Managing Hip Osteoarthritis: Stay Active, Strong, and Independent

Hip osteoarthritis (OA) is common in older adults and can cause pain, stiffness, and difficulty with everyday activities like walking, climbing stairs, or getting in and out of chairs. The good news: physical therapy can help you move better, reduce pain, and stay independent.

What Happens in Hip Osteoarthritis

Hip OA occurs when the cartilage in your hip joint gradually wears down, leading to:

• Pain in the groin, thigh, or buttocks

• Stiffness after sitting or in the morning

• Reduced walking distance or difficulty climbing stairs

• Weakness in hip and thigh muscles

Even mild muscle weakness can make daily activities harder and increase fall risk.

What to Expect in Physical Therapy

Physical therapy focuses on safe movement, strength, balance, and functional training.

1. Exercise Therapy (Most Important!)

Your therapist will design a personalized exercise program, which may include:

Hip Strengthening

• Seated Hip Abduction: Sit tall and move your leg out to the side, then back in (10–15 reps per leg)

• Standing Hip Extension: Stand holding a chair, move one leg backward slowly (10–15 reps per leg)

• Bridges: Lie on your back with knees bent, lift your hips, hold 3–5 seconds, lower slowly (10 reps)

Hip Flexibility

• Seated or Standing Hip Flexor Stretch: Step one leg back, keeping torso upright, feel stretch in front of hip (20–30 sec per side)

• Seated Hamstring Stretch: Extend one leg, lean slightly forward to stretch the back of thigh (20–30 sec per leg)

Balance and Functional Training

• Single-Leg Stand: Hold a chair for support, lift one foot slightly off the ground, hold 10–20 sec per side

• Sit-to-Stand Practice: Stand up from a chair slowly and controlled, repeat 10 times

• Step-Ups: Step onto a low step and back down, alternating legs (10 reps each)

Aerobic Exercise

• Walking, stationary cycling, or water walking for 10–20 minutes, 2–3 times per week

Tip: Start slowly, progress gradually, and stop if sharp pain occurs.

2. Hands-On Therapy (Manual Therapy)

Your therapist may gently mobilize the hip joint or work on surrounding muscles to:

• Reduce stiffness and discomfort

• Support your exercise program

3. Education and Self-Management

You’ll learn:

• Why movement is safe and beneficial

• How to pace activities and reduce flare-ups

• Tips for supportive footwear and walking aids

4. Optional Add-Ons

• Aquatic therapy: Exercise in water for less joint stress

• Dry needling: Short-term muscle relief if needed

• Weight management guidance: Reduce hip load and improve mobility

Tips for Older Adults

• Move daily — avoid long periods of inactivity

• Follow your home exercise program consistently

• Use supports or walking aids as recommended

• Progress exercises slowly, under guidance

Key Takeaways

• Hip OA is common but manageable

• Exercise and movement are essential for pain relief and function

• Manual therapy, balance, and functional training help older adults stay independent

• Education and a guided plan reduce flare-ups and fall risk

Reference

Koc, T., et al. (2025). Hip Pain and Mobility Deficits — Hip Osteoarthritis: Revision 2025 Clinical Practice Guideline. Journal of Orthopaedic & Sports Physical Therapy, 55(11), CPG1–CPG31. doi:10.2519/jospt.2025.0301