Hip Stiffness: Causes and How to Loosen a Stiff Hip

What hip stiffness feels like

• difficulty bending forward to tie shoes or put on socks
• trouble lifting the leg into a car or bath
• a tight feeling in the groin or front of the hip after sitting
• "gelling": stiffness on getting up that eases after a few steps
• reduced ability to turn the leg inward or spread the knees apart

The hip joint is deep in the groin, so true joint stiffness is usually felt there rather than on the outside of the hip. See also hip stiffness or tightness.

Causes of hip stiffness

Hip osteoarthritis

Arthritis of the hip, mostly osteoarthritis, is the main cause in people over 50. The cartilage thins and bone spurs form. Typical features:

• morning stiffness lasting less than 30 minutes
• stiffness after sitting that eases with movement
• groin and front-of-thigh pain, sometimes felt at the knee
• gradual loss of the ability to rotate the hip inward
• worse after heavy activity, better with rest early on

Tight muscles

Long hours of sitting shorten the hip flexors at the front and weaken the glutes. Runners and cyclists also get tight hip flexors, hamstrings and iliotibial band. This stiffness eases with movement and stretching, and the joint moves freely when tested by a doctor.

Impingement and labral tear

In femoroacetabular impingement, an extra bony edge on the ball or socket pinches the joint during deep bending. It can lead to a hip labral tear. Young, active adults notice groin pain, stiffness, clicking or catching, worse with sitting in low chairs or squatting.

Inflammatory conditions

Other causes

• Hip bursitis: pain and tenderness on the outside of the hip, worse lying on that side.
• Avascular necrosis: deep groin pain and stiffness from loss of blood supply to the femoral head; linked to steroids and alcohol.
• After injury or surgery: scar tissue and muscle guarding.
• Children: irritable hip after a virus, Perthes disease, slipped capital femoral epiphysis and juvenile arthritis cause a limp and stiffness.
• Parkinson's disease: general rigidity can include the hips.

How doctors find the cause

A doctor will ask how long morning stiffness lasts, what improves it, your age and activity, and about pain elsewhere. They will watch you walk, test hip range of motion (especially internal rotation and flexion), and check your back and knees.

• X-ray: shows joint space narrowing and bone spurs in osteoarthritis, and bone shape in impingement.
• MRI: for labral tears, avascular necrosis or stress fractures when X-rays are normal.
• Blood tests: inflammation markers (ESR, CRP) and antibodies if inflammatory arthritis or polymyalgia is suspected.

How to relieve hip stiffness

Movement

• Move little and often: stand up and walk for 2 minutes every 30 minutes of sitting.
• Low-impact exercise: walking, cycling, swimming, water aerobics and tai chi keep the joint moving without overloading it.
• Strengthening: bridges, side-lying leg lifts, clamshells and sit-to-stand exercises support the joint. Exercise is a core treatment for hip osteoarthritis in national guidelines.

Stretches to try daily

• Hip flexor stretch: half-kneel with one knee on a cushion and gently shift your hips forward; hold 30 seconds each side.
• Figure-four stretch: lying on your back, cross one ankle over the opposite knee and draw the legs toward you.
• Knee-to-chest stretch: lying on your back, pull one knee gently toward your chest.
• Butterfly stretch: seated, soles of the feet together, let the knees drop.

Stretch after a warm-up or a warm shower, and stop if pain is sharp.

Other measures

• Heat before activity (a warm bath or heat pack) loosens stiff joints.
• Weight loss: each pound lost reduces load on the hip with every step.
• Pain relief: acetaminophen (paracetamol) or topical or oral NSAIDs, following the label dose; avoid oral NSAIDs if you have kidney, stomach or heart problems.
• Walking aids: a cane held in the hand opposite the stiff hip reduces load.
• Physical therapy for a tailored program.

Medical treatment

Steroid injections can help some people with arthritis or bursitis. Inflammatory conditions are treated with disease-modifying medicines or steroids under a rheumatologist. Arthroscopy treats some labral tears and impingement. Hip replacement is very effective for severe osteoarthritis that limits daily life despite other treatment.

Frequently asked questions

Why are my hips stiff in the morning?

Short morning stiffness that eases within 30 minutes is typical of hip osteoarthritis or tight muscles after a night of not moving. Stiffness that lasts more than an hour, or affects both hips and shoulders, suggests inflammation such as rheumatoid arthritis, ankylosing spondylitis or polymyalgia rheumatica and should be checked.

Why do my hips get stiff after sitting?

Sitting shortens the hip flexor muscles and lets joint fluid settle, so the hip feels tight when you stand. This gelling is common with osteoarthritis and tight muscles and usually eases after a few steps. Regular movement breaks and hip flexor stretches help.

Is walking good for stiff hips?

Yes. Walking keeps the joint moving, nourishes cartilage and strengthens supporting muscles. Start with short walks on flat ground and build up. If walking causes increasing pain, try cycling or water exercise, and ask a physical therapist for guidance.

When should I see a doctor for hip stiffness?

See a doctor if stiffness lasts more than a few weeks, morning stiffness lasts over an hour, it limits walking or dressing, or there is clicking, locking or night pain. Seek urgent care for fever with a hot, swollen hip, or inability to bear weight after a fall.