Exercises
The hip joint, as the most stressed joint of the human body with the largest range of motion, is supported, moved and secured by about 18 different muscles in its guidance.In addition to the gluteal muscles (outer hip muscles), these include the hip flexor muscles (inner hip muscles), the deep-lying hip muscles and the adductor muscle group (muscles for pulling the leg towards the body). By training these muscle groups in a targeted and balanced manner, it is possible to better buffer large loads, protect the ligamentous apparatus and protect the cartilage of the hip joint from excessive, uneven wear and tear. It is important, however, that the opponent of the muscle being trained (opponents are e.g. hip flexors and extensors) is strengthened with the same degree and intensity, so that no imbalance occurs between the two, which in turn can lead to incorrect loading of the joint system.
In the same way, stretching exercises (5-10 minutes/day) are of enormous importance in order to keep the hip muscles supple and prevent shortening. If there are already pre-existing diseases of the hip joint, strengthening the hip muscles is all the more important, as it can relieve the joint and support the healing process. It is advisable to seek out physiotherapists who can specifically determine the right exercises for the respective malfunction of the hip joint and can help to perform them correctly and later integrate them independently into everyday life.
These strengthening exercises include, for example, exercises in a standing position (e.g. lateral, horizontal lifting of the stretched leg to strengthen the abductor muscles of the hip) or lying down (e.g. building a bridge, lateral support stand with lifting of the painful leg), which should be performed daily with at least 10 repetitions. Swimming or aqua gymnastics can also be used to gently strengthen the hip muscles, as the buoyancy of the water relieves the joint and the resistance of the water strengthens the muscles.
Crawl and backstroke swimming is more recommended than breaststroke. The therapy depends entirely on the cause of the pain. While fractures of the pelvis (stable pelvic ring fractures) usually do not require further treatment other than pain treatment, an unstable pelvic ring fracture usually requires surgical treatment.
Cracks in the muscles of the pelvis are also usually treated conservatively. Arthrosis of the hip joint is also treated in early stages with painkillers and physiotherapy only. In advanced stages the implantation of an artificial hip joint (hip-TEP) is indicated.
A distinction is made between chronic and acute hip pain. Acute pain occurs suddenly and unexpectedly, the cause is usually a trauma, in the form of a pulled or torn muscle or a fracture of the pelvic bone or neck of the femur (also after trauma). The causes of chronic pain in the hip are in most cases signs of wear in the hip joint due to years of incorrect loading.
This so-called hip arthrosis (coxarthrosis) is the most common cause of hip pain, especially in older people. In early stages, there are few complaints, mostly only when the hip joint is fully loaded. In advanced stages of osteoarthritis, patients already complain of pulling and biting pain at rest, which brings them into a relieving posture and prevents them from continuing to perform habitual movements of the hip.
Diagnosis of hip pain includes not only a detailed interview with the patient, but also a physical examination as well as an imaging examination in the form of an X-ray, where fractures or arthroses can be seen. Fractures can be seen even more clearly in a CT or MRT. In the case of stable fractures of the pelvis, treatment is usually carried out conservatively, and if instabilities are present, surgery must be performed. In addition to the forms of treatment, physiotherapeutic exercises should be performed for all hip pain.
