Treatment of hip arthrosis from a physiotherapeutic perspective

Synonyms

• Coxarthrosis treatment
• Hip arthrosis treatment
• Rehabilitation for hip arthrosis

General recommendations for hip arthrosis

• Movement/activity without load within the current load capacity of the hip joint instead of protection
• Everyday stresses and strains such as climbing stairs, long walks, lifting and carrying weights, reducing knees and carrying them out consciously and economically
• Avoid sitting low, use an armchair and possibly a wedge cushion or special arthrosis seat cushion
• Strength training, mobilisation, balance, endurance and fitness training
• Recommended sports: Functional gymnastics with strength-stretching, coordination and balance exercises, pendulum exercises as a balancing movement for joint stress in everyday life, medical strength training, cycling, possibly with E. Bike, or bicycle ergometer, swimming, aqua jogging
• Use group offers such as rehabilitation sports or sports for seniors in a club
• Jogging, skiing, tennis, squash, avoiding football
• Weight reduction, already 5% weight reduction results in a clinically relevant relief of the hip joint
• Healthy, balanced diet, avoid poisonous food
• Food supplement with chondroitin sulfate, hyaloronic acid

Hip arthrosis: Problem area pain

• Pain in the hip joint, groin, buttocks, equilateral knee joint, muscle pain, pain at night
• Start-up pain in the morning, after prolonged sitting
• Pain intensification – fatigue and stress pain during the day after prolonged walking, climbing stairs or hiking, after carrying heavy objects or gardening
• Primary or secondary back pain as a result of hip joint arthrosis

Hip arthrosis: physical therapy for the problem area of pain

Transverse twists are performed passively by a therapist. Transverse stretching is performed transversely (in contrast to longitudinal stretching, which the patient can perform independently) to the muscle course and can be used for pain relief and as preparation for longitudinal stretching. Transverse friction is also performed passively by a therapist.

The tendons of the affected musculature are worked on transversely to their course at the bone attachment. The fascia ball offers a possibility of self-treatment. In trigger point treatment, a therapist uses various techniques to treat local muscle hardening, particularly in the hip flexors, splay, abduction and external rotation muscles of the hip joint.

The fascia ball offers one possibility of self-treatment. The use of electromagnetic fields can lead to a regeneration of the cartilage and bone tissue of the arthrotic joint. Especially in combination with other pain and movement therapies, pain relief and functional improvement can be achieved.

In medical taping of coxarthrosis, elastic tapes are applied to the skin in a specific application form. The aim is not to immobilize the joint, but rather to relieve pain and improve mobility by acting on the muscles (reducing tension, improving metabolism) and the joint (improving the feeling of movement). Starting position: supine position over the roll, hands supported backwards Exercise performance: roll out the lumbar region in small areas piece by piece from the beginning of the lumbar spine to the sacrum Alternative starting position: standing on the wall, roll between lumbar region and wall Starting position: sitting on the roll or fascia ball (punctual) exercise performance: Shift weight to one half of the buttocks, find the point of pain in the pain area Roll back and forth over a small area Starting position: Stand sideways on the affected leg above the fascial roll, other leg in front of it, hands supported in front of the body Exercise: Roll out the entire area between hip joint and knee over a small area in the pain area Alternative starting position: Stand sideways on the wall, roll between lateral thigh and wall

• Heat application via fango, hot roll
• Transverse strain, transverse friction and trigger point treatments
• Ice application, curd wrap
• Baths
• Electrotherapy, also in the form of a TENS unit for use at home
• Bemer therapy
• Medical taping
• Connective tissue – fascia treatment for hip arthrosis:
• In addition to stretching and strengthening the muscles surrounding the hip joint, treatment of the connective tissue around the hip joint has a pain-relieving and movement-expanding effect.

This treatment can be carried out passively as a connective tissue massage/friction techniques by a physiotherapist or as self-therapy. – With the help of the fascia roller and the fascia ball, adhesions of the connective tissue are loosened, elasticity and blood circulation are improved. – Dosage: 2-3/week, 10-20 times over the affected pain area until a significant relaxation is achieved, longer if the pain is more severe.

The pressure on the connective tissue area to be treated can be varied by supporting the hands. – The treated muscle areas should not be tensed during the roll-out despite pain provocation. – Lower back fascia:

• External rotators buttock fascia:
• Lateral hip joint fascia:
• Often limited directions of movement are the internal rotation, extension, abduction, and flexion of the hip joint
• This often results in movement restrictions of the spine, knee and ankle joints with incorrect posture and altered gait pattern (“limping”)
• Loss of strength in the hip, leg, foot and trunk muscles
• Muscular imbalances (The optimal cooperation of all joint-bearing muscles necessary for movement is called muscular balance.

Loss of strength, tension and muscular shortening lead to an imbalance (Muscular Dysbalance) in the tension relationship between agonist (player) and antagonist (opponent) and in the cooperating muscle chains). In hip arthrosis, the hip flexor muscles in particular are disproportionately strained, which in turn leads to an inhibition and loss of strength in the hip extensor muscles. – Weakness of coordination and balance with the risk of falls