Weak hips stem from a surprisingly wide range of causes, and most people dealing with the problem have more than one working against them at the same time. Prolonged sitting, joint disease, tendon damage, aging-related muscle loss, hormonal shifts, nutritional shortfalls, and even poor muscle firing patterns can all leave the muscles around the hip unable to do their job. The hip is one of the most mechanically loaded joints in the body, and when the muscles surrounding it weaken, the consequences ripple outward to the lower back, knees, and ankles.
Prolonged Sitting and Gluteal Amnesia
If you spend most of your day in a chair, your gluteal muscles gradually lose the ability to activate on demand. This phenomenon, sometimes called “gluteal amnesia,” refers to impaired signaling between the nervous system and the glute muscles. It is not that the muscles disappear; they simply stop firing when they should. The condition is increasingly recognized as a contributor to both hip weakness and low back pain, particularly among women who sit for extended periods.
Research on sedentary populations has found that gluteal amnesia contributes significantly to low back pain and functional disability related to prolonged sitting.1Journal of Health, Wellness and Community Research. Effects of Clamshell Versus Gluteal Bridge Exercises on Low Back Pain, Gluteal Strength, and Disability Due to Prolonged Sitting in Females with Gluteal Amnesia The hip abductors, extensors, and external rotators all suffer when you remain seated for hours. Over time, the hamstrings and lower back muscles start compensating for lazy glutes, which creates a cycle: the hip muscles get weaker from disuse, the compensating muscles get overworked, and pain drives you to move even less.
What makes this cause so common is how invisible it feels. You may not notice any weakness until you try to run, climb stairs, or do a single-leg balance exercise and realize the hip simply cannot stabilize. The good news is that this type of weakness is among the most reversible, but it does require deliberate retraining, not just “moving more.”
Osteoarthritis and Structural Joint Conditions
Joint disease is one of the most powerful drivers of hip weakness, and it works through several mechanisms at once. In hip osteoarthritis, the combination of cartilage breakdown, inflammation, and pain leads to generalized weakness on the affected side. That weakness comes from muscle shrinkage, reduced muscle density, and a neurological phenomenon called muscle inhibition, where the nervous system dials down activation of muscles around a painful joint to protect it.2PubMed Central. Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits This means even mild-to-moderate arthritis can measurably reduce hip strength, not just advanced cases.
A related structural problem is femoroacetabular impingement, where the shape of the hip bones causes abnormal contact during movement. People with this condition show consistent strength deficits across multiple hip muscle groups. One study found they were roughly a quarter weaker in hip adduction and flexion and about 18% weaker in external rotation compared to healthy controls.3Osteoarthritis and Cartilage. Hip muscle strength in patients with symptomatic femoroacetabular impingement Another study placed the deficit at 16 to 19% weaker than healthy controls across all hip muscle groups, with the involved side’s abductors about 8.5% weaker than the uninvolved side.4PubMed. Hip muscle strength in male and female patients with femoroacetabular impingement syndrome: Comparison to healthy controls and athletes
A systematic review and meta-analysis of hip muscle changes in femoroacetabular impingement found significantly reduced hip flexion and extension strength, along with compensatory changes in how the body recruits surrounding muscles to pick up the slack.5PubMed Central. Hip muscle changes in femoroacetabular impingement: a systematic review and meta-analysis Those compensations may feel like they are “working around” the problem, but they tend to set the stage for additional injuries elsewhere in the kinetic chain.
Tendon Damage and Gluteal Tendinopathy
The tendons that anchor hip muscles to bone are a frequent but under-recognized source of weakness. Gluteal tendinopathy, which involves degeneration or irritation of the tendons attaching the gluteus medius and minimus to the greater trochanter, directly impairs hip abductor strength. This condition is common in middle-aged and older women and is sometimes mistaken for hip bursitis.
Research measuring hip abductor torque found that people with gluteal tendinopathy were about 32% weaker on their symptomatic side than healthy controls, and even the asymptomatic hip was roughly 23% weaker.6PubMed. Hip Abductor Muscle Weakness in Individuals with Gluteal Tendinopathy The fact that both sides are affected suggests the condition does not just weaken the painful hip; it reflects a broader change in how the body uses these muscles. Within the affected person, the symptomatic hip was still about 11% weaker than the less painful side, indicating local tendon damage adds an extra layer of deficit on top of the bilateral weakness.
What makes tendinopathy tricky is that it often develops gradually. You may notice lateral hip pain when lying on that side at night or when walking uphill, but by the time you investigate, the weakness has already become substantial.
Aging and the Steep Drop After 75
Muscle mass around the hip declines with age, and the rate of that decline is not steady. A study of hip fracture patients found that the loss begins gradually around age 61 but accelerates sharply after 75, with the steepest drop occurring between ages 75 and 79.7PubMed Central. Aging-related muscle mass decline in hip fracture patients across age groups That acceleration matters because it means people who felt reasonably strong at 70 can experience a rapid, noticeable loss in hip function within just a few years.
This is not purely a muscle-size issue. Aging also changes muscle quality: fat infiltrates the muscle tissue, nerve signaling slows, and fast-twitch fibers shrink disproportionately. The hip abductors and extensors are particularly vulnerable because they are the main stabilizers during walking. When they weaken, gait becomes unsteady, fall risk rises, and the cycle of reduced activity and further weakness accelerates. Resistance training can slow this process considerably, but the window for building meaningful reserves gets narrower with each passing decade, which is why clinicians push strength work well before frailty sets in.
Hormonal Shifts and Pregnancy
Estrogen does more for the musculoskeletal system than most people realize. After menopause, the drop in estrogen affects tendons directly: tendon elasticity decreases, load transfer changes, healing capacity drops, and collagen turnover is disrupted. Tendon cells have estrogen receptors that appear to regulate repair and limit fatty degeneration, so when estrogen falls, the tendons around the hip become stiffer and more vulnerable to breakdown.8Muscles, Ligaments and Tendons Journal. Postmenopausal estrogen deficiency and tendon degeneration: a systematic review This is one reason gluteal tendinopathy is so much more common in postmenopausal women. The muscles themselves may still have reasonable capacity, but if the tendons connecting them to bone cannot transmit force properly, the result is functional weakness regardless of muscle size.
Pregnancy is another period of significant hip vulnerability. The physiological changes during pregnancy, including ligament laxity driven by the hormone relaxin, weight redistribution, and altered biomechanics, create conditions where the hip and pelvis are under unusual stress.9PubMed Central. Pregnancy-Related Hip and Pelvis Musculoskeletal Conditions, Risk Factors, and Prevention Many women develop hip or pelvic girdle pain during pregnancy that persists postpartum, and the deconditioning that often accompanies late pregnancy can leave the hip muscles weaker than they were before. The weakness is usually temporary if addressed, but many women are never told to specifically rehabilitate their hip muscles after delivery.
Low Vitamin D and Nutritional Gaps
Vitamin D deficiency is linked to a specific pattern of weakness that tends to hit the muscles closest to the trunk, including the hip flexors, extensors, and abductors. Low vitamin D status is associated with proximal weakness and an increased risk of falls, and in severe cases the muscle deficits can be dramatic.10PubMed Central. Vitamin D and muscle Vitamin D acts on muscle cells through specific receptors and influences both the structural proteins within the muscle fibers and the calcium signaling that drives contraction.
This is a cause of hip weakness that is easily overlooked because the symptoms come on slowly. You might attribute the heaviness in your legs to aging or lack of exercise when vitamin D is actually a contributing factor. It is also one of the most straightforwardly correctable causes: getting your levels checked and supplementing if low can make a noticeable difference in strength, particularly if you were significantly deficient. That said, vitamin D supplementation alone is not a substitute for exercise. The two work together, with vitamin D supporting the biological machinery that strength training puts to use.
Post-Surgical Weakness
Hip surgery itself can cause weakness, even when the surgery was meant to fix a problem. Total hip replacement is the clearest example. Hip abductor weakness is a common impairment in the early period after surgery, often contributing to a limp, gait problems, and delayed recovery.11PubMed Central. Immediate Effects of Ultrasound-Guided Superior Gluteal Nerve-Targeted Manual Therapy and Exercise on Hip Abductor Strength, Gait Speed, and Pain in Early Postoperative Total Hip Arthroplasty: A Case Series Part of the problem is the surgical approach itself, which may require cutting through or detaching muscles to access the joint. But emerging evidence also points to dysfunction of the superior gluteal nerve, which supplies the main hip abductor muscles, as an important contributor to post-operative weakness.
This means that some people who had weak hips before surgery due to arthritis may still have weak hips after surgery, just for a different reason. The joint pain may be gone, but the nerve and muscle damage from the procedure can take months to resolve. Targeted rehabilitation in the weeks after surgery matters enormously for long-term outcomes, yet many patients receive only generic instructions to walk and rest.
Faulty Muscle Firing Patterns
Sometimes the hip muscles are not truly weak in terms of size or capacity; they just do not activate at the right time. During movements like hip extension, the normal firing pattern in many people is hamstrings first, then glutes. This means the hamstrings do a disproportionate share of the work while the gluteus maximus lags behind. A study of women performing prone hip extension found that without any coaching cues, the hamstrings activated nearly 200 milliseconds before the start of movement, while the gluteus maximus fired only about 12 milliseconds before movement began.12PubMed Central. Muscle activation and movement patterns during prone hip extension exercise in women
When participants were given specific cues to engage their glutes, the firing pattern changed dramatically. The glutes activated much earlier, hamstring activity around the start of movement decreased, and gluteus maximus activation increased throughout the entire movement. This suggests that a significant portion of “hip weakness” is really a coordination problem. The muscles have the strength; they just need to be retrained to turn on at the right moment. This finding has practical implications: if your hip weakness is primarily a timing issue, isolated strengthening exercises that let you cheat with your hamstrings will not fix the underlying problem. You need exercises that specifically demand gluteal activation.
How Weak Hips Affect Your Knees and Lower Back
One of the reasons clinicians care so much about hip strength is that weakness there tends to cause pain somewhere else. The most studied downstream effect is patellofemoral pain syndrome, the aching around and behind the kneecap that is extremely common in runners and active adults. A systematic review found a consistent relationship between decreased hip strength and this type of knee pain, with the most significant deficits, up to 27%, in hip abductor strength.13PubMed Central. Influence of the Hip on Patients With Patellofemoral Pain Syndrome: A Systematic Review
The relationship is real but more nuanced than it first appears. Cross-sectional studies consistently show that people with knee pain have weaker hips than people without it. But prospective studies, which follow healthy people forward in time, have not clearly shown that hip weakness predicts who will develop knee pain.14PubMed Central. Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain? Some clinical trials have found that strengthening the glutes improves knee pain symptoms, but interestingly, the improvement happens without changing knee movement patterns. So hip strengthening helps with knee pain, but the mechanism may not be as simple as “strong hips prevent the knee from collapsing inward.” There may be neurological, pain-modulating, or load-distribution effects at play. Regardless of the exact mechanism, the clinical takeaway is clear: if you have chronic knee pain or low back pain with no obvious local cause, your hips are worth investigating.
Why Standard Tests Can Be Misleading
If you have ever been assessed for hip weakness in a clinic, there is a good chance the Trendelenburg test was used. This is the classic single-leg stance test where the clinician watches whether your pelvis drops on the unsupported side. It looks intuitive: if your hip abductors are weak, the pelvis should drop. But the test turns out to be a poor measure of actual hip muscle strength. A study using 3D motion analysis and muscle dynamometry found only very weak, non-significant correlations between measured hip abductor torque and the amount of pelvic drop during the test.15PubMed Central. Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry In other words, you can have significant hip weakness and still “pass” the Trendelenburg, or conversely, your pelvis can drop for reasons other than weak abductors.
This matters because people sometimes leave a clinical exam being told their hips are fine when they are not, or being told their hips are the problem when the weakness actually lives elsewhere. Formal strength testing with a dynamometer is more reliable but not always available in routine clinical settings. If you suspect hip weakness is contributing to your symptoms and a quick screening test says otherwise, it may be worth pushing for more thorough evaluation.
Exercise Selection for Rebuilding Hip Strength
Not all hip exercises are created equal, and the choice matters more than you might expect. One of the challenges in hip rehabilitation is that the tensor fascia lata, a small muscle on the outside of the hip, tends to dominate during many common exercises. If you are trying to rebuild the gluteus medius and maximus, exercises that let the TFL take over are counterproductive. An electromyographic study using fine-wire electrodes found that clamshells, sidesteps, unilateral bridges, and quadruped hip extensions were the best exercises for preferentially activating the glutes while keeping TFL involvement low.16PubMed. Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes
There is also a practical lesson about what flexibility work can and cannot do. A study of a daily lunge-and-reach stretching program found that it improved hip flexibility and jump performance but did not significantly improve gluteal strength or single-leg bridge endurance.17PubMed Central. Improved Hip Flexibility and Gluteal Function Following a Daily Lunge-and-Reach Stretching Intervention Stretching can free up range of motion, which is valuable, but it does not build the force-producing capacity that weak hips actually need. If your rehab program is heavy on stretching and light on targeted resistance work, you are likely addressing only part of the problem.
The combination that tends to work best is targeted strengthening exercises with intentional cueing (consciously squeezing the glutes rather than just going through the motion), done consistently over weeks. As the firing-pattern research showed earlier, cueing alone can shift how much the glutes contribute to a movement. When you pair that neurological retraining with progressive loading, the gains tend to be faster and more durable than with either approach alone.