When Elvis the pelvis gyrated and thrust his way across national television screens, audiences were delighted and censors were scandalised. But physiotherapists were probably standing up in their seats cheering at the display of such healthy and limber hip movements.

Hips are a key weight-bearing joint, yet we rarely give them the amount of love and attention they deserve.

“You might not realise how important it is or how much it does until it’s painful or restricted in some way, and you’re no longer able to use it in the same way that you could before,” says a physiotherapist, Dr Michael O’Brien from La Trobe University in Melbourne. A hip fracture, particularly in elderly people, can precede a serious decline in health, which makes maintaining hip health vital for healthy old age.

Strengthen your hip muscles

The ball-and-socket hip joint is very mobile, able to move in many directions and rotate, so it’s vital to keep the muscles around the hip joint strong to support it and reduce the risk of pain and hip osteoarthritis, O’Brien says.

“That can be doing reformer pilates, it could be doing some simple exercises at home, some simple weight-bearing exercises,” he says.

It’s also important to work the hip across all the planes of movement, not just back and forth. Some simple exercises include standing on one foot and rotating your pelvis from side to side, or holding the lunge position and moving the front knee slightly from side to side.

The gluteal muscles in the buttocks, and abdominal stabilising muscles are also important for hip health, says a physiotherapist, Dr Jillian Eyles from the University of Sydney.

“The tiny, boring glute exercises actually really hurt [in terms of fatiguing muscles] and they’re really boring … [but] they’re the ones that are really helpful,” Eyles says.

Gluteal exercises include squats, lunges and a “gluteal bridge” – lying on your back, planting the soles of your feet on the floor or bed and lifting your pelvis up off that surface. For abdominal core strengthening and stabilising, she also recommends reformer pilates or yoga.

Stay active

For all the hype about “10,000 steps a day” being the ideal – and unproven – goal for physical activity, the evidence actually suggests that significant benefits accrue at far lower step counts, says Prof Rana Hinman, a research physiotherapist at the University of Melbourne.

“[Ten thousand] was a really scary number, I think even for someone who didn’t have health problems … and for someone with joint pain, or someone who’s older, that’s just an unachievable goal,” she says. But research suggests even 7,000 steps a day can have major benefits for health.

“Even for every extra 1,000 steps that you can do, we’re seeing it now with mortality benefits, cardiovascular benefits, and we see it with osteoarthritis, with knowing that we can prevent functional decline over time as well,” Hinman says.

She also stresses that even older people with hip pain or osteoarthritis shouldn’t let it stop them participating in physical activity they enjoy. “Generally there’s no evidence that physical activity is going to make your X-rays worse, for example, or push you to needing joint replacement surgery quicker,” she says. “It’s really much more about what the person enjoys doing, what their joint allows them to do, and feels comfortable with doing.”

Falls prevention

More than 16,000 Australians aged over 45 years fracture a hip each year, 90% of those require surgery and about one-quarter of people who experience their first hip fracture die within a year. Among older Australians, falls prevention is a vital part of hip health.

Part of this is just recognising that activities that used to be easy when we were younger can be dangerous as we age and our balance and vision diminish.

“A lot of people when they’re putting their underwear on or shoes or socks, will try and stand on one leg as they do that,” O’Brien says. “Often that’s something that we stop doing as we get older, and we sit down because it’s a little bit safer.”

Falls prevention clinics, which can be found in hospitals around the country, can also provide education, physiotherapy and exercise programs to help reduce the risk of repeat falls.