Cycling against hip pain (CHAIN)

The CHAIN (Cycling Against Hip Pain) programme is a 6-week exercise and education treatment pathway for people with hip pain. It is designed to promote the self-management of hip pain and is based on the latest NICE guidelines for the treatment of osteoarthritis. These guidelines recommend local muscle strengthening, aerobic exercise, and education as a core part of the treatment. Cycling strengthens muscles around the hip, helps to reduce pain, and is an excellent form of aerobic exercise.

Results from the CHAIN programme:

  • 86% of participants reported improvements in walking and completing daily activities.
  • 100% of participants said they would recommend the programme to a friend.
  • 83% of participants had increased leg strength

Each week, groups of up to 15 people attended a 30-minute education session with a physiotherapist, followed by 30-minutes of exercise on static bikes at Littledown and Pelhams Park Leisure Centre operated by BH Live. Participants were given a home exercise programme, encouraged to cycle and asked to keep a diary. Over 78% of participants had improvements in function, and ability to carry out everyday activities, and 100% of participants said they would recommend the programme. Participants reported feeling fitter and stronger, having improved flexibility, less disturbed sleep and reduction in pain and their need to take analgesics. Participants also reported feeling more motivated to continue exercising.

To get more insights in the patient benefits and outcomes of the CHAIN programme , read the 2015 CHAIN report  on the evaluation of the CHAIN programmes Oct 2013 to April 2015.


CHAIN programme


Benefits of non-surgical management of osteoarthritis

Around a third of people aged over 45 years in the UK (8.75 million in total) have sought treatment for osteoarthritis, and 2.12 million people have done so for osteoarthritis of the hip.

CHAIN, Cycling Against Hip Pain, is a 6-week programme conceived by Professor Middleton and Associate Professor Wainwright and developed with local partners in Dorset. It was designed as an effective way to implement NICE guidelines on hip osteoarthritis. The programme provided a combination of education and static cycling, designed to improve mobility and increase people’s confidence in managing their condition. It brought together a range of local partners in a unique and innovative partnership to provide the programme. An initial programme was delivered from October 2013 to April 2015.