The most common cause of arthritis in the hip is osteoarthritis, a type of arthritis caused by age-related wear and tear. Osteoarthritis affects people of all ages, but most commonly, people over 60. Hip injuries increase the risk of hip arthritis and so does the anatomical problem where the bones of the hip don’t fit well together, causing hip impingement.
Hip osteoarthritis mainly affects the ball (femoral head) at the top of your thigh bone (femur). As you get older, this cartilage breaks down and wears away. This can lead to pain, stiffness, and limited mobility. Damage to the cartilage in this area causes pain and stiffness and can lead to loss of mobility and deformity of the hip joint.
Osteoarthritis of a hip can make exercise more challenging, yet it can also be beneficial by boosting muscle strength and size for better joint support, reducing stiffness, and improving flexibility of the hip. However, studies show exercise is more effective in improving the quality of life for people with knee osteoarthritis than hip arthritis. However, it’s important to stay physically active, to preserve muscle mass.
Exercising with Hip Osteoarthritis
The key to exercising with hip osteoarthritis is to do it safely and in a way that doesn’t aggravate pain. Let’s look at some guidelines for doing that.
Avoid High-Impact Exercise
Even if you have hip arthritis, you still need cardiovascular exercise, but high-impact exercise where both feet leave the ground at the same time is too jarring if you have an arthritis hip. This includes exercises that entail running or jumping.
Why is high-impact exercise a problem? The amount of force that your joints must absorb when you land from a jump or drop down from something is much higher than walking or even jogging on flat ground. This extra force can make your joints ache more than usual and cause added stiffness.
Likewise, when you run or jog, each time your heel strikes the ground, the force travels up your legs to your hips. The extra force your hip sustains with each strike can cause additional joint damage and joint pain. Walking is still safe for mild to moderate hip osteoarthritis, but it’s best to do it on soft surfaces such as grass and ensure that the terrain is even. With uneven terrain, your hips must continuously readjust with each terrain shift and that places more stress on your hip joints.
Forms of cardio exercise that are safer for you if you have hip osteoarthritis include:
- Swimming
- Elliptical machines
- Walking on soft, even terrain
- Recumbent bike
Avoid Exercises That Require Prolonged Standing
When you have hip arthritis, strength training is beneficial because it increases bone density and muscle mass. Strength training that requires prolonged standing — such as squats, lunges, or step-ups — may cause pain or discomfort in your hip joint when you do it over an extended period.
If possible, do strength training exercises sitting when an exercise allows you to do so. For example, sitting biceps curls and triceps extensions is easier on your hips than doing them in a standing position and your upper body will still get the benefits.
Avoid Exercises and Sports Where You Twist Your Body or Change Directions Quickly
Stay away from activities that require twisting at the waist (such as golfing), since this movement puts extra stress on your spine and hips. Likewise, playing sports like tennis and soccer can worsen hip pain and place added stress on your hip joints.
Warm Up and Stretch
Always do a thorough warm-up before exercising with hip arthritis. Make sure your warm-up is low impact. For example, cycling is an effective way to increase your core body temperature and prepare your muscles for exercise without aggravating hip pain. Always stretch afterward to reduce muscle tightness. Include hamstring stretches and hip flexor stretches in your post-workout stretching routine. Keep the movements slow and gentle.
Yoga is another option if you have hip osteoarthritis because it doesn’t require impact from jumping or landing from high heights — two activities that might aggravate your condition. Yoga exercises focus on flexibility, balance, and strength rather than power or speed.
The Bottom Line
You may not feel like exercising when your hip hurts but doing so can help you manage the pain and stiffness. Staying physically active will also help stiffness by improving flexibility. Stay active with hip osteoarthritis (OA), but let pain be your guide. If your hip hurts, don’t exercise through it. Modify exercises if they cause pain. Also, check with your physician before starting an exercise program if you have hip pain and heed their advice when training.
It’s also helpful to keep a training diary. Document the exercises you do and your hip symptoms afterward, so you can identify exercises that make your hip pain and stiffness worse. Make sure you’re giving your body enough recovery time after each workout too. A training diary will help you determine whether you’re pushing too hard.
The most important message is to listen to your body and adapt your workouts based on how your hip feels. If you feel discomfort, take a break, and see if the pain persists. If it does, you’re pushing too hard and may need to modify some exercises or give yourself more recovery time. Also, applying heat or cold to arthritic joints may be beneficial. Ice reduces inflammation while heat increases blood flow and reduces stiffness and spasm. Experiment to see which works best for you.
Stay active! You need movement to reduce joint stiffness and stay as mobile as possible.
References:
- McNair PJ, Simmonds MA, Boocock MG, Larmer PJ. Exercise therapy for the management of osteoarthritis of the hip joint: a systematic review. Arthritis Res Ther. 2009;11(3):R98. doi: 10.1186/ar2743. Epub 2009 Jun 25. PMID: 19555502; PMCID: PMC2714154.
- Harvard Health Publishing. “Exercise is good, not bad, for arthritis”
- “Exercises for Hip Osteoarthritis – Arthritis Foundation.” https://www.arthritis.org/health-wellness/healthy-living/physical-activity/getting-started/exercise-benefits-for-hip-osteoarthritis.
- Denegar CR, Dougherty DR, Friedman JE, Schimizzi ME, Clark JE, Comstock BA, Kraemer WJ. Preferences for heat, cold, or contrast in patients with knee osteoarthritis affect treatment response. Clin Interv Aging. 2010 Aug 9;5:199-206. PubMed PMID: 20711439; PubMed Central PMCID: PMC2920200.
- “National Statistics | CDC – Centers for Disease Control and Prevention.” https://www.cdc.gov/arthritis/data_statistics/national-statistics.html.
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