Strengthening the muscles around your hip is one of the most effective ways to reduce hip pain, regardless of the underlying cause. A meta-analysis of nine trials found that exercise programs produced a statistically significant reduction in hip pain scores, with strengthening-focused routines showing the strongest benefit. The key is matching the right type of exercise to your current pain level and building up gradually.
Why Exercise Helps Hip Pain
Your hip joint relies on surrounding muscles for stability, shock absorption, and proper alignment. When those muscles are weak or tight, the joint itself takes on more stress with every step. Exercise works on two fronts: strengthening muscles so they absorb more force before it reaches the joint, and improving flexibility so the joint moves through its full range without compensation patterns that create new pain.
The initial goal is calming irritation and inflammation while preventing the stiffness and muscle loss that come from avoiding movement. Once that baseline is established, the focus shifts to rebuilding strength and restoring symmetrical range of motion. Current clinical guidelines recommend individualized exercise programs performed one to five times per week, with sessions lasting 30 to 120 minutes, over a period of 5 to 16 weeks.
Gluteal Strengthening Exercises
The gluteus medius is a critical stabilizer of the hip and pelvis. It prevents your pelvis from dropping to one side when you stand on a single leg, controls inward rotation of the thigh bone, and supports the hip and knee during walking and running. Weakness here is linked to altered movement patterns and increased injury risk.
For people just starting out or dealing with significant pain, these lower-load exercises target the gluteus medius effectively:
- Clamshells: Lie on your side with knees bent and feet together. Open your top knee like a clamshell while keeping your feet stacked. This preferentially activates the gluteus medius over other hip muscles.
- Side-lying leg raises: Lie on your side with your bottom knee bent for stability. Lift your top leg straight up, keeping your toes pointed forward, not toward the ceiling.
- Glute bridges: Lie on your back with knees bent, feet flat on the floor. Press through your heels to lift your hips. A single-leg version increases demand on the gluteus medius of the stance leg.
- Sidesteps with a resistance band: Place a band around your ankles or just above your knees and take controlled steps sideways, keeping tension in the band throughout.
As strength improves, single-leg exercises like lunges and single-leg squats demand greater gluteus medius activation because the muscle has to stabilize the pelvis without help from the other leg. Forward lunges with a weight held in the opposite hand produce more gluteus medius activity than quadriceps or hamstring activity, making them a surprisingly effective hip exercise. Pairing lunges with clamshells or glute bridges in the same workout helps ensure balanced activation.
Exercises for Hip Bursitis and Tendon Pain
Greater trochanteric pain syndrome, the clinical term covering hip bursitis and tendon problems on the outside of the hip, requires a more cautious progression. When pain is high, the goal is to load the tendons gently without aggravating them.
Start with isometric contractions: pushing against resistance without actually moving the joint. For example, lying on your back with a resistance band around your ankles and pressing outward (hip abduction) without letting your legs move. Begin in gravity-eliminated positions (lying down) and progress to against-gravity positions (standing) as pain allows. These isometric holds build tendon tolerance without the repetitive friction that worsens bursitis.
Once pain settles into a lower range, you can progress to full-motion strengthening that includes both the lifting and lowering phases. Eccentric strengthening, where you focus on slowly controlling the lowering portion of a movement, is particularly effective for tendon recovery. Standing on one leg at the edge of a step and slowly lowering the opposite hip, then using both legs to return to the start position, is one common approach. The goal at this stage is returning to single-leg functional activities and eventually sport-specific movements.
Hip Flexor Stretches
Tight hip flexors, the muscles along the front of your upper thigh that pull your knee toward your chest, are a common contributor to anterior hip pain. Sitting for long periods shortens these muscles over time, and they can pull the pelvis into a forward tilt that compresses the front of the hip joint.
The half-kneeling hip flexor stretch is one of the most effective options. Kneel with one foot flat on the floor in front of you, knee at 90 degrees. Tuck your pelvis by squeezing your glutes on the kneeling side, then shift your weight forward until you feel a stretch through the front of the back thigh and groin. Keep your back straight. For a deeper stretch, reach the arm on the kneeling side up overhead and slightly across your body. Hold for 30 seconds on each side, repeat for three sets, and aim for at least twice a day.
A supine version works well if kneeling is uncomfortable. Lie on your back at the edge of a bed with both legs extended. Pull one knee toward your chest while letting the other leg hang off the edge of the bed. The weight of the hanging leg creates a gentle stretch through the hip flexors without requiring you to balance.
Water-Based Exercise
Aquatic exercise removes much of the gravitational load on your hip while still providing resistance for muscle strengthening. Water’s natural buoyancy takes pressure off bones, joints, and muscles, making it a practical option when land-based exercise is too painful. Walking in chest-deep water, performing leg movements while holding the pool edge, and swimming all build hip strength and improve range of motion with significantly less joint stress.
Research consistently includes aquatic therapy among effective approaches for hip osteoarthritis. Pool-based routines involving walking, step exercises, and hip movements in multiple directions can serve as a bridge to land-based strengthening for people with high pain levels. Water temperature also matters: warm water (around 83 to 88°F) helps relax muscles and reduce stiffness during the session.
Low-Impact Aerobic Options
Aerobic conditioning matters for hip pain because it improves blood flow to the joint, helps manage body weight (which directly affects joint loading), and reduces the systemic inflammation that worsens osteoarthritis. Stationary cycling and elliptical machines are two of the best land-based options because they move the hip through a large range of motion with minimal impact. Cycling also gently pumps synovial fluid through the joint, which nourishes cartilage that has no blood supply of its own.
Tai chi, though often overlooked, has been studied as an exercise intervention for hip osteoarthritis and combines gentle movement with balance training. The slow, controlled weight shifts strengthen the hip stabilizers while improving proprioception, your body’s awareness of where the joint is in space.
Exercises and Activities to Avoid
Running generates forces up to three times your body weight with each foot strike, making it one of the worst choices for an already painful hip. Jumping creates similar impact loads. Sports involving sudden starts, stops, and direction changes, like singles tennis, soccer, and hockey, place high rotational and shear stress on the hip joint.
Exercising on uneven surfaces, such as rocky trails or sand, forces constant hip adjustments that can flare pain. Heavy squats and leg presses load the hip joint under compression and should be avoided or significantly modified during active pain. Prolonged standing without breaks also increases joint stress, even though it doesn’t feel like “exercise.”
Warning Signs to Watch For
Most hip pain responds well to a gradual exercise program, but certain symptoms suggest something beyond a typical muscle or joint issue. Hip pain accompanied by fever, unexplained weight loss, burning with urination, or pain that wakes you at night warrants prompt medical evaluation. A history of cancer, particularly prostate, breast, or reproductive cancers, is relevant because these can spread to bone in the hip region. Pain following a significant trauma, or hip pain in someone who has used corticosteroids for an extended period, also calls for imaging before starting an exercise program.