Exercising With "Degenerative Hips" (Hip Osteoarthritis) - Kevin Keti Osteopathy
Kevin Keti Osteopath

Exercising With "Degenerative Hips" (Hip Osteoarthritis): What Actually Helps—and Why

Evidence-based guidance for managing hip pain through movement

Recently, a patient came to see me after being told they had "degenerative changes" in the hip. They left clinic with a label, but no plan. If that sounds familiar, this post is for you. I'll explain why movement is medicine for hip osteoarthritis (hip OA), what kinds of exercise work, and how to start safely even when you're sore.

First, a quick reframe: "degenerative" ≠ doomed. Osteoarthritis is common, especially after 40. X-rays and MRIs often show "wear-and-tear" changes even in people with no pain. More importantly, your symptoms are changeable.

High-quality guidelines in the UK make it clear: exercise is a core treatment for OA—right alongside education and, where appropriate, weight management (NICE, 2022).

What the Research Actually Says

  • Exercise helps pain and function. Systematic reviews focused on hip OA show clinically meaningful improvements in pain and daily function with exercise therapy (Teirlinck et al., 2021).
  • Exercise + education is first-line care. International guidelines consistently recommend exercise, education, and weight management as the most evidence-based starting point for hip/knee OA (Gibbs et al., 2021; Holden et al., 2020).
  • Real-world programs work. Large cohorts completing 8–12 weeks of supervised, neuromuscular exercise and education (e.g., the GLA:D®️ program) report 26–33% pain reductions and better walking and sit-to-stand performance (Roos et al., 2023).
  • Not every trial is positive. A well-designed RCT of a specific physiotherapy package for hip OA found no difference vs. sham—reminding us that content, progression, and adherence matter (Bennell et al., 2016).

Why Exercise Helps a Painful Hip

Stronger muscles = happier joint

Targeted strengthening (glutes, hip abductors/extensors, deep rotators) improves load sharing so each step stresses the joint less (Young et al., 2021).

Better movement = less irritation

Mobility work and practice of functional movements (sit-to-stand, stair climbing) smooth out sticky patterns that can flare symptoms (Young et al., 2021).

Fitness buffers pain

Aerobic activity improves general pain modulation, sleep, and mood—all of which influence how the hip feels day to day (NICE, 2022).

My Simple, Evidence-Informed Starter Plan (8–12 weeks)

These building blocks echo what effective real-world OA programs deliver (Roos et al., 2023):

  • Strength — 2–3 sessions/week, non-consecutive days
  • Mobility — most days, 5–10 minutes
  • Aerobic activity — build to 150–300 min/week total
  • Balance/coordination — 2–3×/week, 3–5 minutes

"But it hurts when I start"— the pain-monitor rule I teach

Some discomfort at first is normal and doesn't mean harm. NICE guidance explicitly advises telling people that pain may rise when starting, but benefits accrue with consistency (NICE, 2022).

Listen to your body, but don't let initial soreness stop you from moving. Gradual progression is key.

Smart Add-ons (used with exercise, not instead of it)

  • Education & behaviour support — combining exercise with education boosts adherence and results (Holden et al., 2020).
  • Weight management if needed — even modest weight loss improves pain and function in OA (NICE, 2022).
  • Manual therapy — can be considered for hip OA only alongside exercise to help short-term comfort and movement (NICE, 2022).

Common Myths

  • "Exercise will grind my joint down." False—exercise improves joint health and function (Young et al., 2021).
  • "If it hurts, I'm making it worse." Not necessarily—early soreness is common and expected (NICE, 2022).
  • "Rest is best." Short rests can help, but long-term rest weakens and stiffens joints (Young et al., 2021).

When to Get Extra Help

  • Night pain that doesn't settle, sudden deterioration, or catching/locking should be assessed (NICE, 2022).
  • If symptoms remain limiting after a solid trial (8–12+ weeks) of care, discuss further options (NICE, 2022).

Bottom Line

Exercise is not an optional extra for "degenerative hips"—it's front-line treatment. The right blend of strengthening, mobility, aerobic work, and education can reduce pain and improve function (NICE, 2022; Teirlinck et al., 2021).

If you're interested in personalised, one-to-one sessions to help you manage hip osteoarthritis safely and effectively, you can book an appointment or contact me directly for tailored advice and support.

References

  • Bennell, K.L., et al. (2016) 'Effectiveness of physiotherapy for hip osteoarthritis: a randomised controlled trial', JAMA, 316(19), pp. 1987–1997.
  • Gibbs, A.J., et al. (2021) 'Systematic review of clinical practice guidelines for hip and knee OA', Osteoarthritis and Cartilage, 29(1), pp. 1–13.
  • Holden, M.A., et al. (2020) 'Recommendations for delivery of therapeutic exercise in knee/hip osteoarthritis', Arthritis Care & Research, 72(11), pp. 1497–1505.
  • National Institute for Health and Care Excellence (NICE) (2022) Osteoarthritis in over 16s: diagnosis and management. NICE guideline [NG226]. Available at: https://www.nice.org.uk/guidance/ng226
  • Roos, E.M., Barton, C.J., Davis, A.M. et al. (2023) 'Immediate outcomes following the GLA:D®️ program for hip and knee osteoarthritis in Denmark, Canada and Australia', Osteoarthritis and Cartilage Open, 5(3): 100345.
  • Teirlinck, C.H., Verhagen, A.P., et al. (2021) 'Effect of exercise therapy in patients with hip osteoarthritis: a systematic review and meta-analysis', BMJ Open, 11(3), e040587.
  • Young, J.J., et al. (2021) 'Exercise Therapy for Knee and Hip Osteoarthritis: A Narrative Review', PM&R, 13(10), pp. 1118–1127.

Ready to Start Your Journey to Better Hip Health?

Book a personalised osteopathy session today and get expert guidance on managing hip osteoarthritis through evidence-based exercise and treatment.

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