Physiotherapy for baby/infant

The examination of the hip is one of the standard examinations for newborns/babies and is performed in the first weeks of life as part of the U-examinations (usually U3) using ultrasound. The picture shows the steep position of the acetabulum in hip dysplasia. Before and in addition to physiotherapeutic treatment methods, the child’s hip is often stabilized with orthoses or spreader pants, or at the beginning with a plaster cast.

In severe cases, usually when a dislocation is also present, surgery may also be necessary in which the femoral head is brought into the correct position and then fixed in place.The femoral head can be centered in its acetabulum and the ossification of the acetabulum can be influenced favourably by a spread (abduction) and flexed position of the thigh. Physiotherapy can also be performed with a baby. If severe hip dysplasia is present, gentle mobilization techniques can be used to move the child’s hip joints in abduction and flexion, thus improving the joint mechanics. The mobilization takes place after the fixation. These articles may also be of interest to you: Physiotherapy for a child’s hip dislocation, Physiotherapy for a child’s hip dysplasia

Physiotherapy for adults

Hip dysplasia in adults usually manifests itself as groin pain or pain in the lumbar spine or front thigh. It can also lead to a more internally rotated gait pattern, i.e. when the toes point more inwards when walking. Often the shoes are unevenly worn.

However, these are not clear signs. Further diagnostic imaging is required. In adulthood, the hip is fully developed, which means that a change in the ossification is no longer possible.

If the symptoms and limitations are very severe, surgical therapy is usually necessary. A common procedure is the triple osteotomy, in which the femoral head is surgically brought into the correct position. If there is severe wear in the affected joint, an endoprosthesis can also be inserted (joint replacement as in arthrosis therapy).

Subsequently, physiotherapy is now indicated to correct existing muscular imbalances, which have been caused by years of malpositioning. It is especially important to train the extensors, i.e. the hip-extending musculature as well as the external rotators and abductors (outward rotating and abducting muscles). A gait training may also be necessary, in which the slightly outward rotated position of the hip is increasingly taken into account.