Can Physical Therapy Help Hip Arthritis? What Treatment Can—and Cannot—Do

Hip arthritis can make everyday movements feel much harder than they should. Getting out of a chair, putting on shoes, walking uphill, exercising, and even sleeping can become painful. Once arthritis appears on an X-ray, many people assume the only options are to live with it or schedule a hip replacement.

That is not always the case.

Physical therapy cannot remove arthritis or regrow the cartilage in your hip. It can, however, improve the way your hip and the rest of your body move, increase the amount of activity your hip can tolerate, and reduce the effect arthritis has on your life. Current clinical guidelines recommend exercise-based physical therapy as a central treatment for hip osteoarthritis.

What Does Hip Arthritis Feel Like?

Hip osteoarthritis commonly causes:

  • Pain in the groin, front of the thigh, buttock, or occasionally the knee

  • Stiffness after sitting or first thing in the morning

  • Difficulty putting on socks and shoes

  • Pain getting in and out of a car

  • Reduced walking tolerance

  • Difficulty with stairs, squatting, or standing from a low chair

  • Loss of hip rotation or extension

  • A limp or change in the way you walk

An X-ray can confirm structural changes in the joint, but the image does not tell the whole story. Some people have significant arthritis on imaging with relatively little pain, while others are very limited. Treatment should be based on your symptoms, mobility, strength, and goals—not the X-ray alone.

Can Physical Therapy Actually Reduce Hip Arthritis Pain?

Yes. Research shows that exercise therapy can improve pain and function in people with hip osteoarthritis. The goal is not to “fix” the X-ray. The goal is to make your hip and the surrounding system stronger, more mobile, and better able to handle the activities that matter to you.

The most effective program is usually more than a generic sheet of stretches. It should address the specific limitations that are making your hip painful and then progressively build your capacity.

How We Progress Physical Therapy for Hip Arthritis

1. Reduce Pain and Irritability

We first identify what your hip currently tolerates. You may not need to stop exercising, but you may need to temporarily change your walking volume, workout selection, stride length, sitting position, or the depth of certain movements.

Hands-on treatment may help reduce pain and stiffness in the short term. It can be useful, but it should support an active program rather than replace one.

2. Restore Useful Range of Motion

Hip arthritis often limits extension and rotation. The lower back, pelvis, knee, and ankle may then compensate.

We work to improve the motion that is both available and useful without repeatedly forcing an irritated joint. We also address surrounding joints when their limitations are increasing the demand on the hip.

3. Improve Control and Coordination

Pain can change the way you walk, climb stairs, balance, and transfer your weight from one leg to the other. Before simply adding heavier exercises, we improve how you control the pelvis and hip during these movements.

4. Build Hip and Leg Strength

Strengthening is one of the most important parts of treatment. Depending on your evaluation, this may include the gluteal muscles, hip rotators, quadriceps, hamstrings, calves, and trunk.

The correct starting point is different for everyone. A person with an easily irritated hip may begin with supported or shorter-range exercises. Someone who wants to return to tennis, golf, hiking, or strength training will eventually need substantially more loading.

5. Strengthen Functional Patterns

Once isolated strength improves, we progress the movements that affect daily life:

  • Squatting and getting out of a chair

  • Step-ups and stair climbing

  • Single-leg balance

  • Lifting and carrying

  • Walking uphill and downhill

  • Getting down to and up from the floor

At Summit Physical Therapy, we can use VALD strength testing to objectively measure force production and compare one side with the other. This helps us find deficits that may not be obvious by watching you move and gives us measurable targets for your program.

6. Develop Power and Balance

Strength tells us how much force you can produce. Power tells us how quickly you can produce it. That matters when catching your balance, climbing stairs efficiently, reacting to a misstep, or returning to athletics.

For appropriate patients, treatment should progress beyond slow strengthening to faster sit-to-stands, step variations, resisted movements, and other safe power-based exercises.

7. Reintroduce Impact and Change of Direction When Appropriate

Not everyone with hip arthritis needs to run or jump. But people who want to play tennis, pickleball, golf, ski, or return to recreational sports need preparation for faster loading and changes of direction.

We can use VALD ForceDecks to assess force production, balance, and side-to-side differences. The decision to progress should be based on symptoms, strength, movement quality, and objective testing—not age or an X-ray alone.

8. Improve Endurance and Durability

Many people feel better during a few exercises but still hurt after a long walk, a full day on their feet, or several active days in a row. That is a capacity problem.

We gradually increase walking, cycling, strength-training, and activity volume so your improvement holds up in real life.

9. Return to the Activities That Matter to You

The final goal is not merely to complete clinic exercises. It may be walking through New York City, playing 18 holes, lifting at the gym, keeping up with grandchildren, returning to tennis, or delaying hip replacement while staying active.

Your program should prepare you for that specific goal.

Does Exercise Wear Out an Arthritic Hip Faster?

Appropriately dosed exercise does not simply “wear away” the hip. Inactivity often leads to more weakness, poorer conditioning, and less tolerance for activity. The key is matching the type and amount of exercise to the current irritability of the joint, then progressing it over time.

A temporary, mild increase in symptoms does not automatically mean you caused damage. Pain that continues to escalate, significantly changes your walking, disrupts sleep, or remains elevated after exercise may mean the program needs to be adjusted.

Can Physical Therapy Help Delay or Avoid Hip Replacement?

For some people, yes. If pain and functional limitations improve enough, surgery may no longer feel necessary or may be delayed.

Physical therapy will not help every person avoid a hip replacement. Surgery may be appropriate when pain remains severe, function continues to decline, sleep is consistently disrupted, and a well-designed conservative program has not provided acceptable improvement.

Physical therapy is still valuable if surgery becomes the right decision. Improving strength, mobility, and conditioning beforehand can make the early recovery process easier and gives you a clearer plan for rehabilitation afterward.

How Long Does Physical Therapy for Hip Arthritis Take?

Some people notice an early change in pain or mobility within a few weeks. Meaningful strength and capacity improvements usually take longer. Research supports exercise programs carried out over several months rather than expecting a permanent change from a few visits or passive treatment alone.

Your timeline depends on:

  • How irritable the hip is

  • How long symptoms have been present

  • Your current strength and mobility

  • Other back, knee, or balance limitations

  • Your goals and activity level

  • How consistently the program can be progressed

When Should Hip Pain Be Evaluated More Urgently?

Seek medical evaluation promptly for hip pain after a significant fall or injury, inability to bear weight, fever or illness with a hot and painful joint, rapidly worsening symptoms, unexplained weight loss, or severe unrelenting night pain. Physical therapists can also help determine whether symptoms are more likely coming from the hip joint, lower back, tendon, or another condition.

Physical Therapy for Hip Arthritis Near Summit, NJ

At Summit Physical Therapy, we build hip arthritis rehabilitation around what you want to return to—not just what appears on an X-ray. Treatment progresses from pain and mobility work to objective strength testing, functional training, power, balance, and the endurance required for real life.

We serve patients from Summit, Short Hills, Millburn, Maplewood, Chatham, Florham Park, New Providence, Springfield, and South Orange.

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References

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