hip osteoarthritis

Hip osteoarthritis: Avoid surgery (exercises)

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine 

Hip osteoarthritis can make daily activities difficult, such as bending over to tie shoelaces, getting up from a chair, or taking a short walk.


How do we know if our pain comes from osteoarthritis of the hip? What are the causes and symptoms of this condition? Can we do sports? And above all, how to treat it?


This popular article explains everything you need to know about hip osteoarthritis, emphasizing simple concepts and concrete strategies to get better.

Definition and anatomy of the hip


Before going into details, it is important to understand the anatomy of the hip to better understand where osteoarthritis of this joint comes from.


The hip is one of the largest joints in the body. It connects the pelvic bone (via a cavity called the acetabulum) and the femoral head (the upper part of the thigh bone).


hip anatomy


The bony surfaces of the femoral head and acetabulum are covered with articular cartilage, a substance that allows shock absorption and movement.


The surface of the joint is also covered with a thin membrane called synovia. In a healthy hip, the synovium produces a small amount of sufficient fluid that lubricates the cartilage and facilitates movement.


In some situations, the cartilage in the hip joint gradually cracks and wears away. Consequently, its damping capacity is reduced. The joint space between the bones decreases, which can cause the bones of the pelvis and the femur to rub against each other.


This phenomenon corresponds to osteoarthritis of the hip. To compensate for the loss of cartilage, damaged bones may begin to form bony prominences (called osteophytes). This can cause inflammation and pain.


hip osteoarthritis pain


This diagnosis (as well as the presence of osteophytes) can be made with a simple x-ray of the hip.


On the other hand, it should be emphasized that the presence of degeneracy alone is not necessarily problematic. The same is true for the presence of osteophytes. This is because many asymptomatic people (having no pain) sometimes have these changesmedical imaging.


In short, it is the combination of imaging tests associated with the clinical examination by a health professional that will tell more about your hip osteoarthritis, as well as its optimal management.



What are the causes of osteoarthritis of the hip?


The degeneration of the hip joint can come from different causes. Among the most studied are:


  • Overweight or obesity: From a theoretical point of view, excess weight increases the stress on the joints, which can lead to osteoarthritis. However, studies on the subject vary.
  • An overload of the joints by the frequent carrying of heavy loads.
  • Age: it is possible to see osteoarthritis of the hip rather in people approaching 60 years of age. But some rarer cases are also younger.
  • Family history of osteoarthritis: If someone you know has already had osteoarthritis, you will be more likely to suffer from it later on as well.
  • Un history of injury at the hip
  • A deformity of the hip joint at birth (hip dysplasia)
  • Sex : it is more often women who are affected by osteoarthritis.


elderly person with osteoarthritis of the hip



What are the symptoms of osteoarthritis of the hip?


In the presence of osteoarthritis of the hip, several symptoms may appear. Here is a list of symptoms often observed:


  • You will often feel a pain in the fold of the groin. The latter could be felt both towards the front and the inner thigh.
  • You may also feel a buttock pain that radiates all over the back of your thigh, like a sciatica.
  • You may feel a knee pain or isolated pain in the back of your thigh. It should also be taken into account that the pain does not wake up at night, except in cases of severe hip osteoarthritis.
  • The pain could increase when you exert yourself : whether walking, running, climbing or descending stairs. Note also that the latter generally disappears with rest.
  • Upon awakening, it is possible to feel a feeling of stiffness at the joint.
  • If the pain is too great and does not go away, it can cause lameness
  • In the presence of wet or rainy weather, many people say they feel more pain. Strangely, this has not been scientifically proven.
  • There may be a locking sensation ou blockage of the joint. Also, noises of the type squeak ou crackle may be heard during certain movements.
  • A decreased range of motion of the hip is often observed.


morning stiffness from osteoarthritis of the hip


Note that at certain advanced stages, the person may have pain in the hip or at rest, or during all movements.



How long does an attack of osteoarthritis of the hip last?


In the early stages, osteoarthritis of the hip often occurs in attacks. Here is what we can remember about attacks of osteoarthritis of the hip:


  • At the beginning, the pains are aggravated mainly after a vigorous effort, and are relieved by rest within a few hours.
  • Over time, the pain occurs following low intensity activities, and takes longer to subside (a few days).
  • At certain advanced stages of the disease, the person may have pain in the hip or at rest, or during all movements. Crises are therefore almost permanent.


acute attack of osteoarthritis of the hip



Hip osteoarthritis and sport


Have you always been athletic? Do you have hip osteoarthritis and don't really know how to exercise?


We will provide you with the necessary information so that you can practice physical activity despite your hip osteoarthritis.


How to exercise when you have hip osteoarthritis?


Despite the presence of osteoarthritis of the hip, it is recommended to continue physical activity. Indeed, prolonged inactivity comes with several negative consequences for the health of your joints (and your overall health).


prolonged rest vs hip osteoarthritis
As with low back pain, inactivity can make hip osteoarthritis worse.


On the other hand, we must keep in mind certain premises that allow us to play sports without aggravating our condition, or generating pain that would limit daily activities.


Before giving you a list of sports that could help treat your hip osteoarthritis, we must remember the following rule of thumb. To explain it better, let's use the analogy of traffic lights:


  • If the pain is unchanged after physical exertion (or even relieved), we continue because we are on the right track! (GREEN LIGHT).
  • If the pain increases after exertion, but subsides within 24-48 hours, there is nothing to worry about. The parameters can be adjusted, but it is generally a sign that the joint is adapting favorably to the effort. (YELLOW LIGHT).
  • If the pain increases and remains aggravated despite a rest period, this is a sign that an inflammatory process has been created. You must stop the activity, let the hip rest and lower the training parameters at all costs for subsequent sessions. (RED FIRE).



What type of sport to practice?


You don't really know what sport to practice with your hip osteoarthritis? Don't panic, we will give you all the necessary information so that you can easily find your way around.


Here is a list of activities that theoretically put less stress on the joints. Obviously, we will have to keep in mind the analogy of traffic lights, and adjust the effort as needed:


  • Cycling.
  • Swimming.
  • Walking on a soft surface (grass, track, etc.).
  • Gentle gymnastics.
  • The yoga.
  • Tai Chi.
  • Rowing.


If you practice a sport that puts pressure on the hip, it will be necessary to resume gradually by following the precepts indicated on the following infographic :


progression in sports hip osteoarthritis
As with low back pain, hip osteoarthritis requires a gradual return to sports activities.


Hip osteoarthritis treatment 


Here is a list of treatments to consider when suffering from osteoarthritis of the hip:


What medical treatments for osteoarthritis of the hip?


When consulting a doctor, here are some treatments to treat osteoarthritis of the hip:


  • Analgesic drugs: the drug used immediately is often acetaminophen. It will be effective especially if you suffer from mild osteoarthritis. Taking anti-inflammatory drugs can also be considered. However, if you are at an advanced stage of osteoarthritis, stronger medications will be needed.
  • When conservative treatments do not offer results, infiltrations are generally resorted to. Indeed, your doctor may prescribe corticosteroid injections or hyaluronic acid infiltrations in the hip to try to calm the pain.


Physiotherapy treatment for hip osteoarthritis


It is not uncommon for the doctor to offer kinesitherapy (physiotherapy) treatments to rehabilitate hip osteoarthritis. The terms and objectives will be:


  • Reduce muscle pain and tension through various types of massage
  • Relief of symptoms through ice, heat, or electrotherapy modalities.
  • Maintain or partially recover the range of motion of joints affected by osteoarthritis by mobilizations and stretching.
  • Strengthen muscles through exercises to stabilize joints, limit deformities, and regain function.


Exercises to relieve osteoarthritis of the hip


As with sports, practicing therapeutic exercises can help tone and loosen the muscles around the hip joint. This will help relieve symptoms over the long term, and slow down the degeneration process.


Here are exercises regularly prescribed in physiotherapy (physiotherapy) to treat hip conditions:


Hip extension (quadruped position)


  1. Position yourself on all fours (hands under shoulders, knees under hips).
  2. Then find the neutral position corresponding to the position of the pelvis halfway between the anteversion and the posteroversion of the pelvis.
  3. In this position, extend one leg back, making sure to point the foot as far behind as possible.
  4. Slowly return to the starting position, and repeat with the other leg.
  5. Repeat these movements for ten repetitions per leg.


hip extension


One-sided bridge


  1. Lie on your back
  2. Extend the non-painful leg so that the knee is straight and maintain full extension.
  3. Raise the buttocks off the ground by pushing off with the heels of the affected leg.
  4. Slowly lower back to the starting position.
  5. Do these movements for about twenty repetitions. Take breaks as needed.


one-sided bridge


Lumbar twist


  1. Lie on your back with your legs straight.
  2. In a twisting motion, extend one arm to the side and bring the leg to the opposite side.
  3. Using the other arm, add extra pressure at the thigh to increase the level of twisting stretch as tolerated.
  4. Hold the stretch for about 30 seconds and do 3 sets.


lumbar twist


Piriformis stretch


  1. Lie on your back.
  2. Cross the symptomatic leg so that the heel rests on the opposite leg.
  3. Pull the non-symptomatic leg towards you. At this point, you should feel a stretching sensation behind the symptomatic buttock.
  4. Hold the stretch for 30 seconds, then repeat 3 times, taking breaks between each set


piriformis stretch


Natural treatments


Several natural treatments exist to relieve the symptoms related to osteoarthritis of the hip:


  • Many people use dietary supplements. The most commonly used are glucosamine and chondroitin. These are available over the counter.
  • Herbal medicine can also be a good idea to fight hip osteoarthritis naturally.
  • Aromatherapy and homeopathy are two elements that many consider.


It should be noted that the natural products are generally not supported by solid scientific evidence, and that their use is mainly based on empiricism.


The hip operation


The last solution that can be considered when conservative treatments do not work is surgery. A hip prosthesis makes it possible to "replace" the hip joint in order to no longer suffer from osteoarthritis.


hip prosthesis following osteoarthritis of the hip


Several types of prostheses exist, and the indications vary according to the patient and his condition. An orthopedic surgeon is best qualified to determine if the operation is justifiable, as well as the modalities to optimize recovery.





The hip pain can really be disabling. A diagnosis made by medical imaging – in conjunction with a clinical examination – makes it possible to determine whether the symptoms come from osteoarthritis of the hip.


Once the diagnosis is established, the management will depend on the symptoms observed, the functional limitation, the age, as well as the work of the affected person.


Treatment modalities vary from kinesitherapy (physiotherapy) to surgery, drugs, infiltrations, exercises, etc.


A health professional is the best able to follow you in your rehabilitation, and can guide you if you practice sports or leisure activities.


Good recovery !

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