Hip Pain Is Not Just a Part of Getting Older
If your hip aches after a long walk, feels stiff when you get out of the car or has started to limit your golf, tennis or pickleball, you have probably been told it is just age. For most people that explanation is incomplete, and it leads to doing less than the hip can handle.
What is usually going on
Hip pain in active adults over 40 is often linked to osteoarthritis, which is gradual wear and change in the joint. Osteoarthritis is common, but it does not mean the joint is finished. Pain and stiffness are influenced by how well the hip moves and how strong the muscles around it are, and both of those can be improved at any age.
What the evidence says
In 2025, the Academy of Orthopaedic Physical Therapy and the Academy of Sports Physical Therapy published an updated clinical practice guideline on hip osteoarthritis in the Journal of Orthopaedic & Sports Physical Therapy (Koc and colleagues). The guideline names individualized exercise as the primary treatment, with strengthening and mobility work done one to five times per week over roughly 5 to 16 weeks. It also gives its strongest rating to hands-on hip joint mobilization in order to improve motion and reduce pain, and to dry needling for short-term relief in people with mild to moderate arthritis. Patient education about activity and joint loading is supported as well.
The same direction shows up in the knee. A 2025 BMJ systematic review and network meta-analysis pooled 217 randomized trials with more than 15,000 participants with knee osteoarthritis. It found that exercise, and aerobic exercise such as walking, cycling or swimming in particular, reduced pain and improved function with moderate-certainty evidence. No exercise type caused more adverse events than comparison groups, and the authors recommend exercise as a first-line approach. This is knee research and not hip research, but it supports the same principle for arthritic joints in general. Movement, delivered in the right dose, is treatment.
What this means for you
A hip that hurts does not need to be protected by doing less. The goal is to find out why the hip is irritated, restore its motion with hands-on treatment, and then build the strength that lets it handle the walking, golf, lifting or sport you want to keep doing.
The source of hip pain is also not always the hip. The low back, pelvis and foot can each change how the hip is loaded. This is why at Enhance Physical Therapy we examine the whole kinetic chain rather than only the spot that hurts. Every visit is a full 60 minutes one-on-one with a Fellowship-trained physical therapist, and treatment combines manual therapy, exercise and education.
Schedule a visit
If your hip has been slowing you down, you do not have to accept it as a fact of age. You can schedule a visit at https://enhancept.janeapp.com/ and we will find the source and build a plan in order to keep you doing what you love.
Dr. Doug Ashton, DPT, FAAOMPT
Owner, Enhance Physical Therapy
References
Koc TA Jr, Cibulka M, Enseki KR, et al. Hip Pain and Mobility Deficits: Hip Osteoarthritis, 2025 Revision. Journal of Orthopaedic & Sports Physical Therapy (2025). orthopt.org
Yan L, Li D, Xing D, et al. Comparative efficacy and safety of exercise modalities in knee osteoarthritis: systematic review and network meta-analysis. BMJ (2025);391:e085242. PMC
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