Pain guide · Hip pain
Hip osteoarthritis usually shows up from mid-life as an ache in the groin or the front of the thigh with walking, stairs and putting on socks, stiffness after sitting, and morning stiffness that wears off within half an hour.
Every major guideline puts exercise first. It will not make arthritis disappear, but it takes a noticeable edge off pain and makes daily tasks easier, and the benefit lasts as long as you keep it going.
Exercise is for pain that has been checked or is clearly mild and settling.
NICE says osteoarthritis can be diagnosed without imaging in people aged 45 or over with activity-related joint pain and morning stiffness of 30 minutes or less. Imaging is for when something does not fit.
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Do not rely on manual therapy alone (only alongside exercise), acupuncture, TENS or ultrasound, glucosamine, or strong opioids. Steroid injections give relief for 2 to 10 weeks and are meant to support exercise, not replace it. Arthroscopic washout is not offered.
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NICE: offer everyone with osteoarthritis therapeutic exercise tailored to them, such as local muscle strengthening and general aerobic fitness. The ACR strongly recommends exercise, weight loss where relevant, tai chi and a cane if needed. OARSI lists education and structured land-based exercise as core treatments for the hip.
The Cochrane review found land-based exercise lowered pain by about 8 points on a 0 to 100 scale and improved function by about 7, with about 1 in 6 people helped who otherwise would not have been. The pain benefit lasted 3 to 6 months after supervised sessions ended.
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Supervised programmes that met recognised dose recommendations for strength, fitness and flexibility reduced pain clearly; programmes with uncertain adherence did not. A few gentle leg lifts now and then are probably not enough.
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In Denmark's GLA:D programme (two education sessions and twelve supervised exercise sessions over six weeks), people with hip arthritis reported pain about 11 points lower afterwards. There was no comparison group, so some of that is natural ups and downs.
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Pool exercise gives a small short-term benefit. It is a reasonable start if exercise on land hurts too much, but aim to build toward strengthening on land.
For people living with overweight, NICE says any weight loss improves pain and function, and 10% is likely to help more than 5%.
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During the exercise, pain up to about 5 out of 10 is acceptable. It should settle within an hour or so, and your hip should be no worse that night or the next morning. If it is, do less next time (fewer repetitions, a smaller range, a lighter load), not nothing.
Pain can go up a little when you start a new exercise programme; guidelines for arthritis say so and still recommend keeping going. If pain climbs week after week, or a warning sign appears, stop and get it checked.
Start at the first stage. Each move opens a full guide with a 3D demo.
For a flare or the first one to two weeks. Daily, plus a few minutes on a bike if you have one.
3D demoSupine heel slideBeginner · No equipment10 slow reps each side, morning and evening
Harder: Hip Windshield Wipers
3D demoStationary cyclingBeginner · Cardio machine5 to 10 min, low resistance
Harder: Air bike intervals
3D demoGlute bridgeBeginner · No equipment2 sets of 8, small range
Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)
3D demoStanding marchBeginner · No equipment10 each side at a counter
Harder: Standing band hip flexion
3D demoSit to stand from a chairBeginner · A bench or box2 sets of 5 to 8 from a higher chair, hands allowed
Harder: Bodyweight squat
3D demoStanding hip CARsBeginner · A wall3 slow circles each way, stop short of a pinch
Harder: 90/90 hip lift-off
Move on when: Getting out of a chair and walking for 10 minutes feel no worse the next day.
Weeks 2 to 8, with walking or cycling on most days, building toward 30 minutes.
3D demoSit to stand from a chairBeginner · A bench or box3 sets of 8 to 12, lower seat, no hands, slow lowering
Harder: Bodyweight squat
3D demoSide-lying leg raiseBeginner · No equipment2 to 3 sets of 8 to 12 · Clamshells if this irritates
Easier: Lateral band walk · Harder: Step-up with knee raise
3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment3 sets of 8 each side
Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)
3D demoStraight-leg raiseBeginner · No equipment2 sets of 10 each side
Easier: Quad set (static quads) · Harder: Leg extension
3D demoTandem stance and heel-to-toe walkBeginner · A wall3 holds of 20 to 30 s
Harder: Single-leg stand
Move on when: Sets feel steady at the top of the range and the hip settles by the next morning.
From about week 8. Two strength days a week for as long as you want the benefit.
3D demoDumbbell goblet squatIntermediate · A dumbbell3 sets of 8 to 10, to a box
Easier: Bodyweight squat · Harder: Back squat with bands
3D demoDumbbell step-upIntermediate · A dumbbell + A step3 sets of 8 each side
Easier: Step-up · Harder: Back squat with bands
3D demoDumbbell Romanian deadliftIntermediate · A dumbbell3 sets of 8 to 10
Easier: Hip-hinge practice · Harder: Single-leg Romanian deadlift
3D demoSplit squatIntermediate · No equipment2 to 3 sets of 6 to 10 each side, holding a support
Easier: Bodyweight squat · Harder: Reverse lunge
3D demoGet Up and Down from the FloorBeginner · No equipment3 to 5 practice reps
3D demoHip Windshield WipersBeginner · No equipment10 slow reps, stop at any pinch
Harder: 90/90 hip lift-off
Move on when: Add a little load or a harder option every week or two while the hip stays settled.
No exercise is banned by the evidence. Deep squats, deep lunges and very low chairs often aggravate an arthritic hip, so use a box or a higher chair to set the depth and build range back gradually.
Running and jumping are not forbidden, but most people with a painful arthritic hip do better building strength and fitness first with walking, cycling or water exercise. After a hip replacement, follow your surgeon's movement limits.
NICE suggests considering referral for joint replacement when symptoms substantially affect quality of life and non-surgical care, exercise included, has not worked.
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A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.
20 minBeginner7 movesA bench or box, A stepBalance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or boxA 15-minute hip opener: 90/90 switches, windshield wipers, CARs, Cossack squats, frog and pigeon.
15 minIntermediate8 movesA wallYes. Guidelines recommend aerobic activity such as walking as part of treatment. Start with short walks at a talking pace and add a few minutes each week; a stick in the opposite hand can take load off a painful hip.
Chair stands, step-ups, bridges, side-lying leg raises and balance work, built up gradually: the same plan works at any age. Start at stage 1 and use the easier option shown under each move.
Guidelines say exercise is safe and recommended. Pain may rise a little when you start; it should settle by the next morning. A steady increase week after week means the dose is too high, not that you should stop moving.
Usually weeks. Programmes such as GLA:D measure people at 3 months, and NICE stresses that keeping it up is what brings the benefit.
Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.
