Orthopedics & Spine

Hip strengthening for osteoarthritis


October 4, 2021

How physical therapy can help hip strengthening for osteoarthritis in one of the most important joints in the body.

Our hips are crucial joints for stability and for mobility. But for an estimated 27 million Americans, osteoarthritis of the hip joint causes pain and impedes mobility. Hip osteoarthritis often decreases the space between the ball and socket. Sometimes the smooth cartilage that offers a buffer between these two bones has degraded, and the joint then develops inflammation from the increased friction. Hip pain from osteoarthritis can keep you from doing all the activities you enjoy, and it can lead to pain elsewhere in the body. But physical therapy and hip strengthening for osteoarthritis can help.

“The research is pretty robust in our ability to help mitigate pain by doing some hip-strengthening exercises after osteoarthritis has developed,” said Brian Kaufmann, DPT, at Vanderbilt Orthopaedics Cool Springs. Strengthening the muscles can help improve functional movement. And strength work may be able to stave off osteoarthritis in those who don’t have it yet, but more research is needed. “Anecdotally, we’ve got a pretty good idea that exercise can enhance the longevity of our joints,” Kaufmann explained.

The importance of glute muscles

Osteoarthritis presents differently for each patient, so physical therapy involves individualized treatment. “But for the most part with osteoarthritis,” Kaufmann said, “we do see a higher rate of weakened gluteal muscles. There’s a litany of exercises that we can employ to strengthen and fire those glutes and get those working to support our hip joint.”

Strength, mobility, and control

Physical therapy for hip osteoarthritis takes a three-pronged approach to not only strengthen the hips but also to improve mobility and coordination. Increasing mobility in physical therapy helps to build strength throughout the joint’s entire range of motion, while coordination works on the mind-body connection to ensure control. “Just moving the hip joint in a new way,” Kaufmann said, “can often really increase function and decrease pain.”

The physical therapy process

“If I’m doing my job right, most patients are walking out of the clinic with improved function, but also they know how to manage and maintain their new functional ability by themselves.”

Physical therapy typically involves in-person sessions as well as maintaining a prescribed routine at home. Kaufmann said he gives his patients about four exercises to do on their own to continue to build progress between appointments. A formal course of physical therapy may last several weeks, with patients then continuing a take-home treatment plan. “If I’m doing my job right,” Kaufmann said, “most patients are walking out of the clinic with improved function, but also they know how to manage and maintain their new functional ability by themselves.”

Beyond physical therapy

Movement, in general, is important for the hip joints and surrounding muscles. Kaufmann recommends getting at least 15 to 20 minutes of cardiovascular exercise at least three times a week, aiming for an activity you enjoy. “The human body is designed to move rather than sit in one position throughout the day,” he said. “And the toughest part is kind of establishing that awareness within yourself to find ways to move the hips, move your joints, stretch your muscles. It really helps to mitigate pain and has a positive impact on function.”

Hip strength for healthy aging

Strong hips are also important for overall strength and balance. “The hips, the back and the abdominals all work in one kind of orchestrated fashion,” Kaufmann explained. Plus, healthy hips are key for knee and ankle stability.

“The hips are, to me, the most important and sometimes the most neglected muscle group in the body,” Kaufmann said. “As we age, we really start to see that neglect present itself as a decrease in balance or difficulty with routine activities.” That’s why hip exercises are crucial for anyone with osteoarthritis of the joint, but also for all of us. “It’s tremendously important to keep your hips strong, keep your hips flexible, and keep them active,” he added.

Doctor helping patient walk with a wheel chair

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