The team at Therapia Physiotherapy & Pilates is here to help!

There are many reasons why a person might be experiencing hip pain, including issues with the bones (Acetabulum & Femur), joint (where the bones meet, the opposing surfaces are covered in smooth cartilage), capsule (a fluid-filled sac surrounding the joint), ligaments (non-contractile tissues that support the joint), muscles/tendons (contractile tissues that move the joint), bursae (fluid-filled sacs between structures, they help to reduce friction) and/or nerves (information highways to/from the brain & spinal cord). As such, it is important to identify the correct source(s) of the pain.

Correctly identifying the source(s) of symptoms plus any contributing factors enables the team of practitioners at Therapia Physiotherapy & Pilates to develop an individualised treatment program that will effectively manage your symptoms, promote long term recovery and reduce the risk of re-injury.

AAOS 1995-2021

A common cause of ongoing hip pain is osteoarthritis (OA). It is the most prevalent form of arthritis, affecting the quality of life for more than 1.8 million Australians. OA is a chronic, degenerative condition that develops over many months to years. It can occur in any joint of the body but often develops in the weight-bearing joints (e.g. hips & knees). Hip OA is associated with age (>40yrs), gender (women>men), family history, history of being overweight, work history involving lifting heavy loads and/or history of previous severe hip injury.

What changes occur in a hip with OA?

1. The smooth cartilage on the bones slowly wears away
2. The protective space between the bones starts to decrease
3. The bones come into direct contact
4. The bones grow outwards, forming bone spurs
5. The surrounding tissues become inflamed
6. The ligaments and tendons deteriorate

What symptoms are associated with hip OA?

1. Joint pain and stiffness
2. Decreased range of movement
3. Locking sensation
4. Grinding noise or ‘crepitus’
5. Difficulty getting in and out of bed, standing up from a chair, walking, climbing stairs, squatting and/or lifting heaving loads

Pain usually onsets slowly and worsens over time. Pain can include groin and/or thigh pain that may radiate into the buttock and/or thigh. Initially, pain and stiffness are worse first thing in the morning and after rest. Pain may also flare up with vigorous activity. Later, pain and stiffness start to occur during rest and at night.

What will an initial physiotherapy assessment for hip OA involve?

1. Collecting a detailed history of your presentation (e.g. What are your symptoms? How are they changing over time? What activities make them better vs. worse?)
2. Observing your posture and movement patterns (e.g. sit-to-stand, walking, climbing stairs & squatting)
3. Assessing your hip range of movement, muscle strength, joint play and articulating surfaces
4. Testing your nervous system (if/when applicable)

What will physiotherapy treatment for hip OA involve?

At Therapia Physiotherapy & Pilates we treat hip OA using active rehabilitation, specifically we work to manage your pain whilst promoting range of movement, strength and endurance plus dynamic stability (how supported you feel during movements). We will look at your whole body too, not just your hip!

Pain management might involve pain education, remedial massage, dry needling, taping, gait aid prescription, activity modification, ice/heat packs, anti-inflammatory creams and/or taking supplements (e.g. Omega-3).

Range of movement, strength and endurance plus dynamic stability are promoted through a combination of individualised studio-based clinical Pilates and home exercises. Your active rehabilitation program will be developed in collaboration with you and reflect your personal goals plus the most up-to-date research evidence (e.g. GLA:D). We want to help you to minimise your symptoms, increase your function and improve your wellbeing!

All active rehabilitation is conducted in consultation with your GP and any other healthcare providers (e.g. Rheumatologist & Podiatrist).

Why active rehabilitation and exercise are helpful and not harmful in OA!

Multiple research studies have shown that: 

• It takes a lot to damage joints, ligaments and muscles
• Excessive inactivity is worse than minimal activity
• You do not get more OA by being physically active 

NickyLloyd/Getty Images

Benefits of exercising with OA! 

• Improved cartilage quality
• Increased joint range of motion, function and stability
• Reduced pain
• Improved quality of life

Overall, active movement through exercise facilitates synovial fluid circulation in the hip joint, which promotes recovery.

What is GLA:D?

GLA:D (Good Life with osteoArthritis Denmark) is an education and exercise program developed by researchers in Denmark for people living with OA of the hip(s) and/or knee(s). Australian research has shown that participation in the GLA:D program results in decreased pain, pain medication use and perceived need for surgery plus increased joint confidence (GLA:D Australia 2017). Our team at Therapia Physiotherapy & Pilates includes GLA:D certified practitioners. As such, your active rehabilitation program will reflect GLA:D principles.

GLA:D exercises for people living with hip OA include backwards and sideways lunges, hip abduction and adduction, sit-to-stand practice plus step-ups.

GLA:D Australia 2019

Additional, complementary clinical pilates exercises might include foot strap work (hamstring arcs & circles),  scooter, Russian skis and hip opening.

At Therapia Physiotherapy & PIlates we love helping people with hip pain to achieve their personal goals, whether that is to stay active, go for long walks or return to sports. Most of our clients achieve their goals through an active rehabilitation program that includes individualised treatment and exercise programs incorporating GLA:D exercises, Pilates, Yoga etc. 

If you notice any hip pain that is not improving and is affecting your daily function and hobbies, please contact the team at Therapia Physiotherapy & Pilates on 8221 5011, or email us at info@therapia.com.au. 

You can book an appointment to consult with a Physiotherapist below:

We look forward to answering any questions you have, and discussing treatment options with you.

Disclaimer

None of the information in this article is a replacement for proper medical advice. Always consult with a medical professional for advice regarding your individual injury.

If you have experienced or are experiencing any injuries, chronic tightness or pain in the hips and/or knees, it is recommended that you seek the advice of your trusted health advisor (GP, physio, or us!) before you attempt any exercises.

References:

1. American Academy of Orthopaedic Surgeons (AAOS) 1995-2021, Osteoarthritis of the Hip, OrthoInfo, viewed 20 February 2021, <https://orthoinfo.aaos.org/en/diseases–conditions/osteoarthritis-of-the-hip/>.
2. Arthritis Australia 2009, Taking control of your Osteoarthritis – A practical guide to treatments, services and lifestyle choices, Glebe, New South Wales, Australia.
3. GLA:D Australia 2017, Welcome to GLA:D Australia, GLA:D Australia, viewed 22 March 2021, <https://gladaustralia.com.au/>.
4. GLA:D Australia 2019, GLAD NeMEx Program 2019, GLA:D Australia, Melbourne, Victoria.