The article describes the case of a 71-year-old woman with insidious onset of bilateral hip pain, presenting with progressively worsening symptoms. Physical therapist evaluation showed a positive Trendelenburg sign and the Hip Disability and Osteoarthritis (OA) Outcome Score (HOOS) was used. She was diagnosed with moderate right hip OA. Topics include management strategies for OA and the use of land-based therapeutic exercise based on the Cochrane reviews and evidence-based physical therapy.