Hip Osteoarthritis
Osteoarthritis of the hip causes the cartilage in the hip joint to wear away resulting in bone on bone contact and a loss of joint space which can cause pain and inflammation. As the surrounding muscles weaken, this puts further load through the joint. Hip OA is most prevalent in over 65s however being overweight, stressing the joint through high impact sports, previous injury to the joint, genetics and congenital hip defects are all considered associated risk factors.
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Book NowSymptoms
1. Pain which is aggravated with movement, commonly felt in the groin/thigh and can radiate to the buttock and knee2. Stiffness, especially in the morning
3. Loss of mobility in the joint, you may notice it harder to put on socks and tie shoe laces.
4. Decrease in strength and power of the surrounding muscles
5. Changes in how you are walking
6. “Locking” of the hip
7. Leg length discrepancy
Treatments
Exercise such as strengthening the hip and leg muscles and increasing flexibility and range of motion are effective for self-managing the condition [1] as this can decrease pain and increase function [2] and postpone the need for surgical intervention [3].Tai chi uses a combination of strengthening, balance and postural alignment and has therefore been found to manage symptoms of hip OA and improve hip function [4].
Hydrotherapy is a suitable treatment as it takes the load off the joint, allowing for strengthening and flexibility exercises. This can be hugely beneficial if patients are struggling to weight bear [4][5].
Manual therapy such as traction or soft tissue stretching, and massage has additionally been found to provide a short-term reduction in pain and increase in function [1].
A total hip replacement may be required if conservative management has not successfully managed the condition. However, continuing with physiotherapy post-surgery is vital to build the strength and range of movement of your new joint [6]. Pilates based rehabilitation is a safe and controlled setting which can effectively strengthen the hip post-surgery [7].
APOS Therapy is a non-surgical alternative calibrated shoe which works by redistributing the body’s weight through the non-damaged portion of the joint while simultaneously enhancing muscle function of the hip and leg muscles [8]. APOS therapy has been proven to reduce pain, improve function and delay the need for surgical intervention.
References
1.https://www.sciencedirect.com/science/article/pii/S1836955313701796 Bennell, K., 2013. Physiotherapy management of hip osteoarthritis. Journal of physiotherapy, 59(3), pp.145-157.2. https://link.springer.com/article/10.1007/s12325-016-0409-3 Murphy, N.J., Eyles, J.P. and Hunter, D.J., 2016. Hip osteoarthritis: etiopathogenesis and implications for management. Advances in therapy, 33(11), pp.1921-1946.
3. https://ard.bmj.com/content/74/1/164.short Svege, I., Nordsletten, L., Fernandes, L. and Risberg, M.A., 2015. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomised trial. Annals of the rheumatic diseases, 74(1), pp.164-169.
4. https://onlinelibrary.wiley.com/doi/full/10.1002/art.22621 Fransen, M., Nairn, L., Winstanley, J., Lam, P. and Edmonds, J., 2007. Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes. Arthritis Care & Research, 57(3), pp.407-414.
5. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005523.pub3/abstract Bartels, E.M., Juhl, C.B., Christensen, R., Hagen, K.B., Danneskiold‐Samsøe, B., Dagfinrud, H. and Lund, H., 2016. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews, (3).
6. https://www.sciencedirect.com/science/article/pii/S183695531370198X Coulter, C.L., Scarvell, J.M., Neeman, T.M. and Smith, P.N., 2013. Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement: a systematic review. Journal of physiotherapy, 59(4), pp.219-226.
7. https://link.springer.com/article/10.1007/s11999-009-0779-9 Levine, B., Kaplanek, B. and Jaffe, W.L., 2009. Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report. Clinical Orthopaedics and Related Research®, 467(6), pp.1468-1475.
8. https://www.apostherapy.co.uk/conditions-we-treat/hip-pain/hip-osteoarthritis/
9. https://www.longdom.org/open-access/a-non-invasive-foot-worn-biomechanical-device-2161-1076-3-153.pdf Drexler, M., Segal, G., Lahad, A., Haim, A., Rath, U., Mor, A. and Elbaz, A., 2013. A Non-Invasive Foot Worn Biomechanical Device for Patients with Hip Osteoarthritis. Surgery Current Research, 1(5).
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