Hip Pain: 5 Exercises to Help You Manage

Hip pain occurs in 1 of every 4 women over the age of 50. Pain experienced on the outside of the hip and thigh is commonly caused by irritated tendons or the bursa. The bursa is a fluid-filled sack that acts as a cushion between the bone and surrounding tendons. The gluteus medius tendon is the most common structure involved in people who experience pain on the outside of the hip. Pain is increased when lying on the side, walking, or when climbing stairs.

Steroid injections are commonly used to treat pain originating from the bursa or tendons. This often provides substantial short-term pain relief. Unfortunately, the pain is likely to return. Sometimes pain becomes even more severe than before receiving the injection. Thankfully, the latest research shows exercise is extremely effective in the long-term for treating hip pain caused by an irritated bursa or tendon.

Research Shows Exercise is Effective for Managing Hip Pain

A 2018 study published in the British Journal of Sports Medicine investigated the effects of exercise, corticosteroid injection, or no treatment in people with hip pain. The exercise program was administered by a licensed physical therapist during 14 sessions spread over an 8-week period. After one year, 79% of patients performing the exercise program were a treatment success. Only 58% of the patients who received an injection and 51% of patients who received no treatment were judged to be a treatment success after one year.

Exercise Program Basics for Managing Hip Pain

Exercise is prescribed only after an initial examination is performed by a licensed physical therapist with specialty training in orthopedics.  Initially, exercise is prescribed to target activation of the gluteus medius muscle and tendons. Isometric exercises are ideal in the early stages of rehabilitation. When performed properly these exercises cause little to no pain. Dynamic exercises are integrated next, first in lying positions, and then in standing.

It is important that proper technique is always maintained. Exercises are only progressed when certain goals or milestones have been reached. Gradual progressive loading of the injured tendons and muscles leads to resilience and an optimal long-term outcome. The following 5 exercises are examples of the types of exercises physical therapists prescribe for hip pain.

Isometric Hip Abduction in Lying

Lie on your back, with your knees slightly wider than hip width. Place a pillow under the knees and a belt around your lower thighs. Very slowly and gently start to push your knees apart against the belt, but only enough to just take up the slack in the belt. All the big muscles you can feel around your hips and thighs should remain soft and relaxed. You should be aware of deep gentle tension at the side of your hips. Hold the isometric contraction for 10 seconds and perform 10 repetitions.

2-Leg Bridge

Begin lying on your back with the hips flexed and the feet lined up with the shoulders. Perform the bridge by lifting both hips from the floor. A common mistake is to excessively arch the low back. Be sure to achieve the bridge position by extending through the hips. Hold the bridge position for 2 seconds then return to the starting position. Lower the body back down in a slow and controlled manner. Typically, 2 to 3 sets of 10 to 20 repetitions are performed.

Isometric Hip Abduction in Standing

Stand with your feet slightly wider than your hips. Place your hands on the sides of your hips so you can feel the glute muscles activate. Slowly and gently imagine you are going to slide your legs apart – “Imaginary splits”. Think of a slow buildup of muscle activation, rather than a sudden movement. You should only be aware of deep gentle tension at the side of your hips. All the big muscles around your hips and thighs should remain soft and relaxed. If you are unable to relax your larger muscles, you can start this exercise leaning your back against a wall. Hold the isometric contraction for 10 seconds and perform 10 repetitions.

2-Leg Squat

Stand with your feet hip to shoulder-width apart and your weight equally on both feet. About 2/3 of your weight should be back on the heels. The thighs and buttocks begin relaxed. Next, bend at the hips and knees, translating the hips backward, and the body forward, like when you sit down. Keep your knees facing straight ahead. Keep your back long and relaxed. Your physical therapist will tell you how deep to go – usually, start at 1/3 or ½ of the distance to a chair. Move slowly down, pause briefly, and then return slowly to standing. Focus on pushing through your heels and feeling the tension in your buttocks. Typically, 2 to 3 sets of 8 to 12 repetitions are performed.

Lateral Band Walk

The lateral band walk is performed with an elastic band tied around the ankles standing in an upright position with the feet together. During this exercise, the knees and hips are flexed about 30°. The hands are placed on the hips. Sidestepping is initiated by leading with one leg over a distance slightly wider than shoulder width. It is important to keep the toes pointing straight ahead and the knees over the toes throughout the exercise. Tension should be maintained on the band so the feet do not touch. Three slow steps are performed in one direction followed by 3 steps in the opposite direction. Each cycle constitutes 1 repetition. Typically, 6-8 repetitions are performed each set.

Final Thoughts

Hip pain involving the bursa or tendons can be debilitating. You don’t have to suffer any longer.  These 5 exercises are only a small sample of the types of exercises that can help. Meet with your physical therapist and get started on the road to recovery. Your physical therapist will continually assess your injury and progress your exercise program based on your goals. The objective is to decrease pain and restore function as quickly and safely as possible. Contact us today if you have hip pain or simply have questions about which treatments are right for you.




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