Physical Therapy for Hip Arthritis: How to Exercise Safely and Effectively

Find out how physical therapy can help relieve pain and other symptoms of hip arthritis. Learn which exercises are the safest and most effective for hip pain.

If hip pain and stiffness make it difficult to go about your daily activities or even sleep at night, a program of physical activity and physical therapy for hip arthritis can be an important part of your arthritis treatment plan. The right types of activity and physical therapy for arthritis have been shown to relieve pain and possibly even help keep arthritis from getting worse. 

“If you think of your joint as a bridge, your muscles, ligaments and tendons are kind of the suspension for the bridge,” says Maura Daly Iversen dean of the College of Health Professions and Professor of Public Health and Human Movement Sciences at Sacred Heart University in Fairfield, Connecticut. “If you strengthen the muscles there is less pressure on the joints.” 

Less pressure may translate to less pain and slower disease progression, studies show. By reducing pain and slowing disease progression exercise may, in turn, delay the need for hip replacement surgery — if arthritis has not already progressed to the point where surgery is necessary.   

You can strengthen the muscles that support the hip with strength-building exercises performed with free weights or weight machines, bands or even your own bodyweight working against gravity. But range-of-motion and aerobic exercises are important as well. 

Range of motion refers to the ability to move your joints through the full motion they were designed to achieve. Range-of-motion exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly can help maintain and improve the flexibility of the hips. 

Aerobic exercises, including walking, bicycling, swimming or using the elliptical machine, are also important and safe for hips while strengthening the heart and making the lungs more efficient. Aerobic exercise also reduces fatigue and builds stamina. All of these different types of exercise will help reduce or maintain body weight and the pressure placed on hips. 

If you have been diagnosed with hip arthritis it’s important to begin an exercise program as soon as possible. Iversen recommends getting started by seeing a physical therapist (PT), who can do a full musculoskeletal evaluation and determine which exercises are best for you. A physical therapist can also ensure you are performing an exercise in the best position for your body. This can be important if you have joint malalignment, which could cause you to overstrain an aspect of the joint, Iversen says.

In some cases, a physical therapist will prescribe therapeutic exercises. “Therapeutic exercise is different from just walking,” says Iversen. “It is exercise prescribed based on your particular strengths and limitations. A PT will initially prescribe exercise, explain the disease process and how to do the exercise, and ensure you perform it correctly.” Periodic follow-ups with a PT can ensure you are exercising within a threshold that is tolerable for you and gives you the best benefit, she says.

Although your PT will tailor an activity program for you, several types of physical activity are safe and beneficial for most people with hip arthritis. Many of these, including the following, have been incorporated into arthritis-specific exercise programs, some offered by the Arthritis Foundation. 

Walking. One of the most popular forms of exercise for hip arthritis, walking is one we can and should do every day. If you are just beginning a walking program, try to take a few 10-minutes walks a day. Start by walking slowly and build your speed and distance over time. If the weather is bad or you want to mix up your walking program a bit, try walking on a treadmill. If impact bothers you, using an elliptical machine will give you a good workout with less impact because your feet maintain contact with the machine while you are moving, Iversen says.
Aquatic Exercise. Aquatic exercises are performed in about shoulder-height water. The water’s buoyancy helps relieve the pressure of your body’s weight on the hips and other weight-bearing joints while providing resistance necessary for your muscles to get stronger. Regular aquatic exercise can help relieve pain and improve daily function in people with hip osteoarthritis (OA).

Tai Chi. With its gentle, fluid movements, this centuries-old martial art is a natural arthritis workout. Tai chi’s meditative aspects are helpful for reducing stress and anxiety. Its moves have been shown to promote balance, strength and range of motion. 

Yoga. In addition to improved flexibility, the practice of yoga emphasizes postural alignment, strength, endurance and balance, and incorporates breathing practices, as well as techniques such as relaxation and meditation. There are numerous styles of yoga, many of which may prove difficult or too advanced for some with arthritis. If you are interested in trying yoga, be sure to choose a type that’s safe for arthritis and an instructor who has experience working with people who have arthritis.

Although these exercises are appropriate for most people with hip arthritis, everyone is different. If you have concerns, speak with a physical therapist about the best exercises for you. 

To learn more, listen to podcasts about physical activity and arthritis. 


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