3 Tips To Improve Your Hip Mobility

Treating Hip Osteoarthritis with Exercise

Hip Mobility Exercise

Trouble getting out of a chair? Trouble pivoting? Walking? How about lifting your leg on and off the bed? In and out of the car? Mobility in your hips is vitally important for many everyday tasks. Your hips are the connection point of your leg to the rest of your body. Therefore, any lack of mobility in this joint can greatly affect how you function.

Let’s talk about what causes limited hip mobility and, more importantly, what you can do to improve it…

What Does a Hip Mobility Deficit Look Like?

Osteoarthritis (OA) is the most common cause of hip pain in adults over the age of 50. In fact, up to 27% of adults will acquire hip OA, the majority of which are men1.

So what factors are associated with hip osteoarthritis?2,3,4,5,6,7

  • Limited hip Internal Rotation mobility (turning the hip inwards)
  • Acetabular retroversion (the Pelvis is rotated toward the back)
  • Limited hip flexion mobility (lifting the hip up toward your chest)
  • Stiffness of the hip in the morning
  • Pain in the hip
  • Male gender
  • Higher BMI (body mass index)
  • Lower socioeconomic status

Typically, as Osteoarthritis progresses (and isn’t addressed), hip joint range of motion is reduced and muscle weakness develops around the joint 8. These two impairments – limited mobility and weakness – can lead to high levels of disability 9.

But that’s only if Osteoarthritis isn’t addressed.

Interestingly, many people who present with hip pain and stiffness don’t show radiographic evidence of hip osteoarthritis. Similarly, many people who do show evidence of hip OA don’t have hip pain10.

With that in mind, I’d encourage you to focus on improving your mobility and function rather than dwelling on your imaging results.

Now let’s see what can happen when you address hip OA…

Treatment Options for Hip Osteoarthritis

Let’s compare some traditional, more invasive treatment options with more conservative treatment options for hip OA…

Traditional Treatment Options for Hip Osteoarthritis

  • NSAIDs (Nonsteroidal anti-inflammatory drugs):

These are effective for relieving symptoms in people with hip OA11. That’s great, but I’m more interested in improving function rather than merely relieving symptoms, and I’m willing to bet you are, too.

Not to mention the gastrointestinal side-effects associated with use of NSAIDs over time. Plus, although data isn’t conclusive, it’s possible that NSAID usage can actually increase the progression of hip OA by decreasing glycosaminoglycan synthesis12. These factors don’t leave NSAIDs at the top of my treatment list.

  • Glucosamine and Chondroitin:

A study of 222 patients with hip OA gave individuals either glucosamine or placebo once daily for 2 years. Results: no differences were found after 2 years on x-rays or on self-reported outcome measures13,14.

A recent meta-analysis of multiple studies looked at Glucosamine and/or chondroitin taken by people with hip or knee OA. There was no effect on pain or joint space narrowing15.

  • Hyaluronic Acid Injections:

Whether or not intra-articular hyaluronic injections have any benefit has still not been established, even in high-quality studies16.

  • Total Hip Replacement Surgery:

This is the most common surgical procedure for end-stage hip Osteoarthritis17. One study showed – 1 year after hip replacement – a 29% reduction in pain, a 45% reduction in stiffness, and a 68% increase in physical function18.

Although these are pretty good statistics, I always recommend conservative treatment first, as surgery should be a last resort.

Conservative Treatment Options for Hip Osteoarthritis:

1. Weight Loss:

Remember we saw that an increased BMI is a risk-factor associated with the development of hip osteoarthritis? Well, think about it, if the joint has increased stress on it from excess weight, taking stress off that joint by losing weight would make sense, right?

A recent study looked at the effect weight loss – through diet and exercise – had on people with Hip Osteoarthritis. The participants were successful – with an average of 5% body weight reduction after 8 months. This resulted in a 17% improvement in physical function and a 25% decrease in pain19.

I’d highly recommend, if necessary, to pursue a healthy weight loss program with the assistance of your physician, nutritionist, or dietician.

2. Manual Therapy:

Hands-on techniques from your Physical Therapist to improve hip mobility can lead to significant improvements20.

A recent study looking at patients with hip osteoarthritis compared a group that received education plus manual therapy with a group that received education only. After 6 weeks, 76% of the manual therapy group improved, compared with 22% of the education group21.

Manual therapy can include manipulation, mobilization, manual traction, soft tissue mobilization, and muscle stretching. These techniques can be used to improve hip mobility in preparation for exercise22.

3. Exercise:

I’d recommend exercises to improve strength, endurance, and flexibility of the hip. Studies show that exercise to improve hip mobility can significantly improve physical function and reduce pain 23.

Here are a few exercise ideas to improve hip mobility:

Quadruped Rock Backs

 

Single Knee To Chest

 

Standing Hip Adductor Stretch

 

 

Hamstring Stretch

 

 

Kneeling Hip Flexor Stretch

 

Question: What exercises or other treatment options have you found to improve hip mobility? You can leave a comment by clicking here.


  1. Cibulka MT, et al. Hip Pain and Mobility Deficits – Hip Osteoarthritis: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Assocation. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.doi:10.2519/jospt.2017.0301  ↩
  2. Holla JF, Steultjens MP, van der Leeden M, et al. Determinants of range of joint motion in patients with early symptomatic osteoarthritis of the hip and/or knee: an exploratory study in the CHECK cohort. Osteoarthritis Cartilage. 2011;19:411–419. https://doi.org/10.1016/j.joca.2011.01.013  ↩
  3. Jiang L, Rong J, Wang Y, et al. The relationship between body mass index and hip osteoarthritis: a systematic review and meta-analysis. Joint Bone Spine. 2011;78:150–155. https://doi.org/10.1016/j.jbspin.2010.04.011  ↩
  4. Kiyama T, Naito M, Shiramizu K, Shinoda T. Postoperative acetabular retroversion causes posterior osteoarthritis of the hip. Int Orthop. 2009;33:625–631. https://doi.org/10.1007/s00264–007–0507–6  ↩
  5. Ipach I, Mittag F, Walter C, Syha R, Wolf P, Kluba T. The prevalence of ac-
    etabular anomalies associated with pistol-grip-deformity in osteoarthritic
    hips. Orthop Traumatol Surg Res. 2013;99:37–45. https://doi.org/10.1016/j.
    otsr.2012.06.017  ↩
  6. Kakaty DK, Fischer AF, Hosalkar HS, Siebenrock KA, Tannast M. The ischial spine sign: does pelvic tilt and rotation matter? Clin Orthop Relat Res. 2010;468:769–774. https://doi.org/10.1007/s11999–009–1021–5  ↩
  7. Tannast M, Pfannebecker P, Schwab JM, Albers CE, Siebenrock KA, Büchler L. Pelvic morphology differs in rotation and obliquity between developmental dysplasia of the hip and retroversion. Clin Orthop Relat Res. 2012;470:3297–3305. https://doi.org/10.1007/s11999–012–2473–6  ↩
  8. Cibulka MT, et al. Hip Pain and Mobility Deficits – Hip Osteoarthritis: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Assocation. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.doi:10.2519/jospt.2017.0301  ↩
  9. Pua YH, Wrigley TV, Cowan SM, Bennell KL. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rehabil. 2008;89:1146–1154. https://doi.org/10.1016/j.apmr.2007.10.028  ↩
  10. Kim C, Nevitt MC, Niu J, et al. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study. BMJ. 2015;351:h5983. https://doi.org/10.1136/bmj.h5983  ↩
  11. Cibulka MT, et al. Hip Pain and Mobility Deficits – Hip Osteoarthritis: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Assocation. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.doi:10.2519/jospt.2017.0301  ↩
  12. Cibulka MT, et al. Hip Pain and Mobility Deficits – Hip Osteoarthritis: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Assocation. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.doi:10.2519/jospt.2017.0301  ↩
  13. Rozendaal RM, Koes BW, van Osch GJ, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. 2008;148:268277. https://doi.org/10.7326/0003–4819–148–4–200802190–00005  ↩
  14. Rozendaal RM, Uitterlinden EJ, van Osch GJ, et al. Effect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial. Osteoarthritis Cartilage. 2009;17:427–432. https://doi.org/10.1016/j. joca.2008.05.022  ↩
  15. Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network metaanalysis. BMJ. 2010;341:c4675. https://doi.org/10.1136/bmj.c4675  ↩
  16. Lieberman JR, Engstrom SM, Solovyova O, Au C, Grady JJ. Is intra-articular hyaluronic acid effective in treating osteoarthritis of the hip joint? J Arthroplasty. 2015;30:507–511. https://doi.org/10.1016/j.arth.2013.10.019  ↩
  17. Cibulka MT, et al. Hip Pain and Mobility Deficits – Hip Osteoarthritis: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Assocation. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.doi:10.2519/jospt.2017.0301  ↩
  18. Bachmeier CJM, et al. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis and Cartilage. 2001;9:137–146.  ↩
  19. Paans N, van den Akker-Scheek I, Dilling RG, et al. Effect of exercise and weight loss in people who have hip osteoarthritis and are overweight or obese: a prospective cohort study. Phys Ther. 2013;93:137–146. https:// doi.org/10.2522/ptj.20110418  ↩
  20. Brantingham JW, Bonnefin D, Perle SM, et al. Manipulative therapy for lower extremity conditions: update of a literature review. J Manipulative Physiol Ther. 2012;35:127–166. https://doi.org/10.1016/j.jmpt.2012.01.001  ↩
  21. Poulsen E, Hartvigsen J, Christensen HW, Roos EM, Vach W, Overgaard S. Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle threearm parallel group randomized clinical trial. Osteoarthritis Cartilage. 2013;21:1494–1503.https://doi.org/10.1016/j.joca.2013.06.009  ↩
  22. Peter WF, Jansen MJ, Hurkmans EJ, et al. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation. Acta Reumatol Port. 2011;36:268–281  ↩
  23. Krauß I, Steinhilber B, Haupt G, Miller R, Martus P, Janßen P. Exercise therapy in hip osteoarthritis: a randomized controlled trial. Dtsch Arztebl Int. 2014;111:592–599. https://doi.org/10.3238/arztebl.2014.0592  ↩
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