Physiotherapy · Hip arthritis
Hip arthritis physio in Phuket
Our physios test your hip, build your strength step by step and measure whether it is working. If a hip replacement would serve you better, we tell you and refer you to a surgeon.
For new diagnoses, people deciding about surgery, and active over-50s who want to keep moving.
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What the research says
Exercise first. Its effect varies.
Guidelines recommend exercise first for everyone with hip arthritis.1 But the latest Cochrane review found the average pain improvement is small, and results varied across studies.2 That is why we measure your own response.
7of 100
points less hip pain with exercise than without, on average across 9 trials. A 12-point change was judged meaningful.2
41%
still had their own hip six years later after exercise plus education, against 25% with education alone, in one trial.3
15.6%
of hips with frequent pain showed arthritis on X-ray in one US community study. Pain and X-rays do not always match.4
Exercise is a first step, not a promise. We measure whether it is working for you.
How we work
Test, load, retest, refer if needed
We treat hip arthritis like any training goal: find your starting point, load the hip progressively, check the response, and change course when the numbers say so.
Measured, not guessed
We test chair stands, walking speed, strength and a hip questionnaire at the start, at about 3 months and at 12 months, so you and your physio see real change.
Your recovery
Four phases and a 12-week decision
Times are typical, not fixed. You move on when you meet the milestones, and your physio checks each stage.
- 01
Typically 0 to 2 weeks
Understand and start
Your physio confirms it is hip arthritis, checks for other causes and tests your baseline. Sit to stands, bridges, side-lying leg lifts and daily walking, two to three short home sessions a week.
Move on whenYour baseline numbers are recorded, you can use the traffic light on your own, and pain settles to usual by the next morning.
- 02
Typically 2 to 8 weeks
Build strength
Twice-weekly supervised sessions with real load: loaded sit to stands, hip hinges, step-ups, split squats and hip work with machines, cables or bands, building from about 12 reps to 8 heavier ones.8
Move on whenYour chair stand score is above baseline, loads have increased, and a 30-minute walk leaves no red flare the next day.
- 03
Typically 8 to 12 weeks
Build function
Turning strength into the tasks you care about: stairs, car transfers, socks and shoes, longer walks, golf, or getting up from the floor. Then the 12-week retest.
The 12-week decisionImproving: your physio signs off and your coach takes over. Still badly limited: we refer you to an orthopaedic surgeon.1
- 04
From about 12 weeks
Stay strong for life
Two to three strength sessions a week with your coach, walking, cycling or swimming for fitness, and a written flare plan. A retest at 12 months.
Signs it is workingTraining twice a week most weeks, your 12-month retest at or above your 12-week numbers, and flares settling within a week.
UK guidance says a surgical referral should not depend on age, weight or a numerical score.1 If you carry extra weight, any loss is likely to help.1
Between sessions
Pain as a guide
Joint pain may increase when you start exercising, and regular exercise is still worthwhile.1
Check three things: hip pain during and after exercise (up to 5 out of 10 is fine), how it feels the next morning, and daily life: walking, stairs and sleep.
Green: progress
Pain stayed at 5 or below and was back to usual by next morning. Keep going and add a little load next session.
Amber: hold
Pain went above 5 briefly, or took most of the next day to settle. Repeat the same load before progressing.
Red: step back
Pain still raised the next day, or walking or sleep got worse. Reduce the load and tell your physio if it repeats.
Go to hospital now if
Call 1669 in Thailand.
- A hot, swollen, very painful hip with fever or chills
- After a fall, you cannot stand or take weight
- The leg looks shorter or turned outwards after a fall
- Sudden severe hip pain and you cannot walk
- After hip surgery: the wound is hot, red, leaking, or you have a fever
- Chest pain, breathlessness, or a swollen, painful calf
See a doctor within days if pain worsens fast over weeks, wakes you nightly, or comes with weight loss, past cancer, long-term steroids, heavy drinking, long morning stiffness or swollen joints.
Told you need a hip replacement?
Surgery can be the right call
In a Danish trial of 109 people aged 50 or over with severe hip arthritis who had been offered surgery, hip replacement improved a 48-point hip score by 15.9 points at six months, against 4.5 with 12 weeks of supervised strength training.9 A Finnish trial also found a large gap at 12 months against home exercise.10
For milder arthritis, exercise is the first step. A structured 12-week block with testing shows where you stand and gets you stronger either way. Exercise before a hip replacement helped people walk faster and feel better while waiting.11
Patient reviews
What our patients say
Rated 5.0 from 57 Google reviews
“I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”
Catlin McCrackenGoogle review “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”
Michelle LawlorGoogle review “Meaw has been incredible. She helped me recover from long term neck and lower back pain and gave me personalized exercises that I now do daily. These have made a huge difference in my strength, mobility, and overall well-being. I’m so grateful for her expertise and highly recommend her to anyone looking for real, lasting results!”
Jeff CraigGoogle review “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”
Unfiltered OpinionsGoogle review “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”
Jamie AllworkGoogle review “I have been seeing Karim for long term issues with my neck and the results have been fantastic. I have attended several physios in the past and none compare to Karim. His skills and knowledge helped to pinpoint the exact cause of the issues and the treatment plan has made massive improvements.”
joyce billingtonGoogle review “I came to Optimize with chronic back pain and absolutely no ability to train. I was first matched with Khun Meaw, a highly skilled rehabilitation trainer who helped me eliminate my back pain completely. … After that, I continued training with Kate for a full year.”
nesterzhzhotGoogle review
Questions
Hip arthritis questions
Bone on bone: will exercise wear it out?
Does my X-ray show how bad my hip is?
Not reliably. In one US community study, only 15.6% of frequently painful hips showed arthritis on X-ray.4 We judge your hip by symptoms, strength and function.
Does running wear out your hips?
In pooled studies, recreational runners had less hip and knee arthritis (3.5%) than non-runners (10.2%). This is an association, not proof, and long-term competitive running looked different.12
Can exercise replace a hip replacement?
Is any physio treatment good enough?
No. In one trial, a 12-week package of manual therapy, home exercise and advice did no better than a dummy treatment.13 So we keep exercise progressive and measured.
What happens at the free physio assessment?
Your physio checks whether it is hip arthritis or something else, looks at your strength and movement, and gives you an honest view on exercise or a surgical opinion. It’s free, with no obligation.
Physio team
Your physio team
Meaw leads our clinical standards and checks every handover to your coach.
How physiotherapy works here
Meaw
Head Physiotherapist
Karim
Physiotherapist
Also on the team Sukanya, Physiotherapist
Next step
Find out what your hip can do
Message us on WhatsApp to book your free physio assessment. You leave with a clear plan and an honest view on what should come first.
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Questions first? WhatsApp +66 65 914 1604
Sources (13)
- National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. London: NICE; 2022.
- Hall M, Lawford BJ, Hinman RS, et al. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev. 2026;7(7):CD007912.
- Svege I, Nordsletten L, Fernandes L, Risberg MA. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial. Ann Rheum Dis. 2015;74(1):164-169.
- Kim C, Nevitt MC, Niu J, et al. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study. BMJ. 2015;351:h5983.
- Kjeldsen T, Skou ST, Dalgas U, et al. Progressive resistance training or neuromuscular exercise for hip osteoarthritis: a multicenter cluster randomized controlled trial. Ann Intern Med. 2024;177(5):573-582.
- Hall M, Allison K, Knox G, et al. Addition of aerobic physical activity to resistance exercise for hip osteoarthritis (PHOENIX): a randomised comparative effectiveness trial. Lancet Rheumatol. 2025;7(5):e343-e354.
- Ageberg E, Link A, Roos EM. Feasibility of neuromuscular training in patients with severe hip or knee OA: the individualized goal-based NEMEX-TJR training program. BMC Musculoskelet Disord. 2010;11:126.
- Bryld ES, Christiansen L, Ingwersen KG, et al. Training load and pain response during progressive resistance training in patients with hip osteoarthritis in the PROHIP trial. Osteoarthr Cartil Open. 2025;7(4):100690.
- Frydendal T, Christensen R, Mechlenburg I, et al. Total hip replacement or resistance training for severe hip osteoarthritis. N Engl J Med. 2024;391(17):1610-1620.
- Talonpoika A, Karttunen L, Jaroma A, et al. Total hip arthroplasty compared with conservative treatment with a self-directed exercise programme in moderate-to-severe hip osteoarthritis: a randomized controlled trial. Bone Joint J. 2026;108-B(5):588-596.
- Svinøy OE, Nordbø JV, Pripp AH, et al. The effect of prehabilitation for older patients awaiting total hip replacement. A randomized controlled trial with long-term follow up. BMC Musculoskelet Disord. 2025;26(1):227.
- Alentorn-Geli E, Samuelsson K, Musahl V, et al. The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47(6):373-390.
- Bennell KL, Egerton T, Martin J, et al. Effect of physical therapy on pain and function in patients with hip osteoarthritis: a randomized clinical trial. JAMA. 2014;311(19):1987-1997.
This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.