Hip arthrosis: exercises for the problem area of balance

Even without suffering from hip arthrosis, the ability to maintain balance deteriorates from the 4th decade of life if no training stimuli are given. Due to degenerative hip arthrosis, not only strength and mobility suffer, but also coordination (optimal interaction of the muscles involved in joint movement) and equilibrium regulation. The adaptation reaction of the musculature to spontaneous shifts in the centre of gravity, falls, anxiety and protection deteriorates. Intensive balance training/proprioception training (feelers in muscles, capsules, ligaments for neuromuscular control), especially of the deep muscles near the joints in the hip joint and lumbar spine area, complete the strength and functional training for hip arthrosis. Information on the regulation of balance and examples of exercises for balance training and fall prevention can be found under Falling in Old Age.

Hip arthrosis: Problem area Disability in everyday life and when walking

Restriction in professional and domestic life or in leisure activities
Problems when walking longer distances
Difficulties in bending, kneeling, climbing stairs, personal hygiene, especially foot care, dressing
Changes in the gait pattern: Enlarged track width
Hollow back” due to the limited hip extension
Inclination of the pelvis and thorax to the side of the supporting leg (the leg that stands on the floor), a so-called gentle limping develops
Sinking of the pelvis on the free leg side (the leg that is in the air)
Step shortening of the healthy leg due to the painful loading phase on the affected leg

The physiotherapist analyses the patient’s gait pattern and can use this information to determine which goals are achievable for the patient and which exercises are useful. In doing so, he must take into account the patient’s age, individual structural functional limitations and personality structure. Depending on the degree of damage to the hip joint, a hobbling mechanism can certainly be overcome again by improving mobility, pain relief, muscle condition and coordination (optimal interaction of the muscles).

A patient can best accept an irreversible walking disability if no false hopes are raised and the patient is not overtaxed with the exercises and demands. The gait school includes exercises to train weight transfer in standing and walking, emphasis on hip extension in upright walking, climbing stairs and the gait school with walking aids. General recommendations for walking in everyday life:

Soft footwear, low heels, buffered soles, possibly Velcro fasteners for severely restricted hip flexion are recommended. – Instructions for the use of everyday aids, e.g. shoe or stocking hooks
Do not use walking aids such as walking sticks, crutches or walking frames too late, otherwise the asymmetrical gait will cause back pain
Avoidance of long hikes with unaccustomed strain (e.g. climbing), long city walks, jogging
Cycling longer distances better