The hip crowd: our tips on joint health

During the years 2014-15, 28,605 Australians underwent a hip replacement operation, a stark reminder that this is one part of our bodies that we are increasingly not taking care of. But even with a prosthetic hip, you still won’t regain full functionality of this essential joint.

And, unfairly, women are born with a greater predisposition to problems in this area, given their wider hips and larger angle from the hip joint to the knee joint, which causes greater strain compared to the straighter shape of men’s hips.  

So, what can you do to avoid ending up at the orthopaedic surgeon’s office and being told you will be joining the growing queue to undergo a replacement operation? Luckily, there are some straightforward steps you can make part of your everyday routine to keep your hips in shape.

1. Weight control
Yes, you’ve heard this narrative before: your weight has huge implications on almost every aspect of your physical health. It’s no coincidence that as the number of Australians carrying excess weight climbs, so too does the number of joint operations carried out.

Weight gain makes a huge difference to the strength of our hips, with extra weight adding even more pressure on the joints. "Every kilo added to the body is multiplied significantly at the hip joint," says Steven Hill, a physiotherapist at Pittwater Physiotherapy. 

So whilst you may not notice weight gain when it happens slowly and in small increases, your hips, and other joints, certainly do. And for those who have already had their hip replaced, Hill says that weight gain can shorten the life of the prosthetic.

On the flip side, if you work off that excess and get back to a healthy weight, even just dropping 2 kilograms will give significant relief to your hips. 

A program of healthy eating and regular, intensive exercise is the key here, and any GP, dietitian or personal trainer can help with this. As Hill says, “weight in all lower limb issues is paramount”.

2. Use it or lose it
Around the pelvis, there are 2 key muscles that help us maintain balance when we stand on one leg. The gluteus minimus and its close neighbour, the gluteus medius muscles, are vital for staying upright, especially as we age.

However, they’re often the source of many hip problems. “For most people there’s a weakness there and that creates a lot more pressure onto the hip joint itself,” explains Craig Macdonald, principal physiotherapist at Back to Health Physio.

This weakness can result in the painful and problematic issues, including tendinopathies. Macdonald recommends pilates as a good activity to help avoid these problems, as well as exercises prescribed by a physiotherapist, if these muscles are weak.

Other hip-friendly activities include cycling, swimming and yoga, all of which are good at reducing pressure on the joint, while keeping you active and fit, a key step to maintaining strong, healthy muscles and joints.

Hip -cycling -wyza -com -au
Non-impact sports such as cycling keep pressure off the hips

3. Stand and sit properly
“People tend to stand on one leg much more… and that magnifies the pressure on the hip tendons,” explains Hill, saying people make a habit of it early on. “Popping the hip out to the side loads the hip horribly on the outside.”

Seated posture is also important to joint health. As Macdonald says, “sitting well puts a lot less strain on the hips and lower back”, leading to fewer problems and complications down the track.

Correcting these habits will take discipline and concentration, but they will have an enormous benefit on your hips. The Victorian Government’s Better Health Channel site has an excellent guide to improving posture.

4. Pick the right shoes
According to Macdonald, around 70-80 per cent of people’s feet roll inwards too much. As he explains, when this happens, the whole leg rotates with the feet, putting excessive strain on key muscles that keep you upright.

“These muscles are being overloaded with every step that you take, and over a long period that causes them to weaken.”

Proper footwear has a part to play in this problem, with lightweight shoes providing little support to people who need it. Macdonald recommends performing three simple tests on any prospective footwear purchase:

  1. If you can fold it in half, it’s no good. “From the ball to the heel should be quite stiff. It should only bend from the ball of the foot and towards the toes”
  2. “If you try to rotate / twist from the ball of the foot to the heel, there shouldn’t be much movement” 
  3. Give the ‘heel counter’ (the upper back of the shoe) a squeeze. A solid shoe will be quite stiff in this area.

Hip -shoe -wyza -com -auChoose support over style when it comes to footwear. (Image courtesy of © Believe in the Run)

5. Get onto problems early
Both Macdonald and Hill agree that the sooner a patient seeks help for any pain or problems they’re having with their hips, the easier and more effective treatment will be.

“If you start when there’s not much pain, you can avoid getting into much pain, and therefore [treatment] will be quicker and more successful,” says Macdonald. Seeing a physiotherapist and committing to the given exercise plan will pay off.

“Mildly arthritic hips are usually quite manageable, and respond well to early intervention” explains Hill. If patients can get on the front foot, they might well be able to avoid having a hip replacement, which is a big plus.  “[Prosthetic hips] are not the same as your own, original anatomy,” Hill says.

Have you suffered from hip problems? Share your stories below.

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