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Hip · Hip Osteoarthritis

Hip Arthritis

Wear-and-load changes in the hip joint. The surfaces and surrounding tissues have become more sensitive. It’s common with age and it does NOT mean the joint is ‘bone on bone’ or beyond help.

The hip has gradually become deconditioned and sensitised. Guidelines put exercise and education first, ahead of everything else, because it is the single best-evidenced treatment. Stronger muscles offload and support the joint.

How it typically shows up

Deep groin or front-of-hip pain in someone around 50 or older, with brief (under an hour) morning stiffness, restricted or painful turning the hip inward, and pain on walking/weight-bearing, diagnosed clinically. Core treatment is exercise + education.

How long recovery takes

Exercise reliably reduces pain and helps you move better. Most people feel steadily stronger and steadier over a few months of regular sessions, then keep going on their own.

The phased recovery approach

  1. Phase 1 · 1–3 weeks

    Calm

    Get the hip moving comfortably again and learn that some ache and the odd flare are safe, not damage.

    What you get back: everyday moves with less ache.

    • Standing Hip Flexion — 2–3 sets × 8–12 reps · Hold a support and stand tall.
    • Standing Hip Extension — 2–3 sets × 8–12 reps · Hold a support and stand tall.
    • Supine Marching — 2–3 sets × 8–12 reps · Lie on your back with your knees bent and feet flat.
    • Double-Leg Bridge — 2–3 sets × 8–12 reps · Lie on your back with your knees bent and feet flat on the floor.

  2. Phase 2 · 1–3 weeks

    Calm

    Get the hip moving comfortably again and learn that some ache and the odd flare are safe, not damage.

    What you get back: everyday moves with less ache.

    • Standing Hip Flexion — 2–3 sets × 8–12 reps · Hold a support and stand tall.
    • Standing Hip Extension — 2–3 sets × 8–12 reps · Hold a support and stand tall.
    • Supine Marching — 2–3 sets × 8–12 reps · Lie on your back with your knees bent and feet flat.
    • Double-Leg Bridge — 2–3 sets × 8–12 reps · Lie on your back with your knees bent and feet flat on the floor.

  3. Phase 3 · 3–6 weeks

    Rebuild

    Build the muscle around the hip so it carries the load and everyday moves get easier.

    What you get back: longer walks and easier stairs.

    • Low Step-Up — 2–3 sets × 8–12 reps · Stand facing a low step.
    • Hip Hinge — 2–3 sets × 8–12 reps · Stand with your feet hip-width apart and a soft bend in your knees.
    • Double-Leg Squat — 2–3 sets × 8–12 reps · Stand with your feet hip-width apart.
    • Standing Hip Extension — 2–3 sets × 8–12 reps · Hold a support and stand tall.

  4. Phase 4 · 3–6 weeks

    Rebuild

    Build the muscle around the hip so it carries the load and everyday moves get easier.

    What you get back: longer walks and easier stairs.

    • Low Step-Up — 2–3 sets × 8–12 reps · Stand facing a low step.
    • Hip Hinge — 2–3 sets × 8–12 reps · Stand with your feet hip-width apart and a soft bend in your knees.
    • Double-Leg Squat — 2–3 sets × 8–12 reps · Stand with your feet hip-width apart.
    • Standing Hip Extension — 2–3 sets × 8–12 reps · Hold a support and stand tall.

  5. Phase 5 · 2–6 weeks

    Back to walking

    Keep the strength and stamina so walking and everyday life stay comfortable.

    What you get back: walking and daily life, comfortably.

    • Graded Walking — 1 sets × 1200–1800s hold · Walk at a comfortable, easy pace.
    • Sit-to-Stand — 2–3 sets × 10–15 reps · Sit tall on a chair with your feet flat and hip-width apart.
    • Low Step-Up — 2–3 sets × 10–15 reps · Stand facing a low step.
    • Hip Hinge — 2–3 sets × 10–12 reps · Stand with your feet hip-width apart and a soft bend in your knees.

  6. Phase 6 · 3–8 weeks

    Back to the gym

    Load your hips heavier in the gym, backing off only when a session leaves you flared the next day.

    What you get back: lower-body training without a next-day flare.

    • Leg Press — 3–4 sets × 8–12 reps · Sit in the leg-press machine with your feet flat on the platform.
    • Loaded Box Squat — 3–4 sets × 8–12 reps · Hold a backpack or household load close to your chest.
    • Backpack Box Squat — 3–4 sets × 8–12 reps · Wear a securely zipped backpack with a light household load.
    • Sit-to-Stand — 3–4 sets × 8–12 reps · Sit tall on a chair with your feet flat and hip-width apart.

  7. Phase 7 · 2–6 weeks

    Back to sleep

    Get the hip calm and set up right at night so it stops waking you, while you keep the strength around it.

    What you get back: sleeping through the night without the ache.

    • Graded Walking — 1 sets × 900–1800s hold · Walk at a comfortable, easy pace.
    • Supported Sleep Position — 1 sets × 120–300s hold · Lie on your comfortable side with a pillow between your knees, or lie on your back with a pillow under your knees.
    • Standing Hip Abduction — 2–3 sets × 10–15 reps · Stand tall next to a counter, resting a fingertip on it only if needed.
    • Standing Band Abduction — 2–3 sets × 10–15 reps · Loop a band around both ankles and stand tall next to a support.

Exact exercises, sets and progression depend on your severity, equipment and goal — this is the shape of the program, not a one-size prescription.

What matters while you recover

  • Exercise is the treatment, and it’s safe

    Hip arthritis is common and treatable. Exercise is the first-line treatment and won’t wear the joint out. Stronger muscles protect it. Hurt isn’t the same as harm.

  • Motion is lotion, keep moving

    Staying active is part of the treatment. Keep walking within comfort, break up long sitting, and pace big days. The joint does better used than rested.

  • Flares are okay, not damage

    Some pain as you exercise is fine, up to about 5/10, and a flare that settles to baseline within a day is expected, not harm. Beyond that, ease the load but keep moving.

Common questions

Will exercise wear the joint out faster?
No, the opposite. Strengthening offloads and protects the joint, and guidelines make exercise the core treatment for almost everyone with hip OA.
Is it okay if it hurts a bit while I exercise?
Yes, up to about 5/10 is acceptable, and a flare that settles back to baseline within a day is fine. Flares aren’t damage. If pain exceeds that, reduce the load rather than stopping.
What matters most for recovery?
Exercise and education are the first-line treatment. Build hip strength and walking tolerance gradually, pace the activities that flare it, and judge progress by what daily tasks you can do more comfortably.

Go deeper

Related hip conditions

Sources