The Key to Managing Hip Pain – Hip Osteoarthritis
Osteoarthritis (OA) is often referred to as the “wear and tear” type of arthritis. It is the degeneration that occurs in the joint. Specifically, in the hip joint, it is when the cartilage wears down. The hip joint is a ball and socket joint that allows the leg to move forwards, backwards, side-to-side and rotate. The joint is where the top of the femur (ball) sits in a pocket called the acetabulum (socket) on the pelvis. Both the end of the femur and acetabulum are covered in articular cartilage; tissue that acts as a cushion between the two bones. When this tissue starts to wear down it causes joint narrowing and ultimately changes the impact of the two bones against each other.
What does this look like to a patient?
- Stiffness of the hip joint
- Difficulty performing some daily activities like putting on socks, getting out of a chair, walking
- Pain in the groin area that can refer to the buttock or down the thigh
- Pain is often experienced after activity or that wakes you up at night
- Grinding sounds
- Feeling of locking of the hip
Treatment Options:
- Exercise Management
- Medications
- Injections
- Use of weight bearing devices
- Hip Replacement
Exercise Therapy
Exercise is a great option as the first line of offense. Research shows that exercise implemented with the correct progression is an effective tool for managing hip OA. Exercise has been shown to have a variety of positive outcomes such as improved mobility, strength, physical function, quality of life, psychological variables, and sleep. Most importantly exercise can decrease pain and slow the progression of OA (Bennell, K, et. al 2014).
At Acumen we see a large portion of this population who are unaware that the right kind of exercise and exercise progression/program can help them to a better state. Unfortunately, exercise cannot stop or repair the degeneration, but it can help someone live with the current state of their hip and still allow them to enjoy their activities.
Take a peek at some of the exercises we implement in our program:
MOBILITY
Hip Series
- Lying on your back, bend the knees to 90 degrees with your feet on the floor. (pic 1)
- Bring the knees together to stretch the outside of the legs. (pic 2)
- Drop knees out to stretch the groin/adductors. (pic 3)
- Fold the legs to each side (pics 4 and 5) to stretch the IT-Band, quads, glutes.
Lacrosse Ball TFL (Tensor Fascia Latae) Release
Take the lacrosse ball and press your hip against the ball into the wall. Continue until the discomfort is less and the muscle is soft.
Glute Figure Four Stretch- Seated in Chair
- Seated in a chair, have the support leg bent to 90 degrees with the foot flat on the floor.
- Bend the opposite knee and bring the ankle to rest upon the thigh of the support leg.
- You should feel the stretch on the glute of the leg that is up.
- Keeping the back straight, lean forward to increase the stretch if needed.
STRENGTH
Glute Bridge- Double Leg
- Lie on your back, knees bent and your feet hip width apart.
- Feet are flat on the surface.
- Squeeze your glutes and press through your heels to raise your hips up to the ceiling and back down.
- Ensure your back remains in a neutral position by engaging your deep abdominal muscle (slightly pulling the belly button in towards the spine).
Deadbug
- Begin lying on your back with your hands extended above you toward the ceiling, pressing against the exercise ball. Bring your feet, knees, and hips up to 90 degree angles.Have the thighs press into the exercise ball to provide counter pressure to the arms.
- Engage the abdominals by pulling them towards the spine.
- Initiate the exercise by extending one leg, straightening the knee and hip to bring the leg to a hover above the ground. Extend the opposite arm overhead at the same time to also hover above the ground.
- The opposite arm and leg will hold the exercise ball in position during this movement.
- Maintain the position of your lumbar and pelvis as you perform the movement, as your back is going to want to arch.
- Stay tight and return the working leg and arm to the starting position. Repeat on the opposite side.
FUNCTION
Crouch Holds
- Stand with your feet approximately shoulder width apart, directly in front of a low box, chair, medicine ball etc.
- Lower yourself under control or with assistance and sit on the box
- Have your torso upright, possibly by reaching your arms in front of you for a counterbalance.
- Hold the position as prescribed
Sit to Stand Squat
- Find a chair that is a comfortable height to perform this movement. If a chair seems too low, you can adjust the height by using a pillow or towels on the seat.
- Slowly sit back and just before your buttocks touch the chair, hold that position for 3 sec and then fully touch down.
- Slowly lean your torso forward over your toes. As your buttocks lifts, bring your hips under your body and straighten up to a full standing position.
Sled Pushes – Walking
- Grab onto the handles of the sled. Lean forward and engage the abdominal muscles.
- Drive one leg forward with a bent knee as you push forward with the other leg. The pushing leg should go into hip extension with the knee straight and pushing off the toe.
- Allow the other foot to touch down as you alternate the role of the legs to push the slide forward.
