Strong healthy hips are essential for movement, agility and performance. Think about your day to day activities, visualise the multitude of directions your hips have to move and imagine how many muscles are co-ordinating to make it all happen. On one hand the hip joint needs to be exceptionally mobile to facilitate movement in all directions while on the other hand our hips need stability to transfer power from the upper to lower body and vice versa. A complex web of soft tissues including muscles, ligaments and fascia attach in and around the hip joint to provide neuromuscular and proprioceptive input which assists with balance and locomotion. The mechanics, when efficient, are quite incredible.
Unfortunately deskbound jobs, leisure activities that encourage us to be sedentary and repetitive exercise routines are a dangerous combination for hip health.
The question is what can we do?
My biggest piece of advice when it comes to protecting our hips is not to continue to exercise through pain or injury.
We quite often have clients who present with niggling hip pain that’s been around for weeks. Typically it starts as a vague pinching or tightness around the front of their hip during exercises such as squats or running. Initially it doesn’t feel like much to be concerned about but soon enough the discomfort is there every day, without noticing you’re compensating slightly when you walk, even more so when you run, lift weights or play sport. The body naturally recruits surrounding muscles to keep up with continued movement demands and over time these multitasking muscles fatigue, get tight and subsequently limit movement of the hip joint in an attempt to lessen their load. Limiting movement in a joint designed to be mobile places more stress on a focal area of cartilage and may be the catalyst for degeneration of the weight bearing surface. Once that cartilage wears away hip replacement surgery begins to climb up the list of potential management options.
Seeing a physio or health care provider early can allow for appropriate training or lifestyle modifications to be discussed and implemented. I usually suggest my clients have a balance of strength and mobility practices. This may include simple stretches that are specific to the individual (just because your friend has tight hip flexors doesn’t mean you do) combined with a functional strength program that incorporates multi directional exercises. Remember the hips move in all directions so if your exercise regime only includes running, or you only ever do spin class you are most likely neglecting much of the hips rotational requirements. Variation is important and some people may benefit from switching to lower impact forms of training such as swimming or walking. The key is to address such factors early rather than waiting until the damage is already done.
I also think it’s really important for people (where appropriate) to be mindful of their weight. While this may not be a physio specific piece of advice it’s a conversation that sometimes needs to be had. Cartilage can only withstand a certain amount of force before it starts to break down. Every kilo of extra weight can translate to 6kg of extra force across our joints, especially the weight bearing joints such as the hip and knee. That extra 5-10kg you are carrying may be more detrimental than you realise.
Hip replacement surgery is becoming more routine than ever before. Technological advances have certainly streamlined the surgical procedure but like anything there is always risk involved and where possible it’s something that we should all try to avoid.