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Pilates

Every-direction hip Pilates for arthritis: a 25-minute class with no deep bends and a flare-day stop point

A 25-minute Pilates class for hip osteoarthritis. It moves the hip in the directions arthritis tends to take away (turning in, bending, and straightening behind you), builds strength lying, on your side and standing, and keeps every hip bend to about a right angle, so it suits people waiting for a replacement too. On a flare day, stop after the first block. Pain up to 5 out of 10 that's back to usual by the next day is fine. After a replacement, follow your team's precautions and use our hip replacement class instead. Its structure is our own and untested.

25 minBeginner19 movesBand, wall, anchor point, bench or box, stepAbs · Hip flexors · Glutes · Hip abductors · Back · Quads
Follow along: a timer, a cue and the next move, one step at a time.

Lying: breathe and move the hip (about 5 minutes)

  1. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoKnees bent, feet hip-width apartHarder: Roll-up (Pilates)
  2. Supine heel slide10 slow each side
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlide only as far as is comfortable, and bring the knee no closer to your chest than a right angle at the hipHarder: Hip windshield wipers
  3. Hip windshield wipers10 slow passes
    Beginner · Glutes, Adductors · 3D demoBoth feet on the floor, knees together, a small range; stop short of a pinch in the groinEasier: Supine heel slideHarder: 90/90 switch
  4. Bent-knee fall-out5 each side
    Beginner · Abs, Adductors, Hip abductors · 3D demoLet one knee open a little to the side and bring it back, pelvis stillEasier: Supine heel slideHarder: Dead bug heel taps
  5. Knee fold5 each side
    Beginner · Abs, Hip flexors · 3D demoLift to a right angle and no further. Stop point: on a flare day, stop here and finish with the breath reachEasier: Supine heel slideHarder: Dead bug heel taps

Lying and on your side: strength (about 6 minutes)

  1. Supine isometric hip abduction (belt press)3 to 5 holds of 5 to 10 seconds
    Beginner · Hip abductors, Glutes, Abs · 3D demoA belt or band just above the knees; press out gentlyHarder: Lateral band walk
  2. Pelvic tilt into bridge8 slow
    Beginner · Glutes, Abs, Hamstrings · 3D demoPeel up until your hips, knees and shoulders line up; hold 3 secondsHarder: Glute bridge
  3. Single-leg circle (Pilates one leg circle)5 small circles each way, each leg
    Beginner · Abs, Hip flexors, Adductors · 3D demoBend the other knee, foot on the floor; make the circle smaller if the groin pinchesHarder: Corkscrew (Pilates)
  4. Side-lying leg raise8 each side
    Beginner · Hip abductors, Glutes · 3D demoHeel leading, leg slightly behind your body line; a pillow between the kneesEasier: Lateral band walkHarder: Lateral band walk, band at the feet
  5. Side kick (Pilates side kick series)8 each side
    Beginner · Hip flexors, Glutes, Hip abductors · 3D demoFront swing no higher than the hip; take the leg further back than forwardHarder: Side-lying leg circles (Pilates side kick series)

Face down (about 2 minutes)

  1. Swimming (Pilates)2 sets of 20 s
    Intermediate · Back, Glutes, Shoulders · 3D demoSmall lifts; legs only, arms resting, if your back or shoulders complain. It takes each hip behind youEasier: Mermaid (Pilates seated side bend)Harder: Leg pull back (Pilates leg pull up)

Standing at a counter (about 9 minutes)

  1. Standing hip CARs3 slow circles each way, each leg
    Beginner · Glutes, Hip flexors, Hip abductors · 3D demoHold the counter; stop at any pinchEasier: Hip circles on all foursHarder: 90/90 hip lift-off
  2. Standing wall-press hip abduction3 to 5 holds of 5 to 15 seconds each side
    Beginner · Hip abductors, Glutes, Abs · 3D demoSide-on to the wall; keep the standing hip levelEasier: Supine isometric hip abduction (belt press)Harder: Lateral band walk
  3. Standing band hip extension2 sets of 8 each side, light band
    Beginner · Glutes, Hamstrings · 3D demoStop where your lower back starts to archHarder: Back extension on a 45-degree bench
  4. Sit to stand from a chair8 slow, from a higher chair
    Beginner · Quads, Glutes, Hamstrings · 3D demoHands on your thighs if you need themEasier: Sit to stand, pushing on the thighsHarder: Bodyweight squat
  5. Step-up8 each side, low step
    Beginner · Glutes, Quads, Hamstrings · 3D demoA hand on the counter; lower yourself slowlyEasier: Low step-upHarder: Dumbbell step-up
  6. Single-leg stand2 holds of 20 to 30 s each side
    Beginner · Hip abductors, Calves, Glutes · 3D demoFingertips on the counter; pelvis levelEasier: Tandem stance and heel-to-toe walkHarder: Single-leg reach matrix

Finish (about 3 minutes)

  1. Standing hip flexor stretch (split stance)Hold 20 to 30 s, 2 times each side
    Beginner · Hip flexors, Quads · 3D demoTuck your pelvis under first, for a mild stretch at the front of the back hipHarder: World's greatest stretch
  2. Breath reach5 breaths, sitting tall
    Beginner · 3D demoA firm chair, knees below your hipsHarder: Slow breathing (6 breaths a minute)

Tips

  • Two or three times a week, with walking, cycling or swimming on other days (our suggestion; Arthritis UK suggests strengthening on at least two days a week).
  • Pain up to 5 out of 10 during and after the class is fine if your hip is back to usual by the next day. If it isn't, do less next time (fewer repetitions or a smaller range), not nothing.
  • Keep every bend above any pinch at the front of the hip.
  • Waiting for a hip replacement? This class keeps your hip at a right angle or less. After surgery, follow your team's precautions and use our Pilates after a hip replacement class.
  • Pain on the outside of the hip too? Do the holds, skip the side-lying moves, and see our Pilates for hip bursitis guide.
  • Call 999 or go to A&E for severe hip pain after a fall or injury, if you can't walk or put weight on your leg, or for tingling or loss of feeling in your hip or leg after an injury.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

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Questions people ask

How long does the every-direction hip pilates for arthritis: a 25-minute class with no deep bends and a flare-day stop point take?

About 25 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A band, A wall, An anchor point, A bench or box, A step. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 10 of its 19 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.