The mobility of the hip joint can be limited in the case of hip dysplasia. Compensatory axial malpositions and a leg length difference can influence the gait pattern in hip dysplasia. The changed load on the acetabulum promotes the development of hip joint arthrosis. The disease hip dysplasia occurs more frequently in girls than in boys.
5 simple exercises to imitate
1. exercise – “Bridging” 2. exercise – “Variation” 3. exercise – “Squatting” 4. exercise – “Stretching the Adductors” 5. exercise – “Stretching the Hip Flexors
Contents of physiotherapy
- Mobilization
- Strengthening
- Elongation
- Manual therapy
- Physical therapy
- Development of a homework program
Mobilization of the hip and pelvis plays an important role in the therapy of hip joint dysplasia. A muscular imbalance and a restriction of the hip joint’s mobility strengthens relieving postures and promotes incorrect loading of the joint. A mobilizing therapy serves to maintain the mobility and functional efficiency of the joint.
Due to anatomical conditions, however, the results of mobilization are limited in some directions of movement and should not be forced, as joint stability in these areas may be insufficient. Mobilization usually takes place actively by the patient. In practice, mobilization exercises are actively performed.
Specific exercises are used to move the hip joint with the greatest possible range of motion. For example, circling with the knee in front of the body to a large, sweeping extent is an effective exercise. Restricted directions of movement can be worked out and then techniques such as passive movement, passive stretching, manual therapeutic techniques or complementary soft tissue treatments can be improved by therapists.
However, the majority of the work, as far as the mobilization of the joint is concerned, lies with the patient. Once the joints have been treated by the therapist, it is the patient’s task to maintain the mobility of the hip joint and surrounding joints through regular, consistent exercises in order to ensure the success of the therapy. Strengthening is probably one of the main focuses in the treatment of hip joint dysplasia.
Since hip joint dysplasia is an anatomically unchangeable condition, it is particularly important to compensate for any weak points and instabilities by means of a targeted strengthening program in order to avoid long-term incorrect loading of the hip joint itself, but also of surrounding joints. A stabilizing strengthening program is indicated as part of the strengthening process. In practice, working with one’s own body weight is recommended, as this is more functional than training on machines, which should be used as a supplement.
The patient is shown exercises which should be worked out together during the therapy. They serve to stabilize the femoral head in the socket and improve the joint function in everyday life. The success of the strengthening therapy depends on the patient, who urgently needs to perform the exercises regularly and consistently on his own at home after the therapy to ensure long-term improvement.
Stretching is also of great importance in the treatment of hip joint dysplasia. It serves to mobilize the hip joint and is intended to improve the joint position in the socket. Although the focus is on strengthening, the strengthening of weak muscle groups always includes stretching the muscles that are working too hard in order to allow a stabilizing muscular balance.
The stretching should be taught to the patient during therapy, so that he or she can perform it independently and correctly at home. For example, stretching of the gluteal muscles in the supine position (the patient reaches around the hired thigh and turns the other over the hired leg, then pulls the thigh to the chest with his hands, the turned over leg is stretched, the stretch should be felt on the outside of the thigh), or the stretch of the hip flexors (from the supine position, one leg is grasped by the thigh and pulled towards the chest, the other leg remains long and stretched on the pad, also head and back remain relaxed. The pull should be felt in the groin) are important exercises in hip joint dysplasia.The therapist can support the stretching with passive techniques and, if necessary, treat shortened structures manually.
The stretching should be held for about 30 sec, then the position is briefly released and after a pause of about 20 sec the position is taken again. 3-4 sets are sufficient. In manual therapy for hip joint dysplasia, the joint mechanics can be positively influenced.
In the area of the hip joint one often works with a belt that is placed around the patient’s thigh. This allows a better influence on the hip joint. In manual therapy, the aim is to improve the rolling of the femoral head in the acetabulum.
The existing dysplasia can lead to compensatory incorrect loading and relieving postures. These can manifest themselves, for example, in the area of the spinal column, where they can be positively influenced by specific manual therapeutic techniques. After an individual diagnosis, the manual therapist adjusts the patient in a certain position and can then treat, for example, the facet joints of the spine, which are often responsible for pain and tension.
Within the framework of Manual Therapy, in addition to passive therapy techniques, active exercises can also be used for the patient, which are intended to help restore muscular balance and prevent incorrect loading due to the changed hip joint position. Physical therapy can also be used in the treatment of hip joint dysplasia. Since hip joint dysplasia is an existing malformation of the joint, physical therapy aims more at alleviating symptoms than at changing the joint mechanics.
However, this often leads to tension and incorrect loading in the area of the hip itself, but surrounding joints can also be affected by the altered statics. In the physical therapy of hip joint dysplasia, heat applications (hot air, red light, fango) for the relaxation of the musculature can be considered. Electrotherapy and ultrasound can also be applied at the appropriate location.
The current increases the blood circulation and relieves pain. Baths and water gymnastics can be used in case of hip joint dysplasia for a strengthening without stress. It is important to strengthen the muscles of the hip and the pelvis in order to provide muscular support for the femoral head in its socket.
Water gymnastics is ideal for this, as the weight of the body is reduced by the buoyancy of the water, and the joint is protected while the muscles are working. A hip dysplasia is an existing change in the joint, which cannot be fundamentally changed by the therapy. The aim is to influence the muscular stabilization apparatus in such a way as to maintain a physiological joint function that is as unstressed as possible.
It is important to keep in mind that without regular practice, the progress of the therapy will be lost. The muscles must be trained and strengthened permanently, and muscle groups that tend to shorten must be stretched again and again. The consequence of the patient to carry out his homework program regularly is decisive for the long-term success of the therapy.
It is the patient’s responsibility to ask the therapist if there are any uncertainties regarding the exercises, or to demand exercise variations that he can integrate into his daily routine in the best possible way. The therapist should make sure that the exercise program is carried out correctly and that the choice of exercises is optimal and individually adapted to the patient. If complaints or questions arise during the exercises at home, they should be checked by an expert in order to correct any errors as early as possible.
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