What specific exercises help hip hypermobility pain the most?

The short version: no study in this retrieval directly tested exercises for hip hypermobility pain. The closest evidence comes from osteoarthritis and patellofemoral pain trials, which are not the same condition.

The 2017 guideline on hypermobility syndrome says active exercise is the core of treatment, but it is based on expert consensus, not large trials [4]. It notes that 81% of children with the condition report pain made worse by exercise, but structured programs consistently improve pain and function. The guideline calls for multicenter trials because the evidence base is so limited.

What the osteoarthritis and patellofemoral studies show is that hip strengthening exercises reduce pain in those conditions. A 2022 quasi-experimental study found hip abductor strengthening reduced pain in knee osteoarthritis [1]. A 2019 meta-analysis found hip abductor strengthening reduced pain in patellofemoral pain syndrome [3]. A 2016 meta-analysis found exercise therapy reduced pain in hip osteoarthritis by about 5 points on a 100-point scale [2]. None of these studies tested hypermobile hips specifically.

The mechanism makes sense: hypermobile joints lack passive stability from ligaments, so the muscles around the joint have to work harder to keep it stable. Strengthening those muscles should help. But the evidence that it actually works for hypermobility pain specifically is thin. The 2017 guideline is the best source, and it says exercise is the right approach, but the trials have not been done.

My call: hip strengthening exercises are the best bet based on mechanism and indirect evidence, but the direct evidence for hypermobility pain specifically is weak. Confidence: low.