Exercising with hip osteoarthritis - am I doing more damage?



If you have hip osteoarthritis it may impact your ability to exercise and perform your daily activities. People with hip osteoarthritis often experience pain deep in the groin, inner thigh, and outside of the hip. You may also have noticed reduced range of movement through your hips, reduced step length with walking; you may have trouble getting in/out of the car, putting on socks, and picking items up from the floor. All of these symptoms can sometimes make it more difficult to exercise and maintain a healthy lifestyle.


Can exercise help my hip osteoarthritis?


Definitely!


Evidence overwhelmingly indicates that exercise improves pain and function in people with hip osteoarthritis and delays the need for joint replacement surgery.


A 6-year follow-up study which compared exercise plus education to education only, demonstrated how exercise delayed the need for hip replacement surgery by 2 years. The average time before having a hip replacement for people in the exercise group was five and a half years, compared with three and a half years for people who had not had exercise therapy (Svege et al., 2015).


Why is it important to stay physically active if you have hip osteoarthritis?


Exercise has been shown to be one of the best treatments for people who experience hip osteoarthritis. Specific tailored exercises assist in relieving pain and improve joint health and function, this in turn allows you to continue doing the things you love.


Being physically active also assists with weight loss and improving your mood and mental state. It assists in the prevention of other conditions such as high blood sugar levels, high blood pressure and high cholesterol, cancer, heart disease and stroke, to name a few. It is the best thing you can do for your health.


Most importantly targeted exercise for your hip osteoarthritis can significantly improve pain and function. When you exercise your bones become stronger. When your muscles contract they apply pressure and load to the bones, your bones will then adapt to this by increasing their density making them stronger and more durable. A great way to build bone strength is through weight bearing exercises.



What if exercise causes me pain should I stop exercising?


If you have hip osteoarthritis or when you initially start to exercise you may experience some muscle and joint related pain. Do not panic!! Pain is normal and often poorly related to damage. Excessive inactivity is usually worse for your hip osteoarthritis than activity itself. If your body is not used to exercising regularly, increases in pain can be common as your body needs to adjust to the new loads and stressors. The joint pain you experience during exercise should not


exceed your acceptable limit of pain and should reduce in the 24 hours after exercise to the same level as before exercise. If your pain does not settle, your level of exercise is likely too much and you need to reduce this slightly.


What evidence tells us about what exercise and how much exercise we should do


There is strong evidence to suggest that exercise for those with hip osteoarthritis improves pain and function regardless of age, severity of arthritis and pain levels (Royal Australian College of General Practitioners, 2018). Growing evidence recommends exercise should be tailored to the individual's goals and should be performed a minimum of 2 times per week, with 3-4 sessions providing superior outcomes, for a minimum of 6 week period (Juhl et al., 2014). These exercises can include walking/running/cycling, strength and weight training.


If you are unsure about how to start exercising or want further information on what type of exercises you should be doing our physiotherapists are highly trained in the management and prevention of hip osteoarthritis and can provide you with a tailored program based on your functional goals and needs.
















Further information:


GLA:D Australia. (2017, February 16). GLA:D AU. https://gladaustralia.com.au/


Juhl, C., Christensen, R., Roos, E. M., Zhang, W., & Lund, H. (2014). Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis & Rheumatology, 66(3), 622-636. https://doi.org/10.1002/art.38290


Royal Australian College of General Practitioners. (2018). Guideline for the management of knee and hip osteoarthritis. https://www.racgp.org.au/download/Documents/Guidelines/Musculoskeletal/guideline-for-the-management-of-knee-and-hip-oa-2nd-edition.pdf


Svege, I., Nordsletten, L., Fernandes, L., & Risberg, M. A. (2015). Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: A long-term follow-up of a randomised trial. Annals of the Rheumatic Diseases, 74(1), 164-169. https://doi.org/10.1136/annrheumdis-2013-203628


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