Here at Be Mobile Physiotherapy, a lot of people come to us with Hip Osteoarthritis. Understandably, there are a lot of concerns and misconceptions surrounding this condition. Today we thought we would address some of these, but also provide some guidance around what to do to help improve your symptoms so that you can get moving and do the things you love.
Q. My hips are worn out from all the sports I used to play. Isn’t exercise doing more damage?
A. Unlike the joints in a car, our hips don’t simply wear out and need to be replaced after a long period of time. In fact, exercise is very important to keep our joints healthy and happy.
Cartilage does not have a blood supply like our muscles and bones, so it has to get its nutrients from the surrounding synovial fluid in the joint. Think of cartilage-like a sponge. When we exercise, we compress the sponge, and then when we recover the sponge expands, sucking in all the nutrients from the synovial fluid. This is how cartilage regenerates – so it is very important to exercise with osteoarthritis.
Of course, if over a long period of time, there is more loading than our body is capable of recovering from this can be a factor contributing to joint pain. But exercise will still be important to maintain joint health.
Q. That’s all well and good, but my X-Ray shows that my hips are bone on bone! My Doctor told me I have the hips of someone much older!
A. We know imaging findings are not a good indicator of symptoms. About 50% of people with hip pain have no visible signs on X-Ray. It’s also as common for people without pain to have signs of OA on imaging. We care much more about your symptoms than the X-Ray report. Telling someone that they have the hips of someone much older is counterproductive – the older you get, the more likely an X-Ray will show normal age-related changes, but that certainly doesn’t mean you will have symptoms.
Q. But I get lots of hip pain when exercising – doesn’t that mean I should stop?
A. Pain during exercise is very common, especially in people without hip osteoarthritis. If someone with hip osteoarthritis stopped exercising every time they had a little bit of discomfort, not a lot of exercise would get done! This is a problem for a couple of reasons. Firstly, exercise is crucial for good health. Secondly, whenever we stop exercising our joints and muscles become deconditioned which can lead to further inactivity and pain.
b. This is called the cycle of inactivity. The good news is that we can reverse this cycle by performing an exercise program that is matched to our ability level. This means modifying exercises that may be painful - for example, if squatting down all the way gives you intolerable hip pain, you might start with a shallower squat, or just sitting and standing from a chair.
Q. ‘The best exercise for hip osteoarthritis is hydrotherapy’
A. All exercise has health benefits and exercising in water can be a very comfortable form of movement for many. However, having your body weight supported by water does not mimic the requirements of everyday life so it is not the best way to prepare you for things like going up and downstairs, standing from a chair, or getting up and down from the floor. The science strongly supports land-based exercise for hip osteoarthritis. Exercise that replicates these movements strengthens the surrounding muscles and puts loads through the hip joint in a slowly progressed fashion is the best option.
Q. Hip Osteoarthritis runs in my family. My Mother had to have hip replacements so it’s only a matter of time till I need them too.
A. If someone in your family has hip osteoarthritis you are at greater risk of developing it, but it certainly doesn’t guarantee that you will too. Remember that there are lots of things that contribute to osteoarthritis over a lifetime. There are a variety of ways you can help prevent hip OA as well as improve your condition if you have already been diagnosed. These are maintaining a healthy lifestyle and bodyweight, being educated about the condition, and engaging in regular physical activity and resistance training.
Check out our Hip Osteoarthritis - Commonly Asked Question Video for some more info and some exercises to try - https://youtu.be/JnPdX28uIt8