Help for Hip Osteoarthritis: Get Moving Again!

Unfortunately, arthritis manages to get a hold of just about everyone. In fact, 1 in 4 older adults will suffer from osteoarthritis (OA) of the hip. I was recently part of a group that reviewed the best possible treatment that we, as physical therapists, can deliver to help patients decrease their pain and keep moving. I’m excited to share with you some helpful tips on how to manage your hip OA at home.

First of all, I must thank the other members of the group, as I certainly didn’t do all the research myself: Cory Haselman, John Upton, and Isaac Villa.

As with my previous writing on plantar fasciitis, this information was gathered by the American Physical Therapy Association in one of their clinical practice guidelines.

While we don’t really understand the history of osteoarthritis, when the hip is affected we have a pretty good idea of what impairments will be present. The patient will feel pain and stiffness of the affected hip, usually worse in the morning or after a long period of rest. We find a decrease in range of motion and strength, eventually resulting in changes in walking. More specifically, we see decreased hip flexion and weak hip abductors that may eventually lead to slower or painful looking gait.

A lot of times when a joint is painful an individual will stop all activity to avoid pain. If nothing else, I’d like to break this trend. If an individual is avoiding activity to avoid pain, we will usually see greater disability. A better alternative is to modify activity and make lifestyle changes to allow a return to healthy living!

So what can you do at home to help OA of the hip? Here are some beginning steps:

  • Lose weight. Obesity is linked with hip arthritis, as well as an increased risk of falls. In one study, researchers found that an 8% reduction in weight was as effective as a 15% increase in strength to help a patient improve their ability to maintain balance.
  • Participate in aerobic exercise. Go for a walk, ride your bike, hop on an elliptical, etc. I tell my patients to find a mode of exercise they enjoy so they will stick with it. The exercise needs to be performed in a safe manner, so if you are an individual who is at greater risk of falls, I would not recommend walking outdoor trails right away. You can begin with 5-10 minutes of exercise, working your way up to 20-30 minutes. Ideally, you will be exercising at 60-80% max capacity, and doing this five days per week. One way to figure out if you are exercising appropriately would be to work at 60-80% of your max heart rate (target heart rate). To do this you’ll need to do a little math:
    • 220 – age = max heart rate
    • Max heart rate multiplied by 60% and 80% will give you a good range to exercise within.
    • So, for a 65-year-old individual: 220-65 = 155; 60% x 155 = 93; 80% x 155 = 124. While exercising your heart should be beating between 93 and 124 beats per minute.
  • Practice flexibility and stretching. This includes controlled/sustained stretching of leg muscles in a way that does not cause increased pain. Stretches should be held for 20-30 seconds, with three repetitions of each particular stretch. Ideally, you will perform these after you are warmed up. A perfect time to stretch would be after your aerobic exercise. Also, remember to avoid “bouncing” while stretching to prevent injury.
  • Strengthen your muscles. You will want to load your muscles in a gradual manner to build strength while limiting tissue injury. Functional strengthening has been shown to be especially beneficial. Examples of functional training include:
    • Walking, sit to stand (rising from a chair for repetitions), squats, reaching, step ups, step downs.
    • Other traditional recommendations include: Using a cane in the opposite hand of the affected hip and carrying loads (for example groceries, a purse, or brief case) on the same side of the affected hip may help reduce pain and pressure placed on the hip.

Here’s a downloadable document with Home Exercises for Osteoarthritis of the Hip that can help you get moving. However, I do not recommend you perform every one of these exercises. Find the exercises that are challenging and you feel are of benefit and get to work! If you have tried these recommendations on your own and have not achieved the results you had hoped, seeing a licensed physical therapist (PT) may be a good option for you. A PT should make an individualized program to address your limitations and suit your specific needs.

As always, speak with a health care provider before beginning an exercise program. Make sure you feel comfortable with each exercise you perform and that the exercises do not cause increased pain.

I encourage you to ask questions, share your experiences and leave suggestions for future topics in the comments below. I will do my best to respond to each as timely as possible!

imageBryon Renwand, PT, DPT, CSCS, works with ProMedica Total Rehab and received his Bachelors of Science in Exercise Science from the University of Toledo, where he also received his Doctorate of Physical Therapy. For his full bio and other articles, please click here.

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