Practical Ways to Reduce Hip Pain & Improve Post-Surgery Recovery

Hip pain is one of the most common musculoskeletal complaints in active adults over 50 apparently. It often begins gradually — stiffness after long walks, discomfort climbing stairs, difficulty putting on shoes, or a persistent ache at the end of the day. Surgery is not the first step for most. Exercise and education should form the foundation of treatment for hip osteoarthritis before surgery is considered, as recommended by the National Institute for Health and Care Excellence (NICE).

Everybody's hip pain is different and requires early diagnosis and treatment from a physiotherapist before embarking on a group exercise classes.

Common Causes of Hip Pain

Hip pain is not a single diagnosis. It can arise from the joint itself or from surrounding muscles, tendons, or even the lower back.

Osteoarthritis (OA)

The most common cause in later life. Cartilage gradually thins, joint space narrows, and stiffness develops.

Typical symptoms:

• Morning stiffness

• Groin or buttock pain

• Reduced range of motion

• Pain after prolonged walking

Gluteal Tendinopathy

Pain on the outside of the hip is often caused by irritation of the gluteal tendons rather than arthritis.

Common signs:

• Pain lying on one side

• Tenderness over the outer hip

• Discomfort walking long distances

This condition responds particularly well to targeted strengthening.

Hip Impingement or Labral Irritation

Often causes deep groin pain, especially with twisting or pivoting movements. More common in active individuals.

Referred Pain from the Lumbar Spine

Lower back stiffness or nerve irritation can mimic hip joint pain. Differentiating this is important for correct treatment.

Advanced Osteoarthritis

Exercise is highly effective for most mechanical hip pain. However, it is not a cure for every condition.

When there is:

• Severe loss of joint space

• Constant night pain

• Marked restriction in movement

• Major impact on quality of life

Exercise may improve strength and resilience but may not eliminate pain. Hip replacement surgery can be transformative in these cases.

Hip Fractures or Stress Fractures

These require urgent medical management. Sudden severe pain after a fall or inability to weight bear requires immediate assessment.

Inflammatory Arthritis

Conditions such as rheumatoid arthritis require medical treatment to control inflammation. Exercise supports function but cannot control the underlying immune process.

Infection (Septic Arthritis)

Rare but serious. Symptoms may include fever, severe pain, swelling, and inability to move the joint. This is a medical emergency.

Significant Structural Abnormalities

Severe hip dysplasia or mechanical locking from major labral tears may require surgical opinion.

How to Treat Hip Pain

This is a treatment pathway from conservative measures you can take starting today to surgical intervention. Everybody has different needs so always consult a medical practitioner first.

Exercise

Strong evidence supports structured strengthening for hip osteoarthritis. No single exercise type is clearly superior — consistency and progression are what matter most.

Benefits:

• Reduced pain

• Improved walking capacity

• Better balance

• Enhanced confidence in movement

Physiotherapy

Individual assessment identifies:

• Muscle weakness

• Movement compensation

• Load intolerance

• Joint stiffness

Tailored rehabilitation is often more effective than generic exercise.

Weight Management

Reducing excess joint load can significantly improve symptoms when relevant.

Pain Relief or Injections

Used to reduce flare-ups and facilitate participation in rehabilitation.

Hip Replacement Surgery

Highly effective when pain is persistent, severe, and limiting daily life despite comprehensive conservative management. Importantly, going into surgery stronger improves recovery outcomes.

Where Does Pilates Fit In?

Pilates is not a cure for osteoarthritis. However, it is an effective method of delivering targeted strengthening and movement control — both of which are strongly supported by research as first-line treatment for hip osteoarthritis.

Pilates focuses on:

• Gluteal strength

• Core stability

• Pelvic control

• Controlled mobility

• Movement quality

These elements improve how force travels through the hip during walking and daily activities. What really matters is progressive strengthening, correct technique and regular participation.

What Does the Evidence Say?

Systematic reviews of exercise therapy for hip osteoarthritis show consistent improvements in:

• Pain levels

• Physical function

• Walking tolerance

• Balance

4 Pilates Exercises for Healthy Hips

These exercises are performed between 2-3 times a week, with mild and manageable discomfort only.

1. Shoulder Bridge (Pic 1) - Strengthens hip extensors, reduces joint stress

2. Clam (Pic 2) - Gluteus Medius strength, walking stability

   Avoid if you have pain in the side of your hip as it will only aggravate it. Standing hip abduction will activate the same muscles.

3. Swimming (Pic 3) - improves hip-core coordination

4. Standing Hip Abduction (Pic 4)- functional strengthening in standing

In Summary

Exercise -including Pilates-based strengthening is strongly supported as first-line management of hip pain. It may reduce pain, improve walking tolerance and enhance balance. As long as pain is primarily due to muscle weakness, movement compensation or moderate oseoarthritis, structured strengthening like Pilates can significantly improve symptoms.

If you'd like to find out more about my hip-themed pilates classes coming up in April and to book, click here. If you're not local to Goring, you can follow the same course in your own time with my pre-recorded videos online here.