The hip is one of the most commonly fractured bones in people with osteoporosis, so it is especially important for people with low bone density to learn about hip strengthening exercises. According to the Centers for Disease Control and Prevention (CDC), over 300,000 adults aged 65 and older are hospitalized for hip fractures in the United States each year. The incidence of hip fractures increases with age, with the highest rates among adults aged 85 and older. Hip fractures are also more common in women than men, with women accounting for approximately 75% of all hip fractures (CDC, 2016).
Despite a high prevalence of hip fractures in people with osteoporosis, there are steps you can take to prevent hip fractures, including strengthening the muscles and bones of the hip with the right exercises.
In this article, we will focus specifically on exercises for osteoporosis of the hip to help you build strength, prevent falls and feel confident in your hip health.
Why do you need hip exercises?
The hip serves the important role of connecting the legs to the trunk of the body. The joint itself is formed by the bones of the pelvis and femur, with the femoral neck (a narrow portion of the large femur bone) being the area most at risk of fractures (Cedars-Sinai). Fracturing this bone can significantly alter a person’s life by decreasing mobility and increasing the risk of morbidity (Downey, 2019).
As you can imagine, your hips take on a lot of load over time. The hip muscles are the primary muscles involved in standing up, sitting down, walking, and squatting. The muscles surrounding the hip joints need to be strong in order to accomplish these daily movements and many others.
Strengthening the muscles around the hips can also protect the bone integrity and make everyday movements easier. Your hip muscles also play a role in keeping the body upright and maintaining balance. For this reason, it’s no surprise that hip strengthening is especially important for people with osteopenia or osteoporosis.
Strong hip muscles will:
- Protect the bones that make up the hip joint
- Make daily activities, such as the ones mentioned above, easier to do
- Aide in the stability of your legs, which helps with posture and balance
Weak hip muscles can:
- Leave the hip more vulnerable to injuries (such as bone breaks or fractures)
- Contribute to an increased risk of falls
- Cause muscle imbalances, resulting in temporary or long-term hip pain
How to exercise safely
While these exercises are specifically selected to benefit people with osteoporosis, people who have osteoarthritis may also benefit from these exercises. However, depending on your medical history, not all exercises may be appropriate for everyone. These exercises should not cause pain or make you feel unsafe. It is best to get clearance from your doctor or physical therapist before starting a new exercise program, or if you are unsure if a particular exercise is appropriate for you. If you’re able, feel free to mix and match exercises in each of the different positions.
Hip exercises for osteoporosis
Below is a list of hip-strengthening exercises for people with osteoporosis. Hip exercises can be done in multiple positions -- standing, sitting and lying down. Generally speaking, it is best to do the exercises standing up because this is a more weight-bearing position, and weight-bearing exercises are among the best for building bone. However, while you should feel challenged, you should also feel safe while doing your exercises, so pick the position that is best for your fitness level. We included exercises in a variety of positions below so you can do the ones that are most appropriate for you.
If you’d like, you can perform a light warm-up before doing these exercises, such as a 5-10 min walk or cycle on an upright stationary bike.
Sit-to-stand
The sit-to-stand exercise strengthens your quadriceps, hamstrings, and glutes, which are responsible for flexing and extending the hip. Doing this exercise makes it easier to perform daily activities such as standing up from and sitting in a chair or going up and down stairs.
- Start this exercise by sitting at the front edge of a chair. Your feet should be about shoulder-width apart.
- Shift your body weight forward over your toes and stand up by pushing through your heels. Slowly lower back down to a seated position.
- Try to avoid rounding your spine.
- Use your hands for assistance if necessary for safety.
- Perform 5-15 repetitions. Take a 30-60 second break. Repeat 2-3 sets total.
Standing Hip Abduction
Standing hip abduction strengthens the gluteus medius muscle, which helps maintain level hips while standing on one leg, as needed when walking and going up and down stairs. This muscle also helps maintain normal knee alignment.
How to do it:
- Start by standing tall in front of a countertop or a chair to hold onto for balance if needed.
- Keep your knee straight and trunk upright as you kick your leg out to the side.
- Maintain a straight knee and an upright trunk. Avoid leaning your chest in the direction opposite the leg movement.
- Perform 10-15 repetitions in a row on one leg. Then switch to the opposite side.
- Perform 2-3 sets on each leg.
- For an added challenge, you can place a resistance band loop around your ankles.
Squat
This squat exercise strengthens your glutes and quadriceps muscles. These muscles are important for everyday activities such as sitting down into or getting up out of a chair or climbing stairs.
How to do it:
- Start with your feet hip width apart.
- Bend your knees as if you are going to sit in a chair.
- You can bend up to 90 degrees, but go only as far down as is challenging without any pain.
- Return to the standing position.
- For an added challenge, you can hold a weight in each hand while doing this exercise.
Lateral squat walks
The lateral squat walk exercise is a resistance exercises that strengthens the hip abductor muscles in a functional position. These muscles help stabilize the hips during a number of every day activities, while also helping to improve balance.
How to do it:
- Use a chair to safely place a resistance band loop around your ankles.
- Stand up with the loop resistance band around both ankles and assume an athletic stance, keeping your feet hip width apart and your knees slightly bent.
- While keeping your knees bent in a mini squat position and your pelvis level, reach one leg out to the side and take a side step, controlling your trailing leg as you bring it back to a hip width position.
- Repeat stepping to the same side so that you are essentially walking sideways for 5 repetitions as space allows. Then reverse direction.
- Perform 5-10 steps leading with the right leg, then 5-10 steps leading with the left leg (you can stay facing forward the whole time).
- Repeat for 2-3 sets in each direction.
Bridges
The bridge is an excellent exercise for strengthening your glutes, hamstrings, lower back, and core.
- Start by lying on your back with your knees bent and feet flat on the floor. Your arms should be down by your sides, with your palms facing down.
- Slowly lift your hips toward the ceiling. Hold for 2-3 seconds.
- Then slowly lower your hips back down to the starting position.
- Repeat 10-15 times.
- Rest for 30-60 seconds. Repeat 2-3 sets.
Clams
Clams strengthen the gluteus medius and hip rotator muscles, essential for pelvic stabilization and hip mobility when walking, standing, and balancing.
- Start by lying on your side with your knees bent and your head resting on your arm or a pillow.
- While keeping your feet together, lift your top knee as far as possible without letting your pelvis rotate backward.
- Slowly lower your knee back down to the starting position.
- Perform 10-15 repetitions.
- Rest for 30-60 seconds. Repeat 2-3 sets.
All of these exercises are in the Wellen exercise library, and are part of our personalized exercise program designed for people with osteopenia and osteoporosis. Many can be made more challenging by incorporating resistance bands. Whichever exercises you choose, make sure you stick with an exercise program that strengthens and protects the hip to reduce your risk of falls and fractures and help you live a long and active life.
