Eric Tannenbaum, MD

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Hip Arthritis

Exercise is one of the most effective treatments for hip arthritis and is strongly recommended in national guidelines. Strengthening the muscles around the hip and staying active can reduce pain and improve walking, even when X-rays show arthritis.

Prepared by Dr. Eric Tannenbaum, MD · Board-certified orthopedic surgeon, Southern Indiana Orthopedics

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Use this program for

  • Hip osteoarthritis
  • Hip stiffness and weakness from arthritis
  • Strengthening before a planned hip replacement

Before you start

  • Check with Dr. Tannenbaum or your physical therapist that this program fits your condition.
  • Warm up with 5 minutes of easy movement.
  • Move slowly and with control. Quality matters more than speed.
  • Use the pain guide below to decide how hard to push.
0 to 3 out of 10Safe. Keep going.
4 to 5 out of 10Acceptable if it settles by the next morning. Otherwise ease off.
Above 5, or worse the next dayToo much. Reduce the reps, range or weight.

Phase 1: Activate

Weeks 0 to 2

Wake up the hip muscles with gentle exercises.

1Bridge

  1. Lie on your back with knees bent and feet flat.
  2. Tighten your stomach and squeeze your buttocks.
  3. Lift your hips until your body is in a straight line from shoulders to knees, then lower slowly.

3 sets of 10 to 15, hold 2 to 3 seconds at the top, once a day

Progress to a single-leg bridge when 15 feel easy.

2Clamshell

  1. Lie on your side with hips and knees bent and feet together.
  2. Keep your feet touching and lift the top knee.
  3. Do not let your pelvis roll backward. Lower slowly.

3 sets of 10 to 15, once a day

Add a band around the knees to progress.

3Standing leg lift backward

  1. Stand tall holding the back of a chair.
  2. Keep the knee straight and squeeze the buttock to lift the leg backward.
  3. Do not arch your low back. Lower slowly.

3 sets of 10 to 15 each side, once a day

Small and controlled is better than big and swinging.

Phase 2: Strengthen

Weeks 2 to 8

Build strength for daily activities.

4Side-lying leg raise

  1. Lie on your side with the bottom knee bent for balance.
  2. Keep the top leg straight and slightly behind your body, toes pointing forward.
  3. Lift the leg toward the ceiling, then lower slowly.

3 sets of 10 to 15, once a day

Lead with the heel. If the toes turn up, the wrong muscle is working.

5Sit to stand

  1. Sit near the front of a sturdy chair with feet hip-width apart.
  2. Lean forward and stand up without using your hands, if you can.
  3. Lower slowly back to the chair.

3 sets of 8 to 12, once a day

Use a higher chair or a cushion to make it easier. Use a lower chair to make it harder.

6Step-up

  1. Stand facing a step or stair.
  2. Step up with the sore leg, pushing through the heel, and bring the other foot up.
  3. Step down slowly with the other leg first.

3 sets of 8 to 12 each side, once a day

Keep the knee in line with the second toe. Use a lower step to make it easier.

7Kneeling hip flexor stretch

  1. Kneel on the sore-side knee with a pillow under it and the other foot in front.
  2. Tuck your tailbone under and gently shift your hips forward.
  3. Hold the stretch at the front of the back hip.

3 repetitions, hold 30 seconds, once or twice a day

Keep your trunk upright rather than leaning forward.

Phase 3: Function

Weeks 8 and beyond

Improve balance and endurance.

8Single-leg balance

  1. Stand near a counter for safety.
  2. Lift one foot and balance on the other leg, keeping your pelvis level.
  3. Progress by closing your eyes or standing on a pillow.

3 to 5 repetitions, hold 30 seconds each leg, once a day

Keep a slight bend in the standing knee.

9Stationary bike or walking

  1. Ride a stationary bike with the seat high enough that the knee is only slightly bent at the bottom.
  2. Start with low resistance.
  3. Walking on level ground is a good alternative.

10 minutes, building to 20 to 30 minutes, most days

Regular aerobic exercise is one of the most effective treatments for arthritis.

Avoid for now

  • Long periods of sitting without getting up
  • High-impact activities that flare pain for days
  • Stopping all activity; gentle movement helps arthritis

When to move ahead

Some discomfort is normal. Keep exercise pain at 3 to 4 out of 10 or less, and make sure it settles within 24 hours.

Stop and call our office at (812) 376-9353 if you have

  • Pain that is getting worse week to week, or severe pain at night
  • New numbness, tingling or weakness
  • Significant swelling, redness, warmth or fever
  • A joint that locks, gives way or will not move
The research behind this program
  1. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020;72(2):149–162.
  2. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589.

Need more help?

Work with our physical therapists

Our physical therapists at the SIO Physical Therapy & MRI building, 745 Schnier Street in Columbus, work alongside Dr. Tannenbaum and can tailor this program to you.

Request an appointmentCall (812) 376-9353

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