Hip pain is very common and can effect both adults and children throughout their life. To find out more about what the hip is, how pain can arise and ways to help manage hip pain, keep reading!

Hip Anatomy

The hip region is the point at which the legs connect to the torso and upper body. It has a unique anatomy that allows it to be both extremely strong and amazingly flexible, so it can bear weight and allow for a wide range of movements. The hip joint (acetabulofemoral) is located where the head of the femur (thighbone) fits into the rounded socket of the pelvis. This ball and socket joint allows for three distinct types of movement:

• Hip flexion and extension - moving forward and back

• Hip abduction and adduction - moving out to the side and inward

• Rotation - allowing toes to point inward and outward with a straight leg.

The hip joint is what is termed a ball and socket joint, and the following components allow for it to fulfil its function:

• Hip bones - include the femur and pelvis

• Hip articular cartilage - allows for decreased friction between bones and increased gliding motion

• Hip muscles - support joints and enable movements

• Hip ligaments and tendons - bind bones to bones and muscles to bones to ensure stability

• Synovial membrane and fluid - encapsulates hip joint and lubricates it to allow for ease of movement

Symptoms from these conditions can include:

• Pain in the hip joint (usually felt in the groin area)

• Referred pain to the high and knee

• Limping or uneven walking patterns

• Reduced range of motion

• Stiffness in muscles or joint

• Pain when trying to put weight through the leg on the affected side

Common hip conditions

There are many conditions that may cause hips problems however, the most common are:

• Osteoarthritis - This is a common form of arthritis that tends to affect people as they age. It is associated with the degeneration of the joint cartilage and changes in the bone. The exact cause is unknown however, genetics, stress on the joint and local inflammation are thought to play a role.

• Rheumatoid Arthritis - is an autoimmune disease that results in inflammation of the joints. Inflammation within the hip joint can cause pain, prolonged stiffness (often after sleeping or long periods of no movement) and swelling.

• Ankylosing spondylitis - An uncommon form of inflammatory arthritis that can target the spine, knees and hips.

• Bone Fracture - Older people are more prone to hip fractures as your bones decrease in density as they age. Osteoporosis is when you have excessive loss of bone tissue which makes them more prone to fractures. Dislocations of the hip occur when the head of the thigh bone is pushed forwards or backwards out of the socket. These usually occur due to traumatic events such as a car accident or fall.

• Soft tissue pain and referred pain - Pain that can appear to be coming from hip joint can sometimes be related to the soft tissue structures around the hips such as the muscles, tendons, bursae or referred pain from the back. A common presentation is trochanteric bursitis which is the irritation of the soft tissue surrounding the outer hip due to overuse.

• Dysplasia of the hip (children) - Developmental dysplasia of the hip means that the hip joint of newborn babies is dislocated or prone to dislocation. The socket is abnormally shallow which prevents a stable fit.

Falls Risk and Mortality

As we age, there is an increased risk of having a fall. A possible injury that can result from a fall is a hip fracture. The post-surgery prognosis sees an unfortunate decrease in survival rate. Research shows that mortality (likelihood of death) is at 6% 30 days post surgery, 10% 4 months post, 23% 1 year post and 55% at 5 years post. As you can see, there is a 1 in 4 chance of mortality after a recent hip fracture and surgical intervention. This highlights the importance of having strong hips!

Benefits of Exercise

Although hip pain can be debilitating, exercise can help prevent, manage and treat it. Research has shown that strength training can help with treating hip osteoarthritis. While this exercise has to be tailored to the persons needs, it is safe to complete aerobic and strength training to help reduce symptoms. As well as helping to improve hip pain, exercise can help prevent other chronic conditions while also acting on the mechanisms that cause exercise-induced anti-inflammatory effects. For those with hip dysplasia, research has shown that progressive resistance training is feasible and can improve pain levels, functional performance and muscle strength. Considering the mortality risk of falls as we age, a large body of evidence has shown that exercises with a focus on balance and resistance training can help reduce risk of falls by up to nearly 30%. If you do fracture your hip, research has shown that exercise can help with improved hip function and physical performance at the 12 month mark post surgery and is safe and effective.

Exercise 1 - Hip Flexor Stretch

1. Put a cushion or pillow on the floor. Hold onto a bench or chair for support.

2. Lower one knee to the floor with the other leg forward

3. Lean forward with your hips until you feel a stretch in the hip with the knee on the floor.

4. Hold for 30 seconds and complete twice on each side.

Exercise 2 - Seated Marching

1. Sitting tall in a chair, place hands by side

2. Raise one knee up, ensuring you don’t lean back

3. Hold at the top for 1 second then lower back to the floor

4. Alternate knees, aiming for 10 each side for 2 sets

Exercise 3 - Standing Hip Abduction

1. Holding onto a bench or chair for support, place weight through one leg.

2. Send the other leg out to side

3. Slowly lower back to start position

4. Complete 10 each side for 2 sets

If you or a person you know has hip pain and want to know more, please don't hesitate to call us on (07) 3184 0444 or book online to contact our Exercise Physiologists to discuss how exercise can help.

Also we have our Bones & Balance class which is aimed at helping reduce your falls risk and help protect against osteoporosis.