Hip Osteoarthritis | Home Physiotherapy | Physio to Home

Hip osteoarthritis is one of the leading causes of pain and disability in older Australians — and physiotherapy is its most evidence-supported non-surgical treatment. North Tasmania's home physiotherapist explains what works and why.

Hip osteoarthritis is one of the leading causes of pain and disability in older Australians — and physiotherapy is its most evidence-supported non-surgical treatment. North Tasmania's home physiotherapist explains what works and why.

Micheal Ghattas

3/6/2026 · 8 min read

Managing Hip Osteoarthritis at Home: A Guide from a North Tasmania Home Physiotherapist

By Michael Ghattas, DPT | AHPRA Registered Physiotherapist | 18 Years Experience

Physio to Home, North Tasmania | Last reviewed: March 2026

Hip osteoarthritis is one of the most common and most disabling conditions in older adults in Australia. It affects over a million Australians, causes progressive pain and restriction in one of the body's most fundamental joints, and is one of the leading drivers of hip replacement surgery. It is also — and this is the part that surprises many people — one of the conditions most responsive to physiotherapy.

The research is unambiguous: exercise-based physiotherapy produces clinically meaningful reductions in hip pain and meaningful improvements in function across virtually all patients with hip OA, regardless of severity. The persistent belief that rest is safest and exercise is harmful is not supported by the evidence. It is, in fact, directly contradicted by it.

This guide explains what hip osteoarthritis is, what physiotherapy does about it, and how home-based delivery works in practice for people in North Tasmania.

Who this guide is for

This article is for people in North Tasmania living with hip osteoarthritis — or caring for someone who is — who want to understand how physiotherapy can help and what home-based treatment involves. It is particularly relevant for older adults in rural areas where getting to a clinic consistently is impractical.

What Is Hip Osteoarthritis — and What Is Happening in the Joint?

The hip is a ball-and-socket joint — the rounded head of the femur (thigh bone) sits within the acetabulum (socket) of the pelvis. The articulating surfaces of both the ball and socket are covered in articular cartilage, which provides a smooth, low-friction surface for movement and absorbs compressive load during weight-bearing activities.

In hip osteoarthritis, this cartilage undergoes progressive degeneration — thinning, softening, and eventually wearing away — along with changes to the underlying bone (subchondral sclerosis, osteophyte formation) and the surrounding soft tissues. The result is a joint with less cushioning, altered mechanics, and — in most cases — pain, stiffness, and reduced range of motion.

Important things to understand about hip OA

Pain does not reliably reflect the degree of structural change. Many people with significant cartilage loss on X-ray have manageable symptoms, while others with mild imaging changes have severe pain. Hip OA pain is influenced by muscle strength, activity levels, sleep quality, mood, and the sensitivity of the nervous system — not just the structural state of the joint. This is why treating the whole person, not just the X-ray, is essential.

Exercise does not accelerate joint damage. This is the most important and most misunderstood principle in OA management. The muscles surrounding the hip are its primary shock absorbers and stabilisers. Strong muscles mean less force transmitted to the joint with every step. Appropriately graded exercise — the kind physiotherapy provides — reduces joint load rather than increasing it.

Hip OA pain is often felt in unexpected places. Many people with hip OA experience pain primarily in the groin, the inner thigh, or the front of the hip — not the outer hip or buttock as many expect. Others feel referred pain down the thigh toward the knee. This can lead to confusion about the source and delay appropriate management.

Recognising Hip Osteoarthritis: Signs and Symptoms

Hip OA typically presents with:

• Groin, inner thigh, or anterior hip pain that is worse with weight-bearing activity and eases with rest
• Morning stiffness that improves after 15–30 minutes of movement
• Reduced range of motion — particularly internal rotation and flexion
• A limp that develops as the condition progresses, particularly after prolonged activity
• Difficulty with functional tasks including putting on shoes and socks, getting in and out of a car, climbing stairs, and rising from low chairs
• In some cases, a deep, aching night pain that disrupts sleep

If you are experiencing these symptoms and have not had a formal assessment, your GP can confirm the diagnosis — typically with clinical examination and X-ray.

What the Evidence Says About Physiotherapy for Hip OA

The 2019 OARSI guidelines — the most widely referenced clinical guidelines for OA management globally — place exercise as a core recommended treatment for hip osteoarthritis in all patients, regardless of severity or age. This recommendation is backed by high-quality evidence from multiple systematic reviews and randomised controlled trials.

Key findings relevant to physiotherapy management of hip OA include:

• Land-based exercise produces clinically meaningful reductions in pain and improvements in function. The effect size is comparable to non-steroidal anti-inflammatory drugs — without the gastrointestinal and cardiovascular risks associated with long-term NSAID use in older adults.

• Hip-specific strengthening — targeting the hip abductors, extensors, and external rotators — is the most effective exercise approach, producing superior outcomes to general exercise alone.

• Manual therapy directed at the hip joint — including joint mobilisation and traction techniques — produces significant short-term reductions in pain and improvements in range of motion, particularly when combined with exercise.

• Patient education about the nature of OA and the importance of exercise is independently associated with improved outcomes.

How Physiotherapy Manages Hip Osteoarthritis

Hip Strengthening

The primary muscular stabilisers of the hip — the gluteus medius, gluteus maximus, and deep external rotators — are almost universally weak in people with hip OA. This weakness is both a consequence of reduced activity due to pain, and a driver of increased joint load with every step. A structured strengthening programme targeting these muscles is the foundation of hip OA physiotherapy.

At Physio to Home, hip strengthening exercises are prescribed using the equipment and space available in your actual home — your chair, your kitchen bench for support, your bed for lying exercises. No gym required. Exercises progress systematically from low-load movements to more demanding functional tasks as strength improves.

Gait Retraining

Hip OA causes characteristic changes to the walking pattern — reduced stride length, reduced walking speed, increased lateral trunk sway, and a Trendelenburg gait (the pelvis drops on the unsupported side with each step). These compensatory patterns reduce immediate pain but create secondary loading problems in the knee, back, and opposite hip. A home physiotherapist observes your actual gait on your own flooring and retrains these patterns in the environment where they occur every day.

Manual Therapy

Hip joint mobilisation — hands-on techniques that move the femoral head within the acetabulum — reduces pain and improves range of motion in hip OA. Specific longitudinal traction and distraction techniques are particularly effective for the hip, where joint stiffness and reduced joint space contribute significantly to pain and limited movement. Manual therapy is used in combination with exercise and is not a substitute for it.

Functional Goal-Setting and Activity Modification

Rather than focusing exclusively on pain reduction, physiotherapy for hip OA works toward the functional goals that matter most to you — getting in and out of a car comfortably, walking to the letterbox without a limp, managing the stairs without holding the rail. These are the outcomes that determine quality of life, and they are the most meaningful way to measure progress.

Activity modification — identifying which activities are currently loading the hip beyond its tolerance and adjusting them temporarily — is a practical strategy that reduces pain during the rehabilitation phase without requiring complete rest.

Aquatic Exercise and Hydrotherapy

Water-based exercise is particularly well-suited to hip OA because the buoyancy of water reduces joint load while allowing meaningful strengthening and range of motion work. If hydrotherapy is accessible to you in the Launceston area, a home physiotherapist can design a programme to complement your land-based sessions.

Practical Exercises You Can Start Today

The following exercises are appropriate for most people with hip osteoarthritis. If your pain is currently severe or you are post-surgical, consult a physiotherapist before starting.

Clamshell. Lying on your side with hips and knees bent to approximately 45 degrees, keep your feet together and lift your top knee toward the ceiling like a clamshell opening. Hold 2–3 seconds and lower slowly. Repeat 15 times each side. This targets the gluteus medius — one of the most important and most commonly weak muscles in hip OA.

Bridging. Lying on your back with knees bent and feet flat on the floor, squeeze your glutes and lift your hips toward the ceiling. Hold 3 seconds and lower slowly. Repeat 15 times. This strengthens the gluteus maximus and hamstrings.

Sit-to-stand. From a firm chair, stand up and sit back down slowly, controlling the descent. Repeat 10–15 times. Use armrests to assist if needed initially. This is one of the most functionally important exercises for hip OA.

Standing hip abduction. Standing at the kitchen bench for support, lift one leg out to the side to approximately 30 degrees, hold 2–3 seconds, and lower slowly. Repeat 15 times each side. This directly targets the gluteus medius.

Hip flexor stretch. In a half-kneeling position (one knee on the floor, one foot forward), gently shift your weight forward until you feel a stretch at the front of the hip of the kneeling leg. Hold 30 seconds. This addresses the hip flexor tightness that commonly accompanies hip OA.

These exercises should be done daily. Mild discomfort during exercise is expected — pain that is significantly worse than baseline or takes more than 30 minutes to settle after exercise is a signal to reduce the load and consult your physiotherapist.

When Is Hip Replacement Surgery Appropriate?

Physiotherapy is effective for hip OA at all stages — but for some people with advanced disease, surgery becomes the right choice. Hip replacement is appropriate when:

• Pain is severe, persistent, and significantly limiting daily function and quality of life
• A genuine trial of conservative management — including a structured physiotherapy programme — has been completed without adequate relief
• Imaging confirms significant joint space loss consistent with the reported symptoms

The evidence strongly supports physiotherapy before surgery. People who complete a structured prehabilitation programme before hip replacement recover faster, regain function sooner, and spend fewer days in hospital. If surgery is on your horizon, starting physiotherapy now — not after — is the evidence-based approach. See our dedicated guide: Hip Replacement Recovery Week by Week.

Funding Home Physiotherapy for Hip OA in North Tasmania

Medicare GP Management Plan — Up to five subsidised visits per year for people with a chronic condition. Hip osteoarthritis qualifies. Ask your GP.

My Aged Care — Home Care Package — Physiotherapy is covered under all package levels. Contact your care coordinator.

NDIS — Physiotherapy for eligible participants under Improved Daily Living or Improved Health and Wellbeing.

Private health insurance — Most extras policies cover physiotherapy including home visits.

Private self-funding — Direct payment for home visits.

Frequently Asked Questions

My X-ray shows bone-on-bone hip OA. Is physiotherapy still worthwhile?

Yes. The relationship between radiological severity and pain levels is weak — many people with advanced imaging findings have manageable symptoms, and physiotherapy can produce meaningful improvements regardless of X-ray grade. The muscles surrounding your hip are not visible on X-ray, and strengthening them is one of the most effective things you can do to reduce pain and improve function, even with significant joint damage.

Will exercise make my hip OA worse?

No. Appropriately graded exercise does not accelerate cartilage loss. The muscles surrounding the hip are its primary shock absorbers — stronger muscles mean less force transmitted to the joint, not more. The key phrase is "appropriately graded" — physiotherapy provides a programme calibrated to your current capacity that loads the hip without provoking excessive pain.

How long will it take to see results?

Most people with hip OA notice meaningful improvements in pain and function within 6–8 weeks of a consistent exercise programme. Strengthening exercises need to be done daily — not just during physiotherapy visits — and progress is reviewed and advanced regularly. Your physiotherapist will give you a clear sense of realistic expectations at your first visit.

Ready to Start Managing Your Hip OA at Home?

Living with hip osteoarthritis in rural North Tasmania does not mean accepting pain and restricted function. Physio to Home brings AHPRA-registered, evidence-based treatment directly to your door — wherever you are in the region.

Book your first home visit today →

About the Author

Michael Ghattas, DPT

AHPRA Registered Physiotherapist | Doctor of Physical Therapy | 18 Years Clinical Experience

Michael is the founder of Physio to Home, a mobile physiotherapy practice serving older adults and rural residents across North Tasmania. He specialises in musculoskeletal rehabilitation, falls prevention, and aged care physiotherapy delivered entirely in the home setting.

References & Further Reading

Kolasinski SL, et al. 2019 ACR/AF Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. *Arthritis & Rheumatology*, 2020.

Fransen M, et al. Exercise for osteoarthritis of the hip. *Cochrane Database of Systematic Reviews*, 2014.

Australian Institute of Health and Welfare (AIHW). Osteoarthritis. Cat. no. PHE 232. Canberra: AIHW, 2020.

Bennell KL & Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. *Journal of Science and Medicine in Sport*, 2011.

My Aged Care. Home Care Packages Program. Commonwealth of Australia, 2025. www.myagedcare.gov.au