Aim to increase your physical activity over the next 6 months.
Starting your My Hip Strength program is the first step. The second step is to increase your overall physical activity.
Read each tab for tips on how to become more physically active.
Physical activity has many benefits, including:
keeps joints healthy and moving
maintains fitness
improves mood and sleep quality
maintains weight
reduces the risk of health conditions that can make managing hip pain harder (obesity, heart conditions, diabetes)
can lower feelings of social isolation if done with other people.
Despite the benefits of physical activity, people with painful hips tend to be less active.
Scientific evidence shows people with hip osteoarthritis are less active than people of the same age who don’t have osteoarthritis. People with hip osteoarthritis typically spend much of their day being sedentary (sitting still).
There are a lot of reasons why people with painful joints are inactive and more sedentary. These include:
Fear that movement and physical activity will cause pain. This often leads to people changing the way they do things. (e.g. taking the elevator instead of the stairs, reducing the hours that they work, driving instead of walking, taking more rest during the day)
Feeling tired and fatigued
Incorrectly thinking exercise and ‘load’ is harmful to the joint.
Being less active can become a habit. It can be a hard habit to break. The best way to start is to make small changes to your daily routine. Even small changes can have a positive impact on your hip and overall health.
In the next section, we’ll discuss ways to gradually increase the amount of physical activity you do each week. You might like to get back to doing active things you enjoy or try new ways to be active.
As part of the My Hip Exercise program we encourage you to slowly increase the amount of physical activity you do.
Being consistently physically active can be hard, especially if you have hip pain. Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing a little. Gradually build up to the recommended amount.
How much physical activity is recommended?
For hip joint and general health people should spend some time on most days being physically active. It’s recommended adults do at least 150-300 minutes of moderate intensity (e.g. brisk walking, doubles tennis) aerobic physical activity per week. But, if moderate activity is too difficult, light activity is still beneficial. You also don’t need to do 20-60 minutes of activity all at once. Bouts of activity 10 minutes at a time works too!
How to tell if you’re doing light, moderate or vigorous activity?
The easiest way is to notice how hard you’re breathing during an activity.
Light activity = you’re breathing at a normal speed and depth
Moderate activity = you’re breathing harder than normal but can still speak in sentences
Vigorous activity = you are out of breath and can only speak one word at a time
What are some physical activities you can try?
It’s completely up to you! There are many things you can do to be physically active. The important thing is to find something you enjoy doing.
Here are some ideas of different types of activities you can try.
Planned activities: These are activities where you set aside dedicated time to exercise. Ideas to try: swimming, cycling, walking groups, golf, water aerobics, dancing.
Incidental activities: These are active things you do as part of your daily life. Ideas to try: gardening, housework, playing with small children, riding a bike to work, walking to the shops, getting off the bus a stop earlier, parking at a far end of shopping centre parking lot.
Minimise sedentary time (the amount of time you are still during the day): Breaking up periods of sitting is a great place to start. To do this, setting time limits on how long you sit can be useful. Consider breaking up long periods of sitting by getting up and standing regularly. If you have to sit for long periods for your work, consider a stand-up desk. Scheduling short walks into your day is another option. For example, walk to the kitchen or the letter box and back.
Daily step counting: Many people find the easiest way to increase general physical activity is to track how many steps they’re walking each day. In fact, research shows that wearable devices that measure daily step counts can help people increase their physical activity levels! This might work for you too.
In the next section find out more about tracking your daily steps.
Here are references that support this information:
Australian Government. Department of Health. Australia’s Physical Activity & Sedentary Behaviour Guidelines for Older Australians (65 years and older).
World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.
Tracking the number of steps you walk is a great way to monitor how physically active you are each day.
For adults, at least 7,000 steps each day is suggested to meet the minimal recommended amount of physical activity required for good health. In fact, 6,000–8,000 steps each day can reduce the risk of mortality for older adults.
Science tells us that people with osteoarthritis should aim to walk at least 6,000 steps each day. Around 6,000 steps each day can improve current joint disability, prevent future joint disability and has many additional health benefits (e.g. weight loss, diabetes management, heart health).
How to track your daily steps:
There are range of devices that can monitor and count how many steps you walk each day. They’re called ‘pedometers’, ‘wearables’ or ‘activity trackers’. These devices are available at a range of prices. They can be purchased from department stores and many online retailers. If you own a smart phone, you may find your phone includes an in-built device that can count your steps. Some examples include:
Free smartphone apps: For example, Apple Health of Google Fit. If you use an app on your phone, you’ll need to have your phone with you all the time to track your daily steps.
Pedometer: A device worn on a belt. They measure your steps and can estimate how far you’ve walked. You can buy them for a little as $5.
Wrist-worn activity trackers: such as Mi band & Huawei band. These devices can track the intensity of your activity levels and heart rate. They cost about $50.
Smart watches: Examples include Fitbit & Garmin, and can be worn on your wrist. They track the intensity of your activity levels and heart rate. Often they also track other things like the quality of your sleep. They can be the most expensive option.
Tips when getting started:
To start: For one week wear your step counter/ activity tracker each day. Record how many steps you take each day. At the end of the week, calculate your average daily steps for the week (add the number of steps you’ve taken each day, then divide it by the number of days). That’s your starting point.
To increase your steps: Each week try increasing you daily steps by 1000. Try a five-minute walk. Park the car further away at the shops. Get off the bus a stop earlier.
An example: If you’re starting point is 3000 steps per day, you’ll aim to do 4000 steps each day the following week. If you manage that, the following week you’ll aim to do 5000 steps each day. And so on. The aim is to reach 6000 – 8,000 steps each day to support healthy hip joints and maintain general fitness.
In the next section learn about activity pacing. It’s an important skill to help avoid overdoing activities and increases in hip pain.
Here are references that support this information:
World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.
White D K et al., Daily walking and the risk of incident functional limitation in knee osteoarthritis: an observational study. Arthritis Care Res, 2014; 66(9):1328-36.
Pace yourself. Increase your activity gradually over time.
When you increase your activity, it can be easy to get carried away and do too much too soon. This is a trap we call the ‘overactivity cycle’. It’s a common trap.
But the ‘overactivity cycle’ can and should be avoided. The first step is to learn what it is so you know what to avoid. The second step is to replace the ‘overactivity cycle’ and instead adopt the ‘activity-rest cycle’. The ‘activity-rest cycle’ is a safe and effective way to pace your activity and avoid increased hip pain.
The ‘overactivity cycle’ and why to avoid it
The ‘overactivity cycle’ or the ‘boom and bust cycle’ is where you let pain be your guide. Where you keep doing an activity until the pain makes you stop.
It is often tempting to do activities or jobs on days when your hip symptoms are mild, or to do a lot more in a shorter period of time to make up for days when you felt tired or your hip pain was worse. Overactivity can happen when you increase the load placed on your hip by a large amount and in a short space of time, for example, by doubling your usual walking distance in a single day to get all your household chores done quickly. Although the increase in pain felt after this type of overactivity does not mean the joint has been damaged, it can be uncomfortable and requires rest to settle it.
If you repeat this cycle of ‘overactivity’ followed by pain flares and periods of ‘underactivity,’ you may experience muscle weakness, reduced fitness and more joint pain. Over time, you might find you can do less activity before pain forces you to stop or that things you could do before that didn’t hurt now do. As a result, you want to avoid activity even more! It can be a downward spiral.
Pacing activities and the ‘activity-rest cycle’
Pacing your activities is a useful way to avoid the ‘overactivity cycle’. A technique to help you pace activity is called ‘activity-rest cycling’. ‘Activity-rest cycling’ avoids letting pain be your guide. It involves stopping an activity before you experience a symptom ‘flare’. Using ‘activity-rest cycling’ you should stop an activity based on a pre-determined limit (for example time or distance). This limit should be before your joint symptoms (e.g. pain) increases. Doing this can prevent big increases in pain that cause forced periods of rest and underactivity. Using ‘activity-rest cycling’ (and avoiding forced rest) is a great way to help you do more in the long run.
Overall, ‘activity-rest cycling’ is a way to find a balance between activity and rest. It’s an important technique that can help people with osteoarthritis increase physical activity without overdoing it.
‘Activity-rest cycling’ can be hard to do, especially if you’re in the habit of regularly overdoing it. Making a concrete physical activity plan can be a helpful strategy.
In the next section we’ll discuss how to make a physical activity plan for the coming 6 months.
Here are references that support this information:
Butler DS, et al., . Explain Pain: Noigroup Publications, 2013.
Keefe F J, et al., Pain in arthritis and musculoskeletal disorders: the role of coping skills training and exercise interventions. J Orthop Sports Phys Ther, 2016: 24(4), 279-290.
Marietta B et al., Activity Pacing in Chronic Pain Management: One Aim, but Which Method? Part One: Introduction and Literature Review. British Journal of Occupational Therapy, 2004; 67(10), 447-452.
Increasing physical activity and starting regular exercise can be hard! Many people find setting goals and making a ‘formal’ plan helpful to keep them on track. It might work for you too.
To make a plan follow these 5 steps:
Click on each + to read more.
Make a list of all the different ways you could increase your physical activity. Be creative! Make a mental list or write them down using the physical activity template below. Then, pick the activity you think might work for you.
Include in your goal:
How much will you do?
When will you do it?
How often are you going to do it?
When are you going to start?
When will you review your progress?
Keep in mind that you want to avoid the ‘overactivity cycle’. When setting your goal including ‘activity-rest cycling’ is recommended.
First, think of what could get in your way and stop you from sticking to this plan? Some examples might include forgetting, the weather, fatigue.
Next, for each obstacle you identify, think of several possible solutions. It may take some time to figure out what will work. Be creative! Try one ‘solution’ and if it doesn’t work, try something else.
Think of what will make it easier for you to stick to the plan.
Some examples include:
Keeping a record of what you do in a calendar or diary.
Set a reminder on your phone.
Make exercise social, do with a friend.
Use a pedometer to count your steps.
Rate it on a scale of 0 to 10 where 0 = I am not confident at all and 10 = I’m very confident.
If you select 0-5, you’re not all that confident.
How could you change your plan so you feel more confident? Maybe your goal is too ambitious. Change your plan until you feel confident its achievable.
Here are some tips people do to make regular physical activity easier. You might find them useful too.
Even small changes to your daily routine can have a positive effect on your health and your hip.
Avoid long periods of inactivity in your day.
Vary your activity by changing the environment.
Use an activity monitor (such as a Fitbit) to record your daily steps.
Perform moderate intensity activity in bouts of at least 10 minutes. That means you are puffing for 10 minutes continuously.
Do physical activity at the same time as another task. Like the saying goes – two birds one stone.
Make physical activity social. Be active with a friend or family member.
Set a reminder in your phone or block out time in your calendar.
Give yourself rewards. Set targets to reach. Reward yourself each time you reach a target.
A holiday or sickness can get in the way of regular physical activity. If this happens, set a date when you’ll resume your activity.
Write your physical activity plan down. Use the template provided below.
Keep a logbook to monitor your progress.
Watch the videos below to learn tips for starting and sticking to regular exercise.
We recommend you download and print the Physical Activity Template. Use it to record your physical activity plan over the next 6 months.
In the next section, hear from people with osteoarthritis and how they have managed their joint pain using exercise and physical activity.
Hear more from people with osteoarthritis.
Starting strength exercise and increasing overall physical activity has helped hundreds of people with osteoarthritis joint pain. It really is the best medicine.
Watch the videos to hear more from Jennie who has knee osteoarthritis and Max who has hip osteoarthritis.
They talk more about their experience with joint pain and increasing activity.
