Top 5 Exercises for Hip Osteoarthritis

Hip osteoarthritis (OA) is a common degenerative condition that causes pain, stiffness, and reduced function, which can make it difficult for patients to perform daily activities and maintain independence. Osteoarthritis develops when articular cartilage breaks down, leading to structural joint changes, pain, and limited mobility.

Hip OA is the second most common form of OA, and the prevalence has grown sharply, increasing by 113.25 percent between 1990 and 2019.¹ This upward trend, combined with aging populations and rising healthcare costs, reinforces the need for accessible rehabilitation strategies to help patients manage symptoms and maintain function. There is strong evidence to support that a multi-modal physical therapy program, including patient education and targeted exercises, can be helpful for reducing pain and improving function for those with symptomatic hip OA.²

As a rehabilitation professional, you have the skills to help patients maintain mobility and function through a structured rehabilitation program. In some cases, you may be the first provider patients encounter in an attempt to avoid more invasive and costly treatments. By introducing targeted exercises and clear, digestible patient education, you can help promote gentle motion, increase strength, and reduce pain and stiffness in order to keep your patients moving.

In this article, we’ll outline evidence-based exercises for patients with hip OA using protocols from Medbridge’s Pathways MSK and joint pain program. These exercises are designed to meet the needs of individuals with low to medium physical ability or moderate to high pain intensity, giving you the tools to support early recovery and long-term progress.

To help you facilitate home exercise program adherence, we’ve created a free downloadable hip osteoarthritis exercises handout PDF. This resource makes it easy to share the exercises with patients, whether you print it for your practice or send it directly for home use.

Why exercises matter in hip osteoarthritis rehabilitation

While OA is frequently described as a degenerative condition, it’s essential to reframe the conversation around restoring capability rather than focusing on decline. Exercise plays a key role in managing symptoms, maintaining mobility, and supporting joint health. Gentle, controlled movements can reduce stiffness and help preserve range of motion, allowing patients to complete daily activities, such as standing, walking, or getting up from a chair, with greater ease.

Muscle weakness, particularly in the gluteus medius and hip flexors, can contribute to instability and poor mechanics, placing additional stress on the hip joint. Targeted strengthening exercises help address these deficits, providing support and improving overall movement patterns.

Regular movement also promotes circulation and the distribution of synovial fluid, which may help reduce inflammation and stiffness. Over time, patients may build greater tolerance for activity, experiencing fewer flare-ups and more confidence in their ability to exercise safely.

By prioritizing exercises that address mobility, stability, and strength, you can help patients with hip OA manage their symptoms, improve their function, and reconnect with activities that are meaningful to them. This shift in focus—from pain to progress—creates a clear path toward maintaining independence and quality of life.

5 exercises for hip osteoarthritis

Here are five exercises to help manage hip osteoarthritis in patients:

1. Isometric gluteus medius at wall: Improves hip stability and reduces pain.
2. Hooklying isometric hip flexion: Activates hip flexors and enhances trunk stability.
3. Frogger: Promotes controlled hip mobility.
4. Quadruped rocking (Slow): Increases flexibility and reduces stiffness.
5. Standing hip hinge: Reinforces proper hip mechanics.

The early phase of treatment focuses on gentle exercises for hip osteoarthritis that reduce stiffness, alleviate pain, and build foundational strength. These movements help your patients regain mobility and confidence while minimizing strain on the hip joint.

Starting with isometric and low-load exercises provides a safe foundation for improving strength and stability. As patients build tolerance, you can introduce progressions that include more dynamic movements that challenge balance and functional strength. Monitoring patient response allows you to adjust programs to meet their goals, keeping exercise effective and manageable. Let’s take a closer look at each of the five exercises below:

1. Isometric gluteus medius at wall

By targeting the gluteus medius, this exercise provides increased stability for the hip joint, reducing compensatory mechanics and enhancing movement efficiency.

• How to perform: Guide your patient to stand with one side against a wall. Instruct them to lift the foot closest to the wall, bend the knee to 90 degrees, and rest their arm on the wall for support. Ask them to gently push the bent knee into the wall while maintaining a straight back. Hold for 5–10 seconds, then relax. Repeat as tolerated.
• Tip: Cue patients to keep their back straight and focus on squeezing the glutes as they push into the wall.

2. Hooklying isometric hip flexion

This exercise activates the hip flexor muscles while challenging core stability, providing dual benefits for patients who struggle with alignment and trunk control.

• How to perform: Instruct your patient to lie on their back with knees bent and feet flat on the floor. Ask them to lift one leg to a 90-degree angle and place their hand on the knee. Guide them to push the knee toward their chest while resisting the movement with their hand. Hold for 5–10 seconds and instruct the patient to switch sides.
• Tip: Remind patients to keep their core engaged and avoid arching the lower back.

3. Frogger

Designed to promote hip mobility, this exercise emphasizes fluidity and precision, helping patients re-establish control over their range of motion.

• How to perform: Start the patient in a standing position in a flat, open area. Have them lift one leg, bend the knee, and gently swing it out to the side before stepping forward. Repeat with the opposite leg, maintaining a steady, controlled rhythm.
• Tip: Emphasize deliberate, controlled movements to help maintain balance and avoid compensatory patterns.

4. Quadruped rocking (slow)

This gentle movement provides an opportunity for patients to explore weight shifts, building confidence in hip joint flexibility without fear of overextension.

• How to perform: Position your patient on all fours, with hands shoulder-width apart and knees cushioned for comfort. Instruct them to slowly rock their weight back toward their heels while keeping their back flat and chin tucked. Guide them to return to the starting position and repeat as tolerated.
• Tip: Encourage even weight distribution through the hands and knees. If kneeling is uncomfortable, suggest placing a cushion or towel under the knees.

5. Standing hip hinge

By isolating movement at the hip joint, this exercise teaches patients to distinguish between hip and lumbar motion, fostering improved biomechanics and reducing strain.

• How to perform: Have the patient stand upright with feet shoulder-width apart and hands on their hips. Ask them to bend forward slowly at the hips, keeping their back straight and knees slightly bent. Once they reach a comfortable range, have them return to a standing position and repeat.
• Tip: Remind patients to hinge from the hips rather than rounding their back and to focus on maintaining spinal alignment throughout the movement.

Helping patients build strength, mobility, and confidence

Helping patients succeed with exercises for hip osteoarthritis requires a tailored approach that considers their individual goals, tolerance levels, and understanding of recovery. Below are key strategies to help your patients safely engage in their programs and build momentum toward recovery.

Tailor programs to individual needs

Personalizing exercise programs is key to helping your patients progress safely and effectively. Start with two to three sets of 10 to 12 repetitions for each exercise and adjust based on their pain levels, tolerance, and functional capacity. Help your patients differentiate between expected muscular discomfort and pain that may indicate a need for modification, so they feel confident in their ability to engage without overdoing it.

When it’s time to progress, focus on gradual, purposeful changes. You might increase repetitions, extend hold times, or incorporate slight variations to challenge balance, stability, or control. Tools like pain scales, range-of-motion measurements, or functional outcome tests can help you track improvements objectively and guide decisions. Individualizing each program to each patient’s needs gives them the best opportunity to build strength, restore function, and achieve their goals.

Monitor progress and adjust programs

Ongoing assessment is essential for keeping your patients engaged and progressing in their recovery. Encourage patients to provide regular feedback on their pain levels before, during, and after exercises, as well as improvements in mobility—like reduced stiffness or increased range of motion. Be sure to connect progress to real-life functional outcomes, such as walking longer distances, climbing stairs with less discomfort, or completing sit-to-stand transitions more smoothly.

When adjustments are needed, focus on small, intentional changes. You might reduce the range of motion or introduce brief rest breaks to regress the exercises, or add more complexity to the movement to progress the exercises. Recognizing incremental gains, no matter how small, can make a big difference in your patient’s confidence and motivation. Regularly celebrating these improvements helps reinforce their effort and commitment, keeping them engaged in the program and optimistic about their recovery.

Reinforce education to address concerns

Patient education is key to reducing fear and building trust in your designed exercise program. Many patients come in with misconceptions about pain, imaging findings, or the role of movement in managing hip osteoarthritis. Use your expertise to address these concerns and reframe their understanding:

• The benefits of movement: Emphasize that controlled, purposeful exercises reduce stiffness, improve joint health, and support functional activities like walking, standing, and climbing stairs. Help patients see exercise as a tool to restore capability, not cause further harm.
• The role of imaging: Explain that OA-related changes, such as joint space narrowing or osteophyte formation, don’t always align with pain levels. Functional improvements can still happen, even when imaging findings show structural changes.
• Self-management tools: Recommend heat or ice to provide short-term symptom relief. For example, heat can help reduce stiffness before exercise, while ice may ease soreness afterward, making it easier for patients to stay engaged.

Take the time to clarify misconceptions, answer questions, and validate progress. Highlight real-life improvements—like reduced stiffness in the morning or increased comfort during daily tasks—so patients can connect their efforts to meaningful results. By reinforcing education with clear, empathetic communication, you empower patients to approach their recovery with confidence and commitment.

Address movement fears with empathy and guidance

Fear of movement can be a significant barrier for patients with hip osteoarthritis, especially when they believe activity will worsen their pain or joint damage. Your role as their physical therapist is to help reframe movement as a safe, necessary part of recovery. Demonstrate exercises with clear, simple cues, and introduce them gradually to build confidence. Breaking movements into manageable steps allows patients to focus on controlled, pain-tolerant progress without feeling overwhelmed.

Celebrate small, measurable wins—like walking a bit farther, sitting with less discomfort, or improving balance during a movement. These achievements help shift the focus from pain to progress, reinforcing the value of their effort. With empathy, clear guidance, and consistent encouragement, you can empower patients to trust their bodies and see movement as a tool for improving function, mobility, and overall quality of life.

A clear path to improved function and mobility

Hip osteoarthritis challenges your patients’ ability to move, maintain independence, and engage in the activities that matter most to them. By introducing structured, evidence-based exercises for hip osteoarthritis, you provide a pathway to better mobility, reduced pain, and restored confidence. These exercises don’t just target strength and stability—they help patients rebuild trust in their bodies and take an active role in their recovery.

As rehabilitation professionals, your ability to deliver individualized care, monitor progress, and address movement fears is central to helping patients succeed. When exercises are combined with clear education and empathetic support, patients are more likely to stay engaged, achieve meaningful progress, and reconnect with functional goals that improve their quality of life.

Discover how Pathways offers a structured, phased approach to care, giving you the tools to support every stage of recovery. Ask your organization to request a demo today and learn how Pathways can help you deliver exceptional care and empower patients with hip osteoarthritis.

References

1. 1. Fan, Z., Yan, L., Liu, H., et al. The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Res Ther 25, 51 (2023). https://doi.org/10.1186/s13075-023-03033-7
   2. American Academy of Orthopaedic Surgeons. (n.d.). Management of osteoarthritis of the hip: Clinical practice guideline. Retrieved from https://www.aaos.org/globalassets/quality-and-practice-resources/osteoarthritis-of-the-hip/oah-cpg.pdf