Hip pain when you drive usually comes from one of a few familiar places, shown up by a long sit with the hip bent and the legs working the pedals. A deep pinch in the groin crease, worse in a low seat, often comes from the hip joint; an ache on the bony point outside from the outer hip tendons; deep buttock pain from the sciatic nerve or the back; and a sore left hip in a manual car from working the clutch. It is rarely serious, and driving isn't wearing your hip out.
This guide starts with the signs that need help, from a 999 call or accident and emergency (A&E) for severe hip pain after a fall or a crash, to a general practitioner (GP) or the National Health Service's 111 line (NHS 111) the same day for a hot, swollen hip with a high temperature or a swollen calf after a long journey. It then maps the causes by where it hurts and which leg, covers the seat, the pedals, breaks and automatic cars, driving after a hip replacement (the NHS's, the Driver and Vehicle Licensing Agency's (DVLA's) and insurers' rules in their own words), and gives a three-stage plan with a 3D demo of every move.
Exercise is for pain that has been checked or is clearly mild and settling.
Location narrows the likely causes; it does not diagnose.
Possibly the shape of the hip joint (impingement) or its rim (a labral tear). Sitting is a known trigger.
Read: Hip impingement (FAI) →Possibly a labral tear.
Read: Hip labral tear →Often hip arthritis.
Read: Hip arthritis →Possibly the hip flexors, or the hip joint. The clutch link is our reading: no study has tested it.
Read: Hip flexor pain →Usually the outer hip tendons, often called hip bursitis.
Read: Hip bursitis (gluteal tendinopathy) →Possibly the sciatic nerve in the buttock (deep gluteal or piriformis syndrome).
Read: Piriformis syndrome (deep gluteal syndrome) →Often the high hamstring tendon.
Read: High hamstring tendinopathy →Sciatica, from the back. Our back pain when driving guide covers it.
Read: Back pain when driving →A squeezed skin nerve (meralgia paraesthetica).
Read: Meralgia paresthetica →Usually adductor-related groin pain.
Read: Groin strain →Possibly a nerve or the pelvic floor. Our groin pain when sitting guide covers it.
Read: Groin pain when sitting →Our hip pain getting out of a car guide covers how to get in and out.
Read: Hip pain getting out of a car →Our hip pain when sitting guide covers chairs and cushions.
Read: Hip pain when sitting →Your team's plan and precautions come first. A leg that suddenly looks shorter or turned is a possible dislocation: see the warning signs.
Read: Hip replacement →Possibly a broken hip: call 999, as the warning signs say.
Read: Broken hip →A possible clot: get a same-day check, as the warning signs say.
Hip and thigh pain is much less common than back pain in people who drive for a living: about 1 in 5 professional drivers across 8 studies (19.5%, against 53% for the low back), 7.5% of lorry drivers and about 15% of bus drivers. No study gives a figure for ordinary car drivers, and none counts the causes of hip pain when driving, so the map above comes from condition studies and health-service pages.
In younger adults, a deep groin pinch with sitting points to the shape of the hip joint. In 51 people (52 hips) with hip impingement at a US clinic, average age 35, sitting made the pain worse in 65% of hips and 42% couldn't sit for more than 30 minutes; in 118 hips with impingement or a shallow socket, long sitting hurt more than long standing for 62.7%. With impingement, getting in or out of a car was the one questionnaire item that was worse than with a shallow socket. A low car seat bends the hip more, which is when the ball and socket pinch (our reading). These are clinic patients, so they show what impingement can feel like, not how common it is.
From mid-life, a deep groin ache and stiffness after rest is more often arthritis, and the NHS advises against low chairs, which can put extra pressure on your hips. In a real car cabin, right hip arthritis slowed braking and left hip arthritis didn't; yet before a hip replacement, 85% of people having the left hip replaced said driving made that hip hurt more.
In a manual car, the left leg lifts the knee and presses the clutch again and again in traffic, and the right leg hovers between the pedals. No study has measured hip pain from this. In a lab study of 15 healthy adults, the clutch movement was guided by the seat and pedal positions, and people moved in the way that needed least effort. Our reading: the front of the hip on the clutch side is the hip flexors working with the hip already bent, so a seat that is too low or too far back may make it worse. An automatic gearbox takes the clutch away.
NHS inform lists pain sitting with your legs crossed and pain lifting your legs in or out of a car or bed among the signs of outer hip tendon pain, with sitting or standing in one position for too long among its causes. Bucket seats that press on the outer hip are a plausible trigger (our reading; no study).
Across 55 studies of piriformis syndrome, pain made worse by sitting was as common as buttock pain itself (39% to 97% of cases, depending on the study), and deep gluteal syndrome, the wider name for the sciatic nerve trapped in the buttock, has difficulty sitting for 30 minutes in its usual story; most people are treated without surgery. It is real but contested, and the evidence is mostly case reports. Sitting on a thick back-pocket wallet can irritate the nerve, and moving the wallet often settles it (case-level evidence).
Where it hurts is the first clue (the map above). The National Institute for Health and Care Excellence (NICE) says don't routinely use imaging to diagnose osteoarthritis unless the features are unusual. How bad a hip or knee X-ray looked didn't predict how well people with arthritis braked in a real car cabin, so an X-ray can't tell you whether you can drive. In 137 people with arthritis, braking was a little slower with knee arthritis (696 milliseconds) than hip arthritis (592).
A scan matters after a fall or crash with hip pain, for groin pain that hasn't settled after 6 weeks, and before surgery; for impingement, an X-ray with your symptoms and examination, never a scan on its own.
NHS inform says outer hip pain can often take 6 to 12 months of rehabilitation to settle. In the impingement clinic series it took an average of 3.1 years to reach a diagnosis, which says more about how often it's missed than how long it lasts. After a hip replacement, 81% of 130 UK patients were driving again at 6 to 8 weeks, and 38% felt their driving had improved. No one can promise a date.
No trial has tested a driving change for hip pain. The NHS says don't sit in low chairs; NHS inform advises avoiding low chairs and crossed legs with outer hip pain. An NHS trust's seating leaflet says knees should be slightly bent with the pedals fully pressed, so move the seat forward or back to achieve it, and an NHS health board says make sure your feet reach the pedals without stretching. An NHS pain clinic and Arthritis UK suggest an automatic if the clutch is a struggle. These are sensible comfort steps; none has been tested.
NICE says offer therapeutic exercise, tailored to the person, to everyone with osteoarthritis, and warns that joint pain may increase when you start. NHS inform's key for outer hip pain is slow, progressive loading of the muscles, alongside changing what brings it on. Our hip pain getting out of a car guide gives the trial numbers for outer hip pain, hip arthritis and impingement; this guide uses the same moves and doses. No trial has tested exercise for hip pain when driving.
These studies measured braking speed and force in simulators or rigs, mostly set up like an automatic car. Pooled across 7 studies, braking was around or above its level before surgery at 1 to 3 weeks and better than before from 6 weeks, and people reported driving again after about 33 days on average; a meta-analysis of 19 hip and knee studies found right-hip braking back to its level before surgery by 2 weeks. But in 40 people tested in a real car cabin, 35% of those with a right hip and 15% with a left hip replaced still couldn't brake within 0.6 seconds at 6 weeks, and braking force fell by about a third in the first week in another study. Some studies with newer techniques found recovery within 2 weeks; the oldest found most by 8 weeks, but some right hips not until 8 months. After a hip arthroscopy, braking met its baseline after about 4 weeks.
These are small simulator studies, and some disagree. A recovered braking time is a best case, and people often drive before their braking has recovered. It is never permission to drive: your surgeon advises, you must be in control, and your insurer decides your cover.
With a left hip replaced, right-foot braking changed little early on in one study. But a 2023 review concluded that people having a left hip replaced may not be able to drive sooner than those having a right hip replaced, and most studies used automatic set-ups. The Royal College of Surgeons' recovery page (an archived copy; the page has been removed) said a left hip and an automatic may allow earlier driving, but that this should be discussed with your surgeon.
In a meta-analysis of 14 studies, travellers had about twice the risk of a clot in a vein, rising by 18% for each extra 2 hours of travel by any means. In a Dutch study, the risk after car, bus or train journeys was similar to flying, and higher in people who were very tall, obese, on the contraceptive pill or with an inherited clotting tendency. The absolute risk is small: about one clot per 4,656 long-haul flights in a cohort of employees. These figures come from all kinds of travel, and flights for the absolute risk, not from car data. The NHS lists long journeys of more than 4 hours, and surgery, among the times a clot is more likely.
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.
For sitting (our suggestion, built on an NHS occupational therapy leaflet's pacing and the HSE's advice on breaks): sit until just before the ache starts to build, then get up. The ache should settle within about an hour of moving, and your hip should be no worse that night or the next morning. If it is, shorten the next spell rather than avoiding sitting.
For the car (our suggestion, built on the same rule): use the way in and out that keeps it within 0 to 3 out of 10, with the hip no worse that night, and bring back a lower seat, a quicker exit or a long drive one at a time. After a hip replacement, your team's precautions come before any pain rule. Sudden sharp pain with the leg giving way, a leg that looks shorter, or numbness around your bottom aren't pain-rule questions: see the warning signs.
For the drive itself (our suggestion, built on the sitting paragraph above and an NHS pain clinic's pacing): drive until just before the ache starts to build, stop and walk for a few minutes, and check that your hip is no worse that night or the next morning. When a length of drive has passed that check 3 or 4 times, add 15 to 30 minutes. With a groin pinch, the pinch is the limit: change the seat before you add time. After a hip replacement, your team's advice comes before any pain rule.
Start at the first stage. Each move opens a full guide with a 3D demo.
About the first 2 weeks: change the seat and the length of drives first (the written steps below), walk at every stop, and load the outer hip and buttock gently without squeezing the tendons. With pain on the outside of the hip, leave out clamshells and outer hip stretches for now, as our hip bursitis guide says. With a diagnosed condition, that guide's plan comes first; after a hip replacement, your team's plan does.
3D demoSeated marchBeginner · A bench or box5 lifts each leg · From the move page's dose (the NHS sitting exercises). Only as high as there's no pinch: the knee lift of moving your foot between pedals, done sitting. Keep the lift low after a recent hip replacement, as the move page says
Harder: Standing march
3D demoSupine heel slideBeginner · No equipment10 slow repetitions each side, once or twice a day · The move page's dose, an editorial starting point. Bend only to just before any pinch; good after a long drive
Harder: Hip windshield wipers
3D demoSupine isometric hip abduction (belt press)Beginner · A band3 to 5 holds of 5 to 10 seconds, twice a day, at a light effort · The move page's dose (the start of the LEAP trial programme for outer hip pain)
Harder: Lateral band walk
3D demoGlute bridgeBeginner · No equipment2 to 3 at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's hip bridge, with its pacing, as in our hip pain getting out of a car guide. It straightens the hip, the opposite of the driving seat
Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge
3D demoStanding pelvic tiltBeginner · No equipment5 to 10 slow tilts, up to 3 times a day · The move page's dose (a similar NHS standing pelvic tilt's). At every stop as well (our suggestion)
3D demoTreadmill walkingBeginner · Cardio machineA few minutes at each stop, building to 10 to 20 minutes most days · As in our hip pain when sitting guide (our suggestion). Walking outdoors counts the same
Harder: Treadmill jogging
Move on when: A 30 to 45 minute drive with a stop leaves the hip no worse that night or the next morning, and the moves pass the pain rule (editorial).
About weeks 2 to 6, 2 or 3 days a week: the outer hip progression our hip bursitis and car guides use, strength for straightening the hip, the groin and inner thigh, and getting up from lower seats, all short of any pinch.
3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment5 slow repetitions each side once a day, building to 2 sets of 5 to 10 at a somewhat hard effort · The move page's dose (the LEAP trial programme)
Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge
3D demoStanding wall-press hip abductionBeginner · A wall3 to 5 holds of 5 to 15 seconds each side, twice a day · The move page's dose (LEAP's standing hold). Keep the standing hip level
Easier: Supine isometric hip abduction (belt press) · Harder: Lateral band walk
3D demoStanding band hip extensionBeginner · A band + An anchor point2 to 3 sets of 8 to 12 each side, stopping with 2 or 3 reps in reserve · The move page's dose, an editorial starting point. Stop the leg where your lower back starts to arch, as the move page says
3D demoLying adductor ball squeezeBeginner · Other / check instructions5 holds of 5 to 10 s · As in our hip pain when sitting guide (from our hip impingement guide). For the groin and inner thigh
Harder: Copenhagen plank
3D demoSit to stand from a chairBeginner · A bench or box3 sets of 8 to 10, a higher seat first, then lower, no hands · As in our hip pain when sitting guide. It rehearses getting up from a car-height seat
Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat
3D demoLateral band walkBeginner · A band10 to 15 steps each way, without a band at first, then with one · LEAP's side steps, as in our hip pain getting out of a car guide
Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet
Move on when: Every set is within the pain rule, and an hour's drive with one stop leaves the hip no worse the next morning (editorial).
From about week 6, 2 or 3 days a week, then twice a week for the long term: single-leg and loaded hip strength, kept above any depth that pinches, and controlled turning over a planted leg, while long drives come back by the written steps below. No study has tested how driving comes back after hip pain, so the order is our suggestion.
3D demoSplit squatIntermediate · No equipment3 sets of 6 to 10 each side · As in our hip pain when sitting guide. Pad the back knee
Easier: Bodyweight squat · Harder: Reverse lunge
3D demoDumbbell goblet squatIntermediate · A dumbbell3 sets of 8 to 10, to a box or chair set above pinch depth · As in our hip pain when sitting guide, with our hip impingement guide's limit
Easier: Bodyweight squat · Harder: Barbell front squat
3D demoSingle-leg glute bridgeIntermediate · No equipment2 to 3 sets of 8 each side · As in our hip pain when sitting guide
Easier: Glute bridge · Harder: Barbell hip thrust
3D demoStep-upBeginner · A stepLead with the sore leg onto a low step: 2 to 3 at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's pacing, as in our hip pain getting out of a car guide; keep the pelvis level
Easier: Low step-up · Harder: Dumbbell step-up
3D demoHip airplaneAdvanced · No equipment2 sets of 5 slow turns each leg · The move page's dose, an editorial starting point. The twist of getting out, under control (our car guide's reading); not with hip replacement precautions
Easier: Single-leg stand · Harder: Single-leg Romanian deadlift
3D demoKneeling lunge hip flexor stretchBeginner · No equipmentHold 20 to 30 seconds, 2 to 4 times each side · The move page's dose, an editorial starting point. Optional, after a long drive, if it feels good; pad the kneeling knee, and leave it out while the front of the hip hurts
Harder: World's greatest stretch
Move on when: Long drives with stops leave the hip no worse the next morning (editorial). If it flares, go back to shorter drives and the stage 1 moves for a few days, then build again.
Our 3D figure can't show these. They come from the NHS, NHS inform, NHS trusts and a health board (two leaflets past their review dates) and Arthritis UK; our suggestions are labelled. None has been tested for hip pain.
These come from the Highway Code, an NHS pain clinic, an insurer's magazine and the NHS; our suggestions are labelled.
No one can give you a date. Your surgeon advises whether you're fit to drive, you are legally responsible for being in control, your insurer decides whether you're covered, and the DVLA only needs to know in the cases below. These are the rules in their own words.
| Habit or position | Why it matters | Instead |
|---|---|---|
| A low or bucket seat | The NHS says low chairs can put extra pressure on your hips, and a deep bend pinches an impingement hip. | Raise the seat or fix a firm cushion; hips level with or above the knees. |
| Sitting with your legs crossed, or knees squeezed together, with outer hip pain | NHS inform says avoid crossing your legs with outer hip pain. | Knees a little apart. |
| Holding the clutch down in queues | It keeps the left hip working with the hip bent (our reading). | Neutral and the handbrake; an automatic if the clutch is a struggle. |
| Driving for hours without a stop | Discomfort builds with time at the wheel, and the clot risk rises with longer journeys. | Stop before the ache builds and walk; a few standing pelvic tilts.Try: Standing pelvic tilt |
| A thick wallet in your back pocket | Case-level reports describe sciatic nerve irritation from sitting on one. | A front pocket or a bag. |
| Stretching the hip flexors hard while the front of the hip hurts | Stretching them is one of the tests that brings hip flexor pain on, as our hip pain getting out of a car guide says. | Gentle knee lifts sitting down.Try: Seated march |
| Clamshells with outer hip pain | Done lying on your side with the knees together, close to the squeezing position (our hip bursitis guide). | The lying belt press.Try: Supine isometric hip abduction (belt press) |
| Deep squats or pigeon stretches into a groin pinch | Stretching into the pinch doesn't change a bone shape, as our hip impingement guide says. | Goblet squats to a box above pinch depth.Try: Dumbbell goblet squat |
| Driving before your team says so after a hip replacement | The NHS says wait at least 6 weeks, and in one study a third of right hips still braked slowly at 6 weeks. | Be a passenger; practise the pedals in a parked car once your team agrees. |
| Resting the hip completely after a long drive | NICE says joint pain may rise when you start exercising, and it still helps. | A walk and the stage 1 moves.Try: Supine heel slide |
A 15-minute hip opener: 90/90 switches, windshield wipers, CARs, Cossack squats, frog and pigeon.
15 minIntermediate8 movesWallA 25-minute glute workout with bodyweight and a mini band: bridges, clamshells, band walks, kickbacks and lunges.
25 minBeginner9 movesWall, bandA 30-minute joint-friendly circuit built like the GLA:D and ESCAPE-pain programmes: a gentle warm-up, chair, step and band strength moves, balance, then stretches.
30 minBeginner14 movesBench or box, stepA 25-minute routine for a pelvis that feels twisted or uneven: gentle holds, bridges, bird dogs, side planks and single-leg balance, the same on both sides.
25 minBeginner11 movesBand, other / check instructionsA 3-minute standing break to repeat every 30 to 60 minutes at your desk: sit-to-stands, calf raises, marching, an upper-back turn and chin tucks.
3 minBeginner5 movesBench or box, wallA drive keeps the hip bent and still for a long time, with the legs working the pedals, so it shows up problems that are there anyway. A pinch in the groin crease often comes from the hip joint, an ache on the bony point outside from the outer hip tendons, and deep buttock pain from the sciatic nerve or the back. Where it hurts is the best clue.
In a manual car the left leg lifts and presses the clutch again and again; no study has tested whether that causes hip pain, but an automatic takes it away. Before a hip replacement, 85% of people having the left hip replaced said driving made it hurt more. Raise the seat, set the distance and use neutral in queues.
The right leg hovers between the pedals and presses the brake, and right hip arthritis slowed braking in a real car cabin. Set the seat so the knee stays slightly bent at full pedal travel. A hip that makes braking slow or weak is a reason not to drive until it's checked.
A deep pinch in the groin crease, worse in a low seat, often comes from the shape of the hip joint: sitting made the pain worse in 65% of hips in one clinic series. Raise the seat so your hips are level with or above your knees, and stop before it builds. A lump in the groin is different and needs a GP.
Sitting still stiffens an arthritic hip, and long sitting is the commonest trigger for impingement pain. Walk for a few minutes when you stop, and do a few gentle heel slides or bridges at home. Stiffness that lasts more than 30 minutes, or pain at night that won't settle, needs a GP.
A seat that isn't low, your hips level with or a little above your knees, knees a little apart and not crossed, and the knee slightly bent when a pedal is pressed fully. No position has been tested in a trial, so go by comfort.
No study has compared them for hip pain, but an automatic removes the clutch, and an NHS pain clinic suggests one if the clutch is a struggle. After a hip replacement, the braking studies were mostly done in automatic set-ups.
It can: case reports describe sciatic nerve irritation from a thick back-pocket wallet, which often settles once it's moved. Move it to a front pocket or a bag before long drives.
No one can give you a date. The NHS says wait at least 6 weeks and check with your doctor that you're fit to drive; you must be able to control the car and do an emergency stop, and your insurer must cover you. You don't need to tell the DVLA unless your recovery is likely to affect driving for more than 3 months.
Not the DVLA, unless your recovery is likely to affect your driving for more than 3 months. Insurers differ: one says you needn't tell anyone once your doctor has given the all-clear, while the Royal College of Surgeons' recovery page advised telling your insurer. Check your policy.
A little, for most people: in studies of all kinds of travel, the risk rose about 18% for every extra 2 hours, and car journeys carried a similar risk to flights. It is higher after surgery or with other risk factors, so stop and walk on journeys of 4 hours or more, as the NHS advises. A swollen, painful calf or thigh afterwards needs a same-day check.
Call 999 for severe hip pain after a fall or crash, a leg you can't put weight on, or sudden breathlessness or chest pain. Get a same-day check for a hot, swollen hip with a high temperature, a painful swollen calf or thigh after a journey, or a replaced hip that suddenly looks shorter or turned. In the US, call 911 where this page says 999.
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.
