increase local joint inflammation due to joint overload:
- muscle weakness – weak muscles do not provide enough support around the joint
- forcing a joint past its natural range of motion e.g., excessive stretching
- excess impact loading, especially when combined with weak muscles
- too much – too soon – increasing activity more quickly than the joint can adapt
- exercising with high levels of pain
To control joint inflammation associated with arthritis then, optimise your general health, diet, reduce stress levels, get a good night’s sleep and exercise. Exercise is the key factor that ties most of these things together, as it will improve your general health, alleviate stress, improve sleep and keep your muscles stronger … as long as you are choosing the right exercise or combinations of exercise that help rather than aggravate your hip arthritis.
We hope you have learnt a lot in this extensive blog on best exercises for hip osteoarthritis.
We have covered different types of exercises for hip osteoarthritis – card exercise, strengthening and flexibility exercises, and also how you can modify exercises that are irritating your hip pain. If you have been diagnosed with hip osteoarthritis, we would strongly recommend you see a Hip Pain Professional to help advise you on an individualised management program. They will help you to decide on which exercises are best, how much to do and how often. They will help design a program that fits your needs and goals, time availability and financial situation.
Please also take time to look over the “More to Read” section at the bottom of this blog for loads more information on many of the topics we have raised in this blog.
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced sports physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.
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Treatment for Hip Osteoarthritis (OA)? Getting Help – What Are The Options? learn about the many options for treatment you have if you think or know you have hip OA
How to Use a Walking Stick & Why: using a support when you walk can be hugely beneficial – learn why. And learn how to set your walking support up correctly for you.
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Best Exercises For Hip Osteoarthritis
What are the best exercises for hip osteoarthritis: information packed blog - learn about stretching, strengthening, cardio, hydro/water, pain levels and how much