Hip OA most commonly presents with pain in the groin area. Usually, pain develops slowly over time. Research has shown both genetics and age are large contributing factors to pain. Physiotherapy can play a large role in hip OA by reducing pain and increasing function. We aim to improve range of motion, mobility and strength. We also aim to correct any functional changes related to pain or weakness.
Osteoarthritis (OA) is a term describing the degeneration of tissues in a joint due to overloading. OA can result from several different conditions; these conditions are unique in their causes and possible determining factors. OA affects the hip's articular cartilage; this cartilage acts as a cushion between bones. Changes in articular cartilage can lead to further changes in bone, ligaments and joint capsule. This degeneration can lead to pain, but not always. An x-ray is a common imaging technique to determine the presence of OA in joints. However, imaging does not always correlate with pain and function
Hip OA most commonly presents with pain in the groin area of the hip. Usually, pain develops slowly over time. Research has shown genetics weight and age are large contributing factors to pain.3 Often patients will find their pain is aggravated with movements and activities that load the hip, cold weather, or night pain. This pain will lessen as the movement is continued over time; remember, motion is lotion. Another common finding is stiffness, particularly in the morning.1 However, the stiffness usually lessens within an 30 minutes. Loss of range of motion of the hip and crepitus with movement are also common. Crepitus is when a joint is noisy with activity!
You may also find that you seem to walk a little differently. This limb is called a Trendelenburg gait. This occurs when there is pain or weakness in the hip. When walking, there are points where we have a single leg stance. As such, we must support the opposite hip. When pain or weakness inhibits the contraction of the hip muscles, the opposite hip will drop. This drop and tilt of the pelvis may be small at first but will increase over time. As Trendelenburg gait occurs, there is increase stress placed on tissues of the hip and knee. This can increase pain in their already irritated joints.
Physiotherapy and Hip OA
Physiotherapy can play a large role in hip OA by reducing pain and increasing function. We aim to improve range of motion, mobility and strength. We also aim to correct any functional changes related to pain or weakness. Exercise programs have been shown to improve function and decrease pain in hip OA. Some treatment options include heat or ice, using gait aids such as walking sticks, modalities such as TENS or IFC , stretches, exercises and balance / proprioceptive training. Another essential modifiable factor for patients to consider is weight loss, as reduced body weight will decrease loads on joints and tissues.
Our exercise program is broken up into 4 sections: Strengthening using exercise bands, Stretching and Range of Motion, Hip Arthritis Mobilization and Traction exercises, and finally Hip Arthritis Functional Exercises.
Another great option of hip OA is aqua fit, as it creates resistance for the muscles but offloads the joints!
About These Exercises
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1. Hip Osteoarthritis: Etiopathogenesis and Implications for Management | SpringerLink Available from: https://link-springer-com.proxy1.lib.uwo.ca/article/10.1007/s12325-016-0409-3
2. Cooper C, Javaid MK, Arden N. Epidemiology of osteoarthritis. In: Arden N, Blanco F, Cooper C, Guermazi A, Hayashi D, Hunter D, Javaid MK, Rannou F, Roemer F, Reginster J-Y, editors. Atlas Osteoarthr [Internet]. Tarporley: Springer Healthcare Ltd.; 2014 [cited 2021 Feb 8]. p. 21–36. Available from: https://doi.org/10.1007/978-1-910315-16-3_2
3. Lespasio MJ, Sultan AA, Piuzzi NS, Khlopas A, Husni ME, Muschler GF, Mont MA. Hip Osteoarthritis: A Primer. Perm J [Internet]. 2018 Jan 3 [cited 2021 Feb 8];22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5760056/ PMCID: PMC576005
4. Bennell K. Physiotherapy management of hip osteoarthritis. J Physiother. 2013 Sep;59(3):145–157.