Hip pain is a common condition we see in the clinic, and appears to be more common in those over the age of 50.
While there are many potential diagnoses for hip pain, hip pain is often due to tight and weak muscles around the hip.
So what are the best exercises for hip pain?
First, it is important to know whether your hip is due to inactivity, (e.g. too much sitting), overuse (e.g. too much walking/running) or osteoarthritis of the hip joint.
In most cases, these painful hips gradually become more stiff and sore as one’s age progresses into the fifth or sixth decade of life.
Perhaps your own hips have been bothering you as you read this blog article. If your hips have been bothering for some time, someone may have suggested hip replacement surgery to you.
Unless I am sorely mistaken, I believe no one would want surgery as a first option.
Thankfully, you do not have to as there is a far better option:
Exercise!
Why Does Hip Pain Happen?
The hip joint is a ball-and-socket joint supported by many muscle groups.
When these muscles and joints work properly, we can perform actions involving strength, flexibility, mobility and balance so we can walk, run, jump, squat and sit.
However, things do not always go smoothly.
Sometimes we may strain our hip muscles during sports or injure ourselves when we fall.
We may have been overly ambitious with our household chores or walked a longer and harder path!
Hip pain can also come about gradually due to inactivity, resulting in weakened and tight muscles around the hip and lower back.
In those cases, the hips are faced with three scenarios:
- A direct trauma or injury to the structures (such as the joint or muscles) around the hip.=
- The hip joint and muscles are overworked beyond their physical capacity.
- The hip joint and muscles are underworked.
When this happens, the body tries to adapt through changing muscle activation patterns, which includes spasming of the muscles (to brace for pain) or tightening due to lack of strength.
If not addressed, these changes can affect how much and well the hip joint moves.
Over time, this can overload the hip structures and ultimately result in pain.
Finding the Right Exercise for Your Hip Pain
Hip pain affects more than your hips; it can also affect your lower back and knees!
This is why it is important to have the right exercises to improve your hip mobility and strength.
In fact, studies have shown that hip exercises are effective at improving lower back and knee pain!
Because of this, you can do a quick google search or look up YouTube for “THE BEST HIP EXERCISES YOU WILL EVER NEED!”.
But…are they really?
In general, when choosing exercises you should consider:
- A. What is your current physical condition?
- B. What is the exercise trying to achieve?
- C. What type of exercises does your hip need?
- D. Do you have other injuries or health conditions?
With those questions in mind, let us talk about the 4 types of exercises you must include for your hip pain and an example of each you can try!
**DO NOT PERFORM ANY OF THESE EXERCISES IF THEY ARE MAKING YOUR HIP PAIN WORSE**
Exercises for Hip Pain: Strength/Resistance Training
Hip pain can decrease strength in the muscles of the hip joint through:
A. Avoidance of using painful muscles causing weakness and atrophy
B. Overactivity and tension (pain bracing) prevents effective muscular contraction.
Resistance training is an excellent way to address hip pain. Not only can you improve the strength of the muscles, it can allow tense muscles to contract and relax.
There are many exercises to build strength for the hip that can be performed in all positions, ranging from standing to lying on the ground.
A great exercise to start with is the Shoulder Bridge to strengthen the hips:
- Lie on your back with your feet on the ground and knees bent.
- Tilt your pelvis and let the lower back flatten against the floor, then roll your pelvis and spine off the floor (avoid over-tensing your abdominal muscles when lifting)
- You should feel your buttocks and hamstrings working.
- Lower your spine and pelvis back to the ground smoothly.
- Repeat for 6 repetitions for 3 sets.
IMPORTANT: Tilt your pelvis before you lift to prevent over-extending your lower back!
Exercises for Hip Pain: Stretching
Hip pain can cause joint stiffness and restricted range of motion tensing up muscles around the joint in a guarding response (aka bracing for pain).
Stretching is an effective way of claiming back the range of motion. It teaches the brain that the ‘painful’ range is safe so it no longer has to brace at that point of range.
Let us do a Glute/Buttock Stretch together:
- Lie on your back with your feet on the ground and knees bent.
- Lift your left foot over your right knee and pull your right knee towards your chest, interlocking your fingers behind your right thigh.
- Use your hands to pull the uncrossed leg towards your chest.
- You should feel a moderate stretch in the glutes/buttock of the left leg.
- Hold for 30 seconds. Perform 3 sets of 30 second holds before repeating on the opposite side.
AVOID: Stretching into ranges of intense pain.
Exercises for Hip Pain: Motor Control/Coordination
Tension from hip pain also affects the muscles that attach to the lumbar spine and pelvis from the hip. This prevents those areas from being able to move independently of each other!
Thus, one important component of addressing hip pain is to retrain the hip joint to move freely without tensing up the lower back and pelvis.
One great exercise you can do is the Bent Knee Lift:
- Lie on your back with knees bent and feet flat on the ground.
- Place your hands on your pelvis to ensure it remains stationary.
- Press one foot into the ground and lift the other bent leg to a 90 degree angle (aka table top position).
- Lower the leg down to its starting position.
- Repeat for 6 repetitions for 3 sets before repeating on the other leg.
NOTE: This is not a strength exercise. Focus more on moving smoothly with the hip joint!
Exercises for Hip Pain: Balance Retraining
Poor standing balance is a common problem for those with hip pain as they avoid standing on the painful hip. This often comes about from weakness in the hip stabiliser muscles.
Unfortunately, not loading the painful hip affects strength as well as balance. This makes activities like walking, negotiating steps and uneven grounds difficult.
Learning how to shift our weight between our feet is an excellent way to start improving our balance while strengthening the hip muscles.
Now that we have worked on strength, stretching and coordination for your hips, let us practice Weight Shifting in Standing:
- Stand in front of a mirror with your feet hip width apart and toes pointing straight.
- Start shifting your weight side to side between your feet.
- Use the mirror to make sure your shoulders remain level and your hips do not drop.
- Try and bring as much of your weight and balance onto one leg as possible.
- Shift your weight between both feet for 6 repetitions for 3 sets.
HINT: Hold onto the backrest of a chair in front of you for extra support!
Which Exercise is the Best for Hip Pain?
How did you go with those exercises?
Hip pain can affect all of us differently, so we may need more of a certain type of exercise but it is always important to include all of them in your exercise program!
The exercise examples above are generally for early stages of hip pain.
As you start to get better, you should perform more challenging exercises to your strength, flexibility, coordination and balance.
However, the most important point when exercising is always exercise within your limits and never overly strain yourself.
More pain does NOT mean more gain!
Why Do You Still Have Hip Pain?
Hip pain can come from acute injuries or chronic repetitive overuse.
While those exercises above can be excellent for addressing hip pain, how other parts of the body move can potentially affect painful hips, especially when they are compensating for some other forms of pain or injury!
This is where physiotherapists come in handy.
By listening to your story of how you came to have hip pain (and other possible conditions), we can help you make sense of your hip pain AND we can also address other potential causes from the way you move or the activities you perform.
Our Physiotherapist-lid Clinical Exercise classes can also be helpful to assist in your recovery as they aim to assist you:
- Restore your mobility
- Rebuild your strength
- Refine your movement patterns
- Regain your balance
- Reclaim your confidence to move well and to move often!
This is especially helpful to those of you who like proper supervision and someone to give you the right exercises for your hips!
References
Kim, B., & Yim, J. (2020). Core stability and hip exercises improve physical function and activity in patients with non-specific low back pain: a randomized controlled trial. The Tohoku journal of experimental medicine, 251(3), 193-206.
Peterson, N. E., Osterloh, K. D., & Graff, M. N. (2019). Exercises for older adults with knee and hip pain. The Journal for Nurse Practitioners, 15(4), 263-267.