Hip Arthritis: Exercise, Pain, and What Helps

By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published November 2026

It starts as a deep ache in the groin or the front of the hip. Putting on socks gets harder, getting out of the car takes effort, and the first few steps in the morning feel stiff. By the end of a long walk or a day on your feet, your hip is sore.

Hip arthritis is common, especially after age 50, and it can make everyday movement frustrating. The good news is that exercise is one of the most strongly supported treatments. This article explains what hip arthritis is, its common signs, what research says about exercise and hands-on treatment, what a PT plan looks like, and when to see a physician.

The short answer

Hip osteoarthritis is a gradual change in the joint's cartilage and bone that often causes groin or hip pain, stiffness, and trouble with movements like putting on shoes or getting out of a car. The APTA's 2025 hip osteoarthritis guideline gives its top grade to individualized strengthening and mobility exercise, often 1 to 5 sessions a week for 5 to 16 weeks, and to hands-on hip mobilization (guideline summary; Koc et al., JOSPT 2025). The American College of Rheumatology also strongly recommends exercise for hip arthritis (Kolasinski et al., 2020). Sudden severe hip pain, pain after a fall, or not being able to bear weight needs prompt medical care. In California, you can see a physical therapist without a referral.

What is hip arthritis?

The hip is a ball-and-socket joint. Smooth cartilage covers the ball at the top of the thighbone and the socket in the pelvis. In osteoarthritis, that cartilage gradually changes and thins, and the bone underneath changes too. The joint can become stiffer and more sensitive.

Things linked to hip arthritis include age, previous hip injury, the shape of the hip joint, family history, and higher body weight. Arthritis isn't just "wear and tear." Movement and strength are important for keeping the joint healthy.

What are the signs of hip arthritis?

Common signs include:

• Pain in the groin, front of the hip, or sometimes the thigh or knee
• Morning stiffness that usually eases within an hour
• Trouble putting on socks or shoes, or getting in and out of a car
• Pain after long walks or standing
• Reduced hip motion, especially turning the leg inward
• Limping after activity

The 2025 guideline describes typical findings as hip pain in adults over 50, morning stiffness lasting less than an hour, and painful, limited inward rotation of the hip (guideline summary).

Pain on the outer side of the hip is often a different problem, usually involving the tendons there. Read our post on outer hip pain to learn more.

Does exercise help hip arthritis?

Yes. Exercise is a core treatment for hip arthritis:

• The 2025 APTA guideline gives its strongest grade to individualized strengthening and mobility programs, with sessions 1 to 5 times a week for 5 to 16 weeks (guideline summary).
• Water-based exercise is also described as effective, which can help if land-based exercise is painful (guideline summary).
• The American College of Rheumatology strongly recommends exercise for people with hip arthritis (Kolasinski et al., 2020).

Some soreness during exercise is common and usually okay if it settles within a day. Starting at the right level and progressing gradually makes a big difference.

What else helps?

• Hands-on treatment: the 2025 guideline also gives a top grade to hip joint mobilization, which can help with pain and range of motion (guideline summary).
• Education: learning how to pace activity, unload the joint, and keep moving (guideline summary).
• Weight management: for people with higher body weight, modest weight loss can help, ideally with support from a physician or dietitian (guideline summary).
• A cane, when needed: used in the hand opposite the sore hip, it can reduce load while walking.
• Staying active: walking, cycling, and swimming are often well tolerated.

Questions about medication, injections, or hip replacement are best directed to your physician or orthopedic surgeon.

How can physical therapy help?

A physical therapy evaluation may include:

• Where the pain is and which activities bring it on
• Hip motion, including rotation, compared with the other side
• Strength of the hip, thigh, and core muscles
• Walking, stairs, sit-to-stand, and balance
• Screening for signs that need a physician's evaluation

A typical plan may include:

• Progressive strengthening for the hip and thigh muscles
• Mobility exercises and hands-on hip mobilization
• Walking, balance, and stair training
• Guidance on pacing activity and managing flare-ups
• A home program you can keep doing on your own

Physical therapy doesn't guarantee a specific result or timeline. If you're considering or recovering from hip replacement, physical therapy can also help you prepare and recover, following your surgeon's protocol.

At Nova Physical Therapy in North Hollywood, hip pain and arthritis are among the conditions we treat, and every plan starts with an evaluation so treatment fits what we find.

When should I see a doctor?

Get prompt medical care if you have:

• Hip or groin pain after a fall, especially if you can't put weight on the leg
• Sudden, severe hip pain
• A hot, red, swollen joint, fever, or feeling unwell
• Pain at night or at rest that keeps getting worse
• Unexplained weight loss or a history of cancer
• Numbness, tingling, or weakness in the leg
• Morning stiffness that lasts much longer than an hour, or pain in several joints

We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.

Do I need a referral for physical therapy in California?

Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage or see our insurance page.

Frequently asked questions

What does hip arthritis pain feel like?
Often a deep ache in the groin or front of the hip, sometimes spreading to the thigh or knee, with stiffness in the morning or after sitting.

Is walking good for hip arthritis?
Usually, yes. Walking at a comfortable pace and distance helps many people. If walking flares your hip, shorter walks, a cane, or cycling and swimming can help while you build strength.

What exercises are best for hip arthritis?
Strengthening and mobility exercises have the strongest support. A physical therapist can choose exercises that fit your hip, starting level, and goals.

Can physical therapy help me avoid hip replacement?
Physical therapy can reduce pain and improve function for many people, but it can't promise to prevent surgery. Decisions about hip replacement are made with your orthopedic surgeon.

Is it normal for my hip to hurt during exercise?
Mild discomfort that settles within about a day is common. Sharp pain or pain that keeps building means the exercise should be adjusted.

How long does physical therapy take for hip arthritis?
Programs in research often run 5 to 16 weeks. Many people notice gradual improvement over several weeks of consistent exercise.

Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.

About Nova Physical Therapy

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from back and neck pain, sports injuries, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.

Schedule an evaluation

If hip pain or stiffness is limiting your walks, workouts, or everyday tasks, an evaluation can help you build a plan to move with less pain.

Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online

Disclaimer

This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Hip and groin pain have many causes, and only an in-person evaluation can determine what is right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.

References

1. Koc et al. Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2025. J Orthop Sports Phys Ther.2025;55(11). Link
2. Physiotutors. Hip osteoarthritis: the new 2025 clinical practice guideline for physiotherapists (summary). Link
3. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020;72(2):149–162. Link