Physical Therapy Exercises for hip pain.
I love helping patients who are struggling with hip pain. Patients can describe hip pain as being diffused around the hip and into the low back or sharp and tender in one specific area. Even if hip pain is localized to one area, it can often be coming from somewhere else. (More on this to come.) Providing clarity, calming concerns, and giving guidance for treatment can give patients a feeling of empowerment over their pain. In this post I share 4 of my favorite physical therapy exercises for reducing hip pain.
What causes hip pain?
Hip pain can be caused by a number of things: labral tears, osteoarthritis, and bursitis, are just a few diagnoses you may have heard. Sometimes pain comes on slowly and for no clear reason. Other times it is caused by a specific incident. While I recommend seeing your doctor and having necessary imaging done as well as seeing a physical therapist for a full functional assessment, these few exercises can reduce hip tightness and increase hip strength. When performed consistently, they can reduce your pain and get you back to moving the way you want.
Physical Therapy Exercise 1: Press Up
If you’ve read my post on back pain, you’ve already seen this exercise. Why am I recommending a back stretch for hip pain? Because what often presents as hip pain is actually referred pain coming from your back. In this research article, patients who had extremity pain (pain anywhere in your arms or legs), were evaluated using a common physical therapy approach. The results revealed that over 40% of patients were actually experiencing a spine injury that caused pain to go into an arm or leg. This is why it is worth addressing your low back when you have hip pain and why we are careful to ask about back pain when you come to physical therapy. Even if your hip pain is not stemming from your back, increasing your spinal mobility will also help your pelvis and hip move better.
How to perform: lay on your belly with your hands positioned under your shoulders. Push up, straightening your elbows, and keeping your hips down as much as possible.
Parameters: perform 10 reps 1x per day to avoid hip pain and 2-3x per day to reduce current hip pain.
Physical Therapy Exercise 2: Hip Flexor Stretch
We do a lot of sitting. Even if you have an active job, you likely have your hips bent slightly for a large portion of the day. Because of this, it’s common to have tightness in your hip flexor muscle group (the muscles in the front of your hip). When your hip flexors are tight, this can pull your pelvis forward and limit the ability of your femur to move in your hip socket. This overall tightness can lead to poor mechanics in the hip and cause pain. Increasing the flexibility of your hip flexor muscles will allow your hip to move more freely.
How to perform: kneel with one knee up and one knee down. Squeeze your glute (butt) muscle really hard on the leg that is down and slowly push your hips forward. You should feel the stretch in the front of your hip on the leg that is down. If you don’t feel it there, keep adjusting until you do.
Parameters: hold for 30 seconds. Perform 1x per day to avoid hip pain and 2-3x per day to reduce current hip pain.
Physical Therapy Exercise 3: Side Leg Raise
This is the first strengthening exercise in our list today. The muscles on the outside of your hip are extremely important. When you shift your weight onto one leg (like you do when you walk or run) your hip muscles keep your pelvis level. If these muscles are weak, you will have increased stress on your hips, low back, knees, and even your feet. However, if these muscles are strong, you will provide an environment where all of these structures are supported well and can function optimally. This can take stress off your hip structures like your labrum, bursae, tendons, and ligaments.
How to perform: lay on your side with your bottom leg bent and your top leg straight. Roll forward slightly like you are rolling onto your stomach. Lift your leg halfway up and back down keeping your toe pointed down. As you perform more reps, you should feel the muscle on the side of your top hip getting tired.
Parameters: perform reps to fatigue 3x per week. If you can do 30 reps before feeling fatigue in the side of your hip, progress to performing hip abduction in a modified side plank like I show in this video.
Physical Therapy Exercise 4: Squat with a Band
Performing a squat with a band at your knees combines hip strengthening with a functional movement. If you’re having pain with daily activities like climbing steps or getting up from sitting, this exercise will strengthen your hip muscles and the muscles needed to perform stair climbing and getting up from sitting. Adding the band to the squat also encourages your hip muscles to “turn on” when performing functional activities.
How to perform: place a band just above your knees. Perform a general squat sitting your hips back, bending your knees, and keeping your trunk mostly upright.
Parameters: perform reps to fatigue 3x per week. If you aren’t using any weight, work up to 30 reps. If you already perform weighted squats regularly, add a medium to firm resistance band above your knees.
Ready to see these exercises in action? Watch me do them below!
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Disclaimer: These exercises are not a substitute for full medical evaluation. You should consult your doctor if you are experiencing any new pain. If any of these exercises sound especially helpful for you, be sure to discuss with your doctor the best way to implement them into your health plan and ask for a referral to a physical therapist for a full musculoskeletal evaluation.