Physical Therapy Exercises for Hip Pain

Stretches and Resistance Exercise for Healthy Hips

Photo of a woman performing a bridge exercise.
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If you have hip pain, you may benefit from physical therapy exercises to help improve your mobility and ease your pain. Working with a physical therapist (PT) can help determine which exercises are best for your specific condition.

Hip pain often causes loss of range of motion, decreased strength and muscle activation around the hip joint, and pain that limits your ability to walk or run normally. Physical therapy exercises for hip pain can improve your strength and mobility and help you return to your normal activities.

There are many different causes of hip pain. These may include:

If your hip pain was caused by significant trauma, you should visit your physician right away to get it checked out; a serious injury like a fracture may be present, and that needs significant medical care.

Hip pain and impairments may manifest in a variety of symptoms. These may include:

  • Pain in your groin
  • Pain in the front of your hip
  • Lateral hip pain
  • Buttock pain
  • Difficulty moving your hip and leg
  • Difficulty walking, running, or climbing stairs
  • Pain when rising from a seated position

When to See a Doctor

If you have any hip pain or limited mobility, you should check in with your physician. They can help diagnose your problem and get you started on the right treatment.

Physical therapy exercises for hip pain is one treatment that may be effective for you. Exercises may include movements to improve flexibility, strength, and balance.

How Stretching Eases Hip Pain

Hip pain often results in tightness in the muscles or capsule around the joint. Your hip is a ball and socket joint, and it should move through flexion, abduction, extension, and rotation. Tightness in the structures around your hip may pinch on muscles, ligaments, or the joint capsule itself, leading to pain. Pinching or compressing nerves near your hip may also cause pain.

Physical therapy stretches for hip pain can help improve the mobility around your joint. This can take pressure off of muscles, ligaments, or nerves, leading to a decrease or elimination of your pain.

Stretching may also ease hip pain by allowing your hip joint to move fully, improving your functional mobility and decreasing compensatory motions that may be a secondary cause of your pain.

When performing stretching exercises for your hip, you should move slowly into each position until you feel a mild pulling sensation around the area to be stretched. Each stretch should be held for about 60 seconds, and then you should slowly move out of the stretch.

A word of warning: stretching too aggressively or bouncing while you stretch may injure the tissues to be stretched. An excessive tug or pull on a muscle may cause damage, leading to more pain and decreased overall mobility. Remember to move slowly and hold each stretch at its end range position for 60 seconds.

If you are feeling pain during flexibility exercises, stop and check in with your PT. Some physical therapy stretches for hip pain can be modified to allow you to safely stretch without pain.

Is Yoga Safe for People With Hip Pain?

A 2016 study found that certain weight-bearing yoga poses may rapidly fatigue hip muscles in people with hip pain, leading to increased pain and impaired movement. Caution should be used when performing yoga stretches for hip pain. Working closely with your healthcare practitioner is advised before starting hip stretches.

How Resistance Exercise Ease Hip Pain

Hip pain may cause a decrease in muscle activation around your hip. Why? Because pain signals your brain to shut things down a bit so it can assess the damage and allow for some healing to take place. Sometimes, getting muscles started back up again is a challenge, and resistance hip exercises are necessary to do.

Strengthening exercises for your hip can help provide the right amount of support around the joint. This can take pressure off ligaments and nerves, decreasing your hip pain. Improving muscle activation around the joint can also improve your overall functional mobility, allowing you to walk or run freely without pain.

There are different type of resistance exercises for your hip. These may include body weight exercises, resistance band exercises, or weight lifting machines and exercises.

Weight training may not be the best choice if you are experiencing acute hip pain, as this may place excessive stress and strain through your joint, leading to more pain or injury. Some people are able to perform weight training machines, like a leg press or hack squat, under the guidance of their PT and when their pain is at a minimal.

Exercises for Hip Pain

Before starting PT exercises for your hip pain, be sure to visit your physician or physical therapist. They can assess your condition and prescribe the best exercises for your specific condition.

Hamstring Stretch

Your hamstrings attach to the pelvis behind your hip and work to bend your knees and extend your hips. Tightness here may cause pain in the back of your hips and limit your ability to move normally. To effectively stretch your hamstrings:

  1. Lie on your back with both knees out straight.
  2. Bend one knee, and place both hands behind your knee.
  3. While holding behind your knee, straighten your knee out all the way.
  4. Hold the straight knee position for 60 seconds.
  5. Repeat three times for each side.

While stretching your hamstrings, you should feel a pull behind your thigh. If you feel pain, stop the stretch and see your PT.

Hip Flexor Stretch

Your hip flexors are located in the front of your hip and thigh and are often tight when you have osteoarthritis or if you sit a lot for work. To stretch your hip flexors:

  1. Place one knee on the floor and have the other foot flat in front of you (as in a genuflected position).
  2. Keep your shoulders and chest up high, tighten your abdominals.
  3. Slide your body forward until you feel a pull in the front of your hip and thigh on the knee that is on the floor.
  4. Hold the position for 60 seconds, and repeat three times for each side.

If your knee on the floor is painful, place a small pillow underneath it to provide a cushion. A slight stretch should be felt in your thigh; intense pain means you're stretching too far. In this case, reduce the amount you slide forward, or stop the stretch and see your PT.

Iliotibial Band Stretch

The iliotibial band is a thick band of fascia that courses from your lateral hip to your lateral knee. It does not contract, but it attaches to muscles that contract. Pain in your iliotibial band may be felt in your lateral hip. To stretch your iliotibial band:

  1. Lie on your side.
  2. The side that you wish to stretch should be on top.
  3. Keep your bottom knee bent for stability, then reach back and grab the ankle of your upper leg and bend your knee. You should feel a pull in the front of your thigh (the quadriceps muscle).
  4. While keeping your knee bent, gently rest the foot of your bottom leg on top of your upper knee. Use your foot on top of your knee to slowly pull your upper knee down towards the floor. You should feel a pulling sensation on the side of your kneecap where the iliotibial band crosses the knee joint.
  5. Hold this position for 60 seconds, and then relax. Repeat this stretch three times.

Piriformis Stretch

Your piriformis muscle is a small, pear-shaped muscle deep in your posterior hip. It resides near the sciatic nerve and often gets tight if you have hip pain due to sciatic nerve irritation. To stretch your piriformis:

  1. Lie on your back with your feet flat and both knees bent.
  2. Cross on leg over the other bent knee, resting your ankle on your thigh just above your knee.
  3. Place your hands under your thigh of the bent knee with your foot flat.
  4. Pull your thigh up towards your chest. You should feel a stretch in the back of your hip near your buttocks of the foot that is crossed on top.
  5. Hold the stretch for 60 seconds, and repeat three times.

If your sciatic nerve is irritated, this stretch may exacerbate it further, causing pain or tingling in your leg. In that case, release the stretch a bit. If pain or tingling persists, see your PT.

Stretching for your hip pain can be done daily. Be sure to see your PT to ensure that you are doing your hip stretches properly.

Physical therapy resistance exercises for your hip pain can be done three to four times each week. The goal of hip strengthening is to improve stability around the joint. This can relieve pressure from nerves and ligaments and can improve mobility of your hips.

Bridge

The bridge exercise strengthens your gluteus and hamstring muscles that support the back of your hips. To perform the bridge:

  1. Lie on your back with both knees bent and feet flat on the floor.
  2. Engage your abdominals.
  3. Slowly lift your buttocks by pressing your heels down into the floor.
  4. Lift your hips up until your body is in a straight line with your knees, hips, and back.
  5. Hold this position for three seconds, and then slowly lower back down.
  6. Perform 10 to 15 repetitions.

Some people with low back pain may have a difficult time performing the bridge and may need to dial back the challenge a bit. A safe alternative may be performing a posterior pelvic tilt. Your PT is a good resource to check in with if the bridge causes pain.

When the bridge becomes easy, you can make it more challenging by performing a single leg bridge:

  1. Lie on your back with knees bent.
  2. Straighten out one knee and hold it in the air prior to lifting your buttocks up off the floor.
  3. Hold the position for three seconds.
  4. Lower down slowly.

Straight Leg Raising

Straight leg raises are simple, yet effective, exercises to strengthen your hip flexors, hip abductors, or gluteus muscles. To properly perform straight leg raises:

  1. Lie on your back with one knee bent and one knee straight.
  2. Tighten your quadriceps muscle on the front of your straight leg and engage your abdominals.
  3. Lift your straight leg up about 12 inches. Hold this position for three seconds.
  4. Lower your leg down slowly and repeat 15 times.

To strengthen your gluteus medius on the side of your hip:

  1. Lie on one side with your top knee straight and your bottom knee bent about 90 degrees.
  2. Tighten your abdominals and lift your top straight leg up about 12 inches.
  3. Hold this position for three seconds, and then slowly lower your straight leg.
  4. Repeat the exercise for 15 reps.

To strengthen your gluteus maximus in the back of your hip perform the straight leg raise on your stomach. Here's how:

  1. Lie face down with both legs out straight.
  2. Engage your abdominals, and slowly lift one straight leg up about 10 inches.
  3. Be sure not to twist your back or pelvis.
  4. Hold the straight leg raise position for three seconds, and then lower slowly.
  5. Repeat 15 repetitions.

Be sure to stop performing the exercises if you feel any pain that lasts after you perform the exercise. You can make the straight leg raising exercises more challenging by placing a small two or three pound cuff weight around your lower leg.

Monster Walking

Monster walking can help improve hip strength in a variety of muscle groups. It also has the added benefit of being a weight bearing exercise. Here is how to perform monster walking:

  1. Obtain a resistance band that is tied in a loop. The loop shoulder be about 12 inches in diameter.
  2. Place the resistance band around your ankles.
  3. Stand upright with both knees straight, engage your abdominals, and step sideways about 15 inches.
  4. Slowly step sideways in the same direction with your other leg. Maintain tension on the band the entire time; control the motion.
  5. Step 15 times in one direction, then step in the opposite direction. The sideways stepping strengthens your gluteus medius muscles on the side of your hips.

To strengthen your gluteus maximus muscles in the back of your hip:

  1. Keep your knees straight, engage your abdominals, and keep your feet shoulder-width apart.
  2. Step backward slowly, taking small, 5- or 6-inch steps.
  3. Repeat 15 times, then walk forward 15 times. Maintain tension on the band the entire time while monster walking.

Hip Hikers

Hip hikers are a great body weight exercise to strengthen your gluteus medius on the lateral aspect of your hips. Here is how you do it:

  1. Stand on a small 8-inch step stool or the bottom step of a set of stairs. Hold onto something stable.
  2. Stand sideways so one leg if hanging off the edge.
  3. While keeping your support leg straight, lower the leg that is hanging off the edge by dropping your pelvis downward. Keep your abs engaged while you do this.
  4. Hold the lowered position for a few seconds, and then slowly raise your pelvis up. You should feel the side of your hip on the stance leg working to do this.
  5. Repeat the exercise 15 times for each leg.

Some people with groin and anterior hip pain from FAI or osteoarthritis may feel a pinching sensation in their inner groin when performing this exercise. If this happens, stop the movement and check in with your PT.

A Word From Verywell

If you have hip pain, you may benefit from working with a PT to help you fully recover. Your therapist will assess your condition and prescribe exercises to help improve your hip mobility and strength. That way, you can be sure to quickly and safely return to your previous level of activity.

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Article Sources
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  2. Adler KL, Kenney R, Messing S, Giordano BD. Activity of periarticular hip musculature during yoga in patients with hip pain: a descriptive study of a case series. J Yoga Phys Ther. 2016;06(04). doi:10.4172/2157-7595.1000259