A healthy hip is a deep socket holding a round femoral head snugly, with cartilage taking the load. Dysplastic hips start with laxity, meaning the head can shift within the socket during movement. Every step becomes a small impact rather than a smooth rotation.
The body responds the way it responds to any repeated stress: it remodels. The socket flattens, the femoral head loses its round shape, cartilage wears through, and the joint capsule thickens. What began as an alignment problem becomes osteoarthritis, and arthritis is the thing that actually hurts.
This is why age of onset is confusing in this breed. Some Bernese show signs between five and twelve months, during the phase when laxity is greatest and the growth plates are still open. Others cruise through youth and present at six or seven with arthritis that has been building quietly for years. Same disease, two very different presentations.
Body size is the amplifier. A dog of 70 to 115 pounds puts far more force through an unstable joint than a small dog does, and the Bernese also grows to that weight over an extended puppyhood, so the joint is bearing serious load while it is still forming. That combination is why large working breeds dominate the hip dysplasia population.