How Physiotherapy Can Help with Hip Pain and Mobility Issues

Hip pain can make life complicated. Walking, sitting, and even sleeping can be painful. Mobility issues can follow, and daily tasks can feel impossible. But there is hope. Physiotherapy can help. It can ease pain and improve movement. It is a natural way to heal without relying on medications or surgeries.
 

Anatomy of the hip joint

Hip pain is prevalent among the general population and tends to increase with age, weight gain, and a lack of physical activity. The hip joint, one of the largest in the body, functions as a ball-and-socket joint, playing a crucial role in daily movements like walking. Known for its mobility, the hip joint can transfer various forces and weights between the upper and lower limbs. 

• The joint's ball is called the femoral head, while the socket, part of the pelvis, is called the acetabulum. Cartilage surrounds both surfaces, enhancing movement and distributing forces. 
• Strong fibrous tissue called the capsule encases the joint, helping to keep the bones in place. Internally, this capsule is lined with synovium, which produces synovial fluid, providing essential nutrients and lubrication to the joint.
•  Numerous muscles, nerves, bursae, and tendons influence the hip joint, making it densely packed with anatomical structures.

Why does hip pain happen?

Hip pain has many reasons, including age, injury, arthritis, or weak muscles. Sometimes, poor posture or sudden movements can hurt the hip. Sports injuries are common, as is stiffness from long sitting hours. Weak bones can also cause pain. Finding the reason is the first step.

Various factors and structures can lead to hip pain, which can be classified into two categories:

• Inside the joint (intra-articular) and those outside the joint (extra-articular). Hip pain is often associated with muscle or ligament strains, tendonitis, or minor injuries among adolescent patients. 
• In older adults, common causes include osteoarthritis, fractures, bursitis, trochanteric pain syndrome (a type of bursitis), strains in ligaments(ligament injury), tendons, or muscles, labral tears, and avascular necrosis.

The subsequent exercises aim to stretch, strengthen, and stabilise the structures that support your hip. It’s essential to perform within your limits and avoid overstretching if you experience pain. It's typical to feel some muscle soreness after exercising, but you should stop and consult someone if you have joint pain lasting more than a few days. 

If you have undergone a hip replacement, keep in mind the following guidelines:

• Avoid bending your hips beyond 90 degrees.

• Do not roll your knee or toes inward.

• Do not twist your body while sitting or standing.

• Avoid crossing your legs or feet.

Exercises for hip pain

Strengthening exercises

1. Hip abduction (strengthening): Raise your leg to the side, ensuring you do not rotate it outward. Hold for five seconds before returning it slowly, maintaining a straight body. Use a chair or work surface for support.

2. Hip extension (strengthening): Extend your leg backward while keeping your knee straight. Tighten your buttock muscles and hold for five seconds. Avoid leaning forward. Again, use a chair or work surface for support.

3. Hip flexion (strengthening): Hold onto a work surface and march in place, alternately lifting your knees towards your chest. Ensure you don’t raise them above 90 degrees.

4. Bridging (strengthening/stabilising): Lie on your back with your knees bent and feet flat on the ground. Raise your pelvis and lower back off the floor. Maintain the position for five seconds, then lower slowly.

5. Heel to buttock exercise (strengthening): Bend your knee to bring your heel to your bottom. Keep your knees aligned and your kneecap facing down.

6. Mini squat (strengthening): Lower yourself into a squat until your knees are just above your toes. If possible, hold for a count of five. If necessary, use a work surface for support.

Stretching and stabilising exercises

7. Knee lift (stretch): Lie on your back. Pull each knee to your chest alternately while keeping the other leg straight. Move until you feel a stretch, hold for about 10 seconds, then relax. Repeat 5–10 times. If this is challenging, you can start by sliding your heel along the floor towards your bottom and, when comfortable, progress to lifting your knee as described.

8. Short arc quadriceps exercise (strengthening): Roll up a towel and place it under your knee. Keep the back of your thigh on the towel and straighten your knee to raise your foot off the ground. Hold for five seconds and lower slowly.

9. External hip rotation (stretch): Sit with your knees bent and feet touching. Press your knees toward the floor, using your hands if needed. Alternatively, lie on your back and separate your knees while keeping your feet together. Move until you feel a stretch, hold for about 10 seconds, then relax. Repeat 5–10 times.

10. Stomach exercise (strengthening/stabilising): Lie on your back with your knees bent. Place your hands under the small of your back and pull your belly button down toward the floor. Hold this position for 20 seconds.

11. Quadriceps exercise (strengthening): Draw your toes and ankles toward you while keeping your leg straight and pressing your knee firmly against the floor. You should feel a tightness in the front of your leg. Hold for five seconds and relax. You can also perform this exercise while sitting if it is more comfortable.

Treatment approaches for hip pain

The approach to treating hip pain relies on identifying the underlying causes and the intensity of the discomfort. Most cases of hip pain can be alleviated through conservative measures such as:

Conservative measures

1. Activity modification: Avoiding activities that worsen hip joint pain can help alleviate discomfort and swelling.

2. Ice and heat: Applying ice or heat to the affected area can help relieve pain and minimise inflammation.

3. Physiotherapy: Physiotherapy is beneficial for pinpointing the root causes and addressing the structures contributing to your symptoms. At TruePal, we utilise exercise and hands-on treatment to help you achieve your objectives. We can enhance your strength and flexibility and assist in pain relief. Learn importance of physiotherapy post surgery here.

4. Medication: Over-the-counter pain relievers, including anti-inflammatory drugs (like ibuprofen) and pain relief patches or gels, can also provide relief.

Surgical treatments

5. Injections: To help alleviate pain and swelling, corticosteroids or other medications can be injected into the hip joint. A specialist typically performs this procedure.

In more severe scenarios where conservative treatments are ineffective, surgery may become necessary to address hip pain, including:

6. Arthroscopy: This minimally invasive procedure entails inserting a camera and surgical instruments into the hip joint to diagnose and treat conditions such as labral tears.

7. Hip replacement: If you are experiencing significant osteoarthritis that impacts your daily activities, considering a hip replacement may be beneficial. This procedure involves removing damaged tissue and replacing it with an artificial joint.

Lifestyle changes

Physiotherapy is not just about sessions. It involves daily habits, and simple changes can make a big difference. Pain management is not just about treatment but also prevention.

• Stay active - movement keeps joints healthy. Avoiding long periods of sitting can help.
• Correct posture - sitting or standing wrong can worsen pain. Ergonomic chairs and proper posture reduce strain.
• Weight management - extra weight puts stress on the hip. Maintaining a healthy weight reduces pressure on joints.
• Proper footwear - good shoes support joints. Avoid high heels and unsupportive footwear.
• Ergonomic seating - comfortable chairs prevent stiffness. Using cushions for support can help.
• Diet and nutrition: Calcium and vitamin D are essential for bone health. Eating a balanced diet supports overall joint function.

Conclusion

Experiencing hip pain, can be physically exhausting, mentally challanging, and emotionally draining.If you face severe, persistent, or worsening hip discomfort should consult a physician. TruePal provides in-home physiotherapy services, allowing patients to receive necessary care without leaving their residences. For additional health and wellness advice or to schedule an appointment, visit TruePal.

FAQs

1. Can physiotherapy improve hip mobility?  

Physiotherapists and chiropractors address hip discomfort and various musculoskeletal issues. Physiotherapists focus on movement and functionality. They employ manual techniques, exercises, and stretches to enhance hip mobility, alleviate pain, and fortify muscles. Physiotherapy for hip pain targets both the symptoms and underlying causes.  

2. Should I continue to walk if I have hip pain?  

Daily walking or swimming can enhance your overall well-being and relieve pressure on your hip by building strength in other muscle groups. Many individuals cease exercising once their pain subsides, but it is common for them to reencounter issues quite swiftly when they do.  

3. How can you cure tight, weak hips?

Consider incorporating specific stretches for your hip flexors to alleviate tight and weak hips. Exercises such as glute bridges, planks, crunches, and clamshells can strengthen your glutes, core, and piriformis, enhancing both strength and mobility in your hips. Take regular breaks to move throughout the day to maintain flexibility in your hip flexors