Hip pain is one of the most common reasons you pull back from exercise – and one of the most common reasons your hip pain gets worse.
The hip is supported by a substantial network of muscles: the glutes, the deep hip rotators, the hip flexors, the adductors, and the muscles of the lower back. A strong network lets the hip joint move under load with precision and minimal stress on the joint surfaces. A weak one lets daily forces – sitting, standing, climbing stairs, walking on uneven ground – produce discomfort the hip wasn’t designed to generate.
Strength training builds that network. Rest doesn’t.
Where Hip Pain After 50 Usually Comes From
Hip pain in women over 50 commonly originates in a few distinct areas, each with different implications for training.
Hip joint itself. Osteoarthritis of the hip is common and progressive. It produces pain deep in the groin, sometimes radiating to the thigh or buttock. It tends to be worse with weight-bearing, particularly at end ranges of hip flexion and rotation. Gentle strengthening of the surrounding musculature is well-supported for hip osteoarthritis and typically reduces pain over time.
Greater trochanteric pain (lateral hip pain). Pain on the outside of the hip, often worse with crossing the legs or lying on that side. Usually involves the gluteal tendons or bursa at the greater trochanter. This responds well to targeted strengthening of the hip abductors and glutes – and poorly to stretching, particularly hip crossover and iliotibial band stretching, which can aggravate it.
Hip flexor tightness and pain. Discomfort at the front of the hip, often described as tightness. Common after long periods of sitting. Often accompanied by weakness in the glutes – the hip flexors are overactive because the posterior hip musculature isn’t doing its share.
Referred pain from the lower back. Pain that feels like it’s in the hip but originates from the lumbar spine. The pain pattern may be variable, include the lower back, or radiate down the leg – worth distinguishing before loading the hip specifically.
→ Injury or Detraining: How to Tell the Difference
What Safe Training Looks Like for Hip Pain
The approach varies by pain location, but several principles apply across most hip pain presentations.
Start with hip-dominant hinges. Romanian deadlifts, hip thrusts, and cable pull-throughs load the posterior chain without requiring deep hip flexion or significant hip rotation. For anterior or lateral hip pain, these are often the most comfortable early-stage exercises and directly strengthen the glutes and hamstrings most needed for hip stability.
Avoid deep hip flexion in the early stages. Hip pain in the groin or anterior joint area often makes full-depth squats uncomfortable initially. Start with a partial range – a shallow squat or box squat to a high surface – and progress the depth gradually as tolerance improves.
Include hip abductor work. For lateral hip pain (greater trochanteric), strengthening the hip abductors – side-lying clamshells, banded lateral walks, single-leg hip thrusts – is often the most effective intervention. These muscles stabilize the pelvis and take load off the lateral hip structures. Avoid hip crossover stretching, which places the problematic structures under tension.
Progress to single-leg work carefully. Step-ups and split squats are valuable for hip stability but require more lateral control than bilateral exercises. Include them once there’s a foundation of hip strength, with a controlled tempo and hands available for support if needed.
Slow the tempo. A 3–4 second lowering phase on squats, step-ups, and lunges places more demand on the musculature and reduces the impulse loading that can aggravate sensitive hip tissue.
What Tends to Make Hip Pain Worse
Prolonged sitting without movement breaks. Hip flexors shorten and glutes switch off. Starting exercise after a long sedentary period increases the load on an already compromised system. A short dynamic warm-up – leg swings, hip circles, bodyweight hip hinges – before loading reduces this effect.
Stretching lateral hip pain. Piriformis stretches, hip crossover stretches, and IT band foam rolling are commonly recommended for hip pain and routinely make lateral hip presentations worse. The tissue at the greater trochanter is under tension in these positions, not relieved by it.
High-impact activity before building hip strength. Running, jumping, and high step-count walking place repetitive loading demands on the hip that the surrounding musculature needs to be prepared for. Build hip strength before returning to high-impact activity to reduce the risk of flares.
→ Strength Training with Joint Pain After 50
What Changes With Consistent Training
Hip pain that is driven by muscular weakness and reduced load tolerance responds well to progressive strength training. The timeline is measured in months, not weeks – connective tissue and the deep hip stabilizers adapt more slowly than large muscle groups.
The progression is gradual and then noticeable. Activities that were consistently uncomfortable become intermittently comfortable, then routinely manageable. The discomfort that accompanied sitting, climbing stairs, and rolling over in bed begins to diminish as the hip has more muscular support to work with.
→ How to Get Back to Exercise After a Long Break
The free 1-week trial at 29 Again Custom Fitness gives you a direct starting point if you’re in the Timonium area and want to work with a trainer who understands how to program around hip history.
– Stephen Holt, CSCS
29 Again Custom Fitness | Timonium, MD
Nerd Note: Gluteal strengthening is well-supported for greater trochanteric pain syndrome and hip osteoarthritis. Mellor R et al., BMJ (2018); Fransen M et al., Cochrane Database Syst Rev (2014).
