Exercises to relieve hip joint pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

The hips are subjected to a tremendous amount of force with weight-bearing activities.

It is important to get involved in three major types of exercises including stretching, strengthening, and non-impact aerobic forms of exercise.

Stiffness, pain and swelling associated with arthritis can severely reduce the range of motion in joints. Avoiding physical activity because of pain or discomfort also can lead to significant muscle atrophy and excessive weight gain. Exercise, as part of a comprehensive arthritis treatment plan, can improve joint mobility, muscle strength, overall physical conditioning and weight control.

A program that includes a balance of three types of exercises - range-of-motion, strengthening and cardio (endurance) exercises - can relieve the symptoms of arthritis and protect joints from further damage.

The following is a blend of information from the Arthritis Foundation as well as my experience in caring for patients with hip arthritis.

Range-of-motion exercises

Range-of-motion exercises (also called stretching or flexibility exercises) help maintain normal joint function by increasing and preserving joint mobility and flexibility. In this group of exercises, affected joints are conditioned by gently straightening and bending the joints in a controlled manner as far as they comfortably will go. During the course of a range-of-motion exercise program, the joints are stretched progressively farther (maintaining comfort levels) until normal or near-normal range is achieved and maintained.

In addition to preserving joint function, range-of-motion exercises are an important form of warm-up and stretching, and should be done prior to performing strengthening or endurance exercises or engaging in any other physical activity.

Do not do these exercises until you check with your physician or physical therapist

Five excellent ROM of exercises are:

Internal rotation of the hip where you lie on your back bring your knee to your chest, clasp your hands on the front of your shin and internally rotate the hip while keeping the pelvis as flat as possible against the floor.

The next is called thread-the-needle. Again you lie on your back, bend the knee on the good side and place the foot down flat. Take your affected leg, bend the knee and cross your “bad” leg on top of the “good” thigh. Reach down with the arm on the “bad” side through the hole created by the crossed leg on top of the thigh. Reach down with the hand on the good side and clasp both your hands together behind the good thigh. Pull up slowly and gently to stretch the bad hip.

The next is this one. Lying on your back, bend both knees together, and bring them toward your chest. Then slowly move them in an ever-widening circle, keeping your lower spine on the floor. After you do 5 to 10 circles, switch direction. Then slowly come back to your original position.

The Pigeon is a yoga pose where you rest on your elbows and bring the knee of the affected hip up between your arms and let your chest rest on the knee. The weight of your body gives the hip a good internal rotation stress. Be careful with this one and do it under supervision.

Frog is another yoga pose where you rest on your elbows and knees to start. Then spread your knees out as far as you can. Gently bring your buttocks towards your heels with your knees wide apart. You can rotate your hips as well and you will feel an external rotation stretch.

Strengthening exercises

Strong muscles help keep weak joints stable. There are several types of strengthening exercises that keep joints strong. Some people with arthritis avoid exercise because of joint pain. That is not good.

A group of exercises called isometrics are designed to strengthen targeted muscle groups without bending painful joints. Isometrics involve no joint movement, but rather strengthen muscle groups by using an alternating series of isolated muscle flexes and periods of relaxation.

Another group of exercises called isotonics is more intensive, achieving strength development through increased repetitions or by introducing light-weight resistance with small dumbbells or stretch bands.

A physical therapist or fitness instructor (preferably one with experience working with arthritis patients) can provide you with instruction on how to correctly and effectively perform isometric and isotonic exercises.

Hydrotherapy or aquatherapy (water therapy), is a program of exercises performed in a large pool. Aquatherapy may be easier on painful joints because the water takes some of the weight off of the affected areas while providing resistance training.

Endurance exercise

The foundation of endurance training is aerobic exercise.

People with arthritis should perform about 15 minutes of aerobic activity at least three times a week at first, then gradually build up to 30 minutes daily. The activity also should include at least 5 to 10 minutes of warm up plus 5 to 10 minutes of cool down.

Examples of aerobic activities include walking, swimming, low-impact aerobic dance, skiing and biking. The impact on the hips should be gauged by the amount of pain the activity causes. Too much pain obviously is a sign to back off.

Appropriate recreational exercise, including sports, can be helpful to most people with arthritis, but only if it is preceded by a program of stretching, range-of-motion, strength and aerobic exercise to reduce the chance of injury.

Beginning a new exercise program

Regardless of your condition, discuss exercise options with a physician before beginning any new exercise program. Also, begin new exercise programs under the supervision of a physical or occupational therapist, preferably one with experience working with arthritis patients.

People with arthritis who are beginning a new exercise program should spend some time conditioning using a program that consists of range-of-motion and strengthening exercises. Endurance exercises should be added gradually.

If you have had hip replacement surgery, you will also need to get started with a comprehensive exercise program. Proper exercise can reduce joint pain and stiffness and increase flexibility and muscle strength.

People who have an artificial hip should talk to their doctor or physical therapist about developing an appropriate exercise program. Most exercise programs begin with safe range-of-motion activities and muscle strengthening exercises. The doctor or therapist will decide when the patient can move on to more demanding activities. Many doctors recommend avoiding high-impact activities, such as basketball, jogging, and tennis. These activities can damage the new hip or cause loosening of its parts. Some recommended exercises are cross-country skiing, swimming, walking, and stationary bicycling. These exercises can increase muscle strength and cardiovascular fitness without injuring the new hip.

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