11 Hip-Strengthening Moves for Osteoarthritis
What if you could ditch the pain meds you take for hip osteoarthritis (OA) and follow an exercise plan instead? Research suggests you could do just that, says Maura Iversen, D.P.T., a physical therapist and dean of Sacred Heart University’s College of Health Professions in Fairfield, CT. “Studies show that exercise alone is as effective as taking a nonsteroidal anti-inflammatory drug (NSAID) on a regular basis,” Iversen says. “I tell patients, ‘If you do your exercises regularly, you can skip the Naprosyn.’” For best results, you’ll want a plan that includes cardiovascular activity, balance exercises, and strength training.
How Exercise Helps Hip OA
Strength training helps build muscles that support the hip, shifting some of the stress from the joint onto the surrounding muscles, Iversen says. Your muscles also help stabilize the joint and keep it aligned, which prevents OA from getting worse. “Imagine a door hinge,” Iversen says. “In a nicely aligned door, it moves perfectly well. But if the hinge is a bit off, the door won’t move as smoothly and it begins to break down.” The best strategy is to work with a physical therapist (usually covered by insurance, Iversen says). Visit ChoosePT.com to find a PT who specializes in orthopedics. Or talk to your doctor about adding these moves to your routine.
Make Sure You Don’t Overdo It
Some pain when you move is normal with OA, but that shouldn’t stop you from exercising, says Meghan Lamothe, D.P.T., a physical therapist at the Hospital for Special Surgery’s Orthopedic Physical Therapy Center in New York City. Follow her three-point rule: Before physical activity, rate your pain from zero to 10. If your pain goes up by more than three points—say, you go from a three to a seven—you’ve done too much. Stop and rest. If your pain comes back down, you can keep going. For post-exercise pain, try icing the joint for 10 to 15 minutes.
How to Do These Strength Moves
Quality is key. Perform the moves slowly and intentionally, focusing on proper form. Start with two sets of 8 to 10 repetitions for each exercise, three or four days per week (with a day of rest in between), Lamothe says. As you get stronger, you can add a set and/or do 12 to 15 reps, she adds. For all one-sided moves, be sure to repeat all reps on both sides, even if only one of your hips is affected.
Strong glutes help you straighten back up after bending over, which can be especially hard when you have hip OA. Strengthen your glutes with hip extensions.
How to: Stand with your feet hip-width apart, hands on your hips (or on a chair or wall for balance.) Slowly raise one leg behind you, keeping it straight. You should feel your glute contract on that side. Pause at the top, then lower your leg back down. Keep your pelvis facing forward throughout the move, Lamothe says. If you let it rotate toward the leg you’re raising, you may not activate the glute.
Single-Leg Snow Angel (Hip Abduction)
This move hits the muscles on the outside of the hip, the gluteus medius, which is key for keeping your trunk and pelvis stable when you walk.
How to: Lie on your back with your arms at your sides and legs straight. Keeping one leg still, slowly slide the other leg out to the side and then bring it back in (like you’re making a snow angel with one leg). Do 8 to 10 reps, and switch legs. Prefer standing? Do the move next to a chair or wall for balance. Slowly raise your leg out to the side, and lower it back down.
Side-Lying Hip Adduction
Hip adductors are the muscles in your inner thighs that pull the legs together and work with your outer hip muscles (like the gluteus medius) to stabilize your hips. You can strengthen them with side-lying hip adductions.
How to: Lie on your right side with your left knee bent and pointing up, left foot flat on the floor slightly behind you. Keeping your right leg straight, lift it a few inches off the floor. Lower your leg back down. Do 8 to 10 reps on each leg.
People with weak hip flexors (front of your hips) may not lift their foot high enough when walking, leading to very small steps and increased fall risk, Lamothe says. However, if you have tight, irritated hip flexors (common in people who sit a lot), then you may want to avoid exercises like this one, as it can cause more irritation, she adds. A physical therapist can help you make that call.
How to: Lie on your back with your legs straight and hands on your hips. Slowly slide one heel up toward your butt, bending your knee. Slide your heel back to straighten out your leg. Do 8 to 10 reps, and switch legs.
This multi-tasking move hits your glutes, hamstrings, and core, Lamothe says.
How to: Lie on your back with your knees bent and feet flat on the floor, arms at your sides. Press your heels into the floor and brace your core as you slowly raise your hips. Go as high as you can without pain, even if that’s just an inch or two. Lower your hips back down. Too easy? Hold at the top for 3 to 5 seconds or place a light weight (5 pounds max) over your hips.
Your hamstrings work with your glutes to “extend” the hips—like when you straighten up after bending down or stand from a seated position. Hamstring curls strengthen them.
How to: Stand with your feet hip-width apart, hands on your hips (or holding onto a chair or wall for balance). Slowly raise one heel up toward your buttocks, bending your knee. Lower your foot back down. Do 8 to 10 reps on each leg. Too tough? Try performing the move while lying on your stomach.
This move, also called a leg extension, is especially good for the quadriceps. These muscles work with your hip flexors to bend the hips—like when you’re squatting down or lowering into a seated position.
How to: Sit in a sturdy chair with both feet flat on the floor. Slowly straighten one knee until that leg is straight, and return to the starting position. Do 8 to 10 reps, and switch legs.
Sit to Stand
Don’t be fooled by this simple everyday movement: It strengthens multiple muscles, including the quadriceps and the hamstrings, Lamothe says.
How to: Sit in a sturdy chair, and scoot your bottom toward the front of the seat—so your toes are directly below your knees. Cross your arms on your chest. Lean your torso slightly forward (aim for nose over toes), then slowly rise to standing. To return to sitting, push your hips back and bend your knees to lower your body back into the chair, keeping your weight in the heel and midfoot.
Weak core muscles make your trunk less stable, putting extra pressure on your hips, Lamothe says. This move targets the transverse abdominis, which runs like a corset across your midsection, and the obliques, the sides of your core.
How to: Lie on your back with knees bent, fingers lightly touching your hip bones. Take a deep breath in through your nose. As you exhale through your mouth, squeeze the muscles in your lower abdomen and gently press your lower back into the floor. 5-10 reps are recommended; without holding at first, then holding for a few seconds each time is fine. It should feel like you’re hollowing out your lower abdomen, Lamothe says. It’s harder than it sounds!
Elevated Side Plank
Side plank engages your core and outer hip muscles, a.k.a. hip abductors. You can do it on the floor, but if you’re not quite ready for that, use a wall to make it easier.
How to: Stand with your side to a wall. Place your forearm firmly against the wall and lean toward it, moving your feet away from the wall until your body forms a straight line from head to heels. Hold for 10 seconds. Switch sides, and repeat.
Make it harder: Gradually add 5 seconds to your hold time until you get to 30 seconds.
Standard plank targets an important trio of muscles: core, glutes, and quads, Lamothe says. Elevating the front of your body makes the move easier.
How to: Stand facing a table or counter (or any stable surface) with your feet shoulder-width apart. Rest your forearms on the table (shoulders over elbows), and walk your feet back until your body forms a straight line from head to heels. You’ll be supporting your upper-body weight on your forearms. Pull your belly up and in as if pulling on tight jeans. Hold for 10 seconds.
Gradually add 5 seconds to your hold until you get to 30 seconds.
Walk, Stretch, and You’re Done!
This strength workout is the perfect prep for a good walk, Lamothe says. Walk for 5 to 30 minutes. Then, while your muscles are still warm, stretch your hip flexors and quads with the modified Thomas stretch: Lay on a couch or bed with one leg hanging over the side. That’s it! You should feel the stretch in the front of your hip.
To increase the stretch, wrap a belt or towel around the ankle of the hanging leg and gently pull it back toward your head.
- NSAID vs. Exercise for OA: Osteoarthritis and Cartilage. (2017). “One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis: the EXERPHARMA randomized trial.” oarsijournal.com/article/S1063-4584(17)31276-1/fulltext