However you do it, road, mountain, ebike, stationary or spin class – Cycle away your OA!

Pain and loss of function are the main symptoms that people to seek treatment for their Osteoarthritis (OA), which is usually medication and surgical approaches.

If you have mild to moderate hip osteoarthritis, self-managing your symptoms in the early stage of the disease process may have a substantial long-term benefit.

The eventual treatment for end-stage hip osteoarthritis is joint replacement surgery, which is a highly successful operation in terms of clinical outcomes and cost-effectiveness. However, surgery still presents major risks and complications such as dislocation, blood clots and infection. While hip prosthetics continue to improve, wear is unavoidable, and so for patients undergoing surgery at a young age, a revision procedure will also likely be required.

The Cycling against Hip Pain (CHAIN) UK programme for people with hip osteoarthritis encourages self-management of symptoms, to reduce pain, and to improve functional ability through a 6-week, 60-minute programme of education and static cycling sessions at their local leisure centre once a week.

The education topics included: A thirty-minute education session, delivered by a physiotherapist on the benefits of exercise for osteoarthritis, diet and nutrition, pain relief, pacing of activities and lifestyle change and weight loss where appropriate is appropriate.

The exercise component: A thirty-minute indoor cycling session, led by an exercise instructor, were progressive and supplemented with home exercises, (aerobic and local muscle strengthening).

Published results of the initial programme showed statistically and clinically significant improvements in patient-reported outcome measures, hip function, pain on weight bearing and improvements in sit-to-stand and timed up and go tests after the programme was completed.

Many participants, including those with complex other conditions, also reported psychological benefits, including increased confidence in managing their own hip pain and an increase in motivation to exercise.

So, what about 5 years later?

A study published this year, 2020, explores whether participants continued to self-manage their hip osteoarthritis five years after completing the course.

Eighty-three (87%) participants responded to a survey, five years (range 4–6) after completion of a six-week cycling and education programme, 37 (45%) participants had not returned to their general practitioner for further treatment of their hip pain, and 47 (57%) had not pursued surgical intervention. All participants were still engaged in at least one physical activity per week and many reported that they had purchased a bike (29%), joined a gym (30%) or cycled regularly (indoor cycling 25%, outdoor cycling 24%). Eighty (96%) participants reported an increase in knowledge of self-managing their symptoms.


The findings from this study suggest that many patients are motivated to self-manage their hip osteoarthritis, five years following a six-week cycling and education treatment pathway that encourages lifestyle change.

By Carol Armitage, Pre Kure certified health coach and physiotherapist

Cheers to Franco Celligoi pictured, self-named Elderdude, who has successfully cycled his way through 2 TKJR’s.

Keywords: hip; osteoarthritis; physical therapy; total hip replacement (THR); exercise; cycling

Article Self-Management of Hip Osteoarthritis Five Years After a Cycling and Education Treatment Pathway

Thomas W Wainwright 1,2,*, Louise C Burgess 1, Tikki Immins 1 and Robert G Middleton 1,2 1 Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8EB, UK; (L.C.B.); (T.I.); (R.G.M.) 2 The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth BH7 7DW, UK * Correspondence:; Tel.: +441202 91656 Received: 24 January 2020; Accepted: 11 February 2020; Published: 12 February 2020.