Hip Osteoarthritis

There are numerous clinical practice guidelines for how to manage osteoarthritis. These are put together by some of the top researchers and clinicians in the field. Current recommendations all include:

• Exercise works to improve the flexibility, range of motion, strength and endurance of the joint. Muscles across the joint will act like shocks do in a car – better shocks, less wear and tear to the car frame. Stronger muscles, less impact forces to the joint. Studies of exercise in hip osteoarthritis show a moderate benefit to pain and function, regardless of age, severity of joint changes, pain levels and level of function. Importantly, exercise is safe and unlikely to progress disease severity. One study took patients awaiting a total hip replacement put them in a group-based exercise class for 6 weeks and compared them to a control group with no intervention. The exercise group had a significant improvement in pain severity and the amount of interference the pain caused in their daily lives.
  
  Current dosage recommendations for exercise are 1 to 5 times per week over 6 to 12 weeks for mild to moderate hip osteoarthritis, including stretching and strengthening exercises. The Physio Fixes program will guide you through a strengthening program designed to meet you where you’re at and build your strength and flexibility.
  
  
• Weight Loss can be important for offloading the joint. During walking the force on the hip joint is estimated to be 238% of a person’s body weight. On stairs, it increases to 250% for going upstairs and 261% for going downstairs. If a person is overweight or obese a loss of 5% or greater of their body weight has been shown to have clinically significant results. Please discuss this further with your healthcare team as there are numerous other healthcare professions (physician, dietician, nutritionist, etc.) that can make the process of losing weight more effective. 
  
  
• Aerobic exercise has the benefits of reducing fatigue, building stamina/endurance, assisting in weight loss and is beneficial for our general health and other systemic conditions. The current guidelines recommend 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise each week, or a combination of those options. This can be divided into multiple sessions (ie. 5 days for 30 minutes), but should be a minimum of 10 minutes in duration. The most commonly studied exercise is walking. If you are unable to walk or don’t like walking you can use non-weightbearing exercises. This would include things such as biking, swimming, or aquacise. These same guidelines also recommend 2 days/week of strengthening exercises, such as the Physio Fixes program.
  
  
• Assistive walking devices can be useful if you feel your balance has decreased or if using one can help offload your hip joint to allow for better function and less pain. These would include things like a cane or walker. 
  
  
• Pain can be more than just a structural issue. Think about a time when you were short on sleep or stressed, usually, things feel worse. That’s not saying the arthritis isn’t causing structural pain in your hip. However, there may be other factors that can intensify the pain you feel (or conversely, decrease the pain you feel) and are potential areas you can work to address. See this link for a 5-minute video that helps to explain what happens when we have pain and how other things like stress, sleep, fear and beliefs can influence it.

Ready to get started! Please see the Physio Fixes program below to start on your way!