Rehabilitating Hip Injuries: A Guide to Hip Physical Therapy

The hip is a ball-and-socket joint joining the thigh and pelvic bones. It is responsible for our movement and carrying our weight. Any pain, stiffness, or limited movement from accidents, sports injuries, or conditions like arthritis can significantly impact how we move, sit, walk and do our day-to-day activities. Hip physical therapy is a non-invasive, evidence-based approach to rehabilitating hip injuries and also offers the best solutions for hip replacement recovery. It involves the development of personalized treatment plans, including hip mobility exercises that focus on reducing pain, improving range of motion, strengthening the muscles surrounding the hip joint and restoring normal functional ability. 

With alarming statistics from the CDC revealing that 300,000 older adults are hospitalized for hip fractures annually, and another report from Pubmed highlighting the prevalence of hip pain in active and inactive adults (18.4% of adults who have not engaged in physical activity suffer from hip pain, and 12.6% who did engage in physical activity reported hip pain), it’s clear that hip injuries are a pressing concern. This guide emphasizes the transformative role of hip physical therapy in recovery and prevention. Whether you’re currently facing a hip injury, looking to protect your hip health or searching for physical rehabilitation centers near me, our expert insights will equip you with the needed knowledge on hip physical therapy.

Why Opt for Physical Therapy in Hip Injuries?

One of the simple reasons why physical therapy for hip injuries is preferred is because it is a natural and non-invasive treatment. Other reasons include: 

  • You can often avoid surgery and regain functionality and stability with physical therapy.
  • It is cost-effective and can be accessed per your schedule. 
  • It has no side effects and is a better option than pain medications or injections, which have side effects such as stomach ulcers, liver damage, or addiction. 
  • Physical therapy can naturally lubricate the cartilage and reduce inflammation.
  • Physical therapists correct your biomechanical or posture problems during therapy, preventing further damage to your hip joint. 
  • Its holistic approach can also help you cope with the trauma of your hip injury, causing depression, anxiety, or fear of movement.

Different Types of Hip Injuries

Physical therapy is effective for the following types of hip injuries:

  • Hip Strains occur when muscles or tendons around the hip are stretched or torn due to sudden movements or overexertion, like lifting a heavy object.
  • Hip Fractures:  Hip fractures involve a break in the bones of the hip joint. They often result from falls, accidents, or weakened bones due to osteoporosis, making them susceptible to breaking.
  • Hip Bursitis:  Inflammation of the bursa sac, a fluid-filled sac in the hip joint that allows muscles and bones to glide over each other easily, leads to pain and limited movement.
  • Femoroacetabular Impingement (FAI):  Abnormal contact between the hip’s ball and socket joint causes discomfort, especially during hip movement activities.
  • Hip Arthritis: This is a degenerative condition where the cartilage that cushions the hip joint wears away over time, leading to pain and stiffness. Several types of arthritis can affect the hip, with osteoarthritis being the most common.
  • Snapping Hip Syndrome:  This condition causes a snapping sensation or sound during hip movement, usually due to muscle or tendon tightness, resulting in discomfort.
  • Hip Dislocation:  High-impact accidents or trauma can cause the hip joint ball to come out of its socket, leading to severe pain and instability.
  • SLAP Tear (Superior Labrum Anterior and Posterior Tear):  A SLAP tear affects the labrum in the hip joint, a ring of cartilage that provides stability. It often results from repetitive hip movements and can cause pain, weakness, and instability in the hip.
  • Hip Pointer:  A hip pointer is a painful hip bone injury commonly seen in contact sports. It occurs when a direct blow or impact causes a bruise or contusion on the hip bone, leading to pain, swelling, and difficulty moving the hip.

Physical Therapy for Hip Injuries 

Physical therapy is a highly effective solution for recovering from hip injuries. Certified physical therapists assess your injury and create personalized treatment plans, addressing the root causes of discomfort. Hip physical therapy is suitable for individuals of all ages, from athletes with sports-related hip injuries to older adults with age-related problems.

Here’s a closer look at some of the core techniques:

  • Manual Therapy: 

Manual therapy is a hands-on approach that involves the therapist using their hands to massage gently around the injured part of the hip. This therapy helps to reduce pain, improves circulation, and enhances joint flexibility.  Manual therapy techniques include:

  • Therapeutic Exercises: Customized exercises are designed to strengthen the hip muscles, improve flexibility, and enhance joint mobility.
  • Isometric Exercises: Engaging the muscles without moving the joint, ideal for the initial stages of recovery.
  • Plyometric Exercises: Jumping and bounding exercises to improve muscle power. These exercises are especially beneficial for athletes.
  • Gentle movement: Under supervision by an expert physical therapist, walking is motivated to improve its range and reduce stiffness.
  • Massages:  Targeted massage techniques to alleviate muscle tension and reduce pain.
  • Aquatic  Therapy

One of the primary reasons aquatic therapy is favored, especially for hip surgery recovery, is its ability to reduce the amount of pressure exerted on the joints, which makes movement less painful and more manageable. Aerobics and stretching exercises are performed underwater (within the 91-98°F temperature range), which creates hydrostatic pressure, reducing the fear of falling during exercise. Additional benefits of Aquatic therapy include – 

  • Pain Relief: Aquatic therapy offers significant pain relief, making it suitable for conditions like arthritis, chronic pain, orthopedic injuries, and, of course, post-surgical recovery.
  • Muscle and Joint Relaxation: The water environment is soothing for aching muscles and joints, providing a gentle resistance that aids muscle strengthening without causing strain.
  • Natural Resistance: The inherent resistance of water can amplify the rehabilitation process, strengthening muscles without the need for weights or additional equipment.
  • Buoyancy: Water’s natural buoyancy reduces the impact of gravity on sore muscles and joints, making exercises less painful.
  • Wave Propagation/Turbulence: The gentle waves and turbulence in the water allow therapists to manipulate the body subtly, aiding in the therapy process.

Total Performance offers Aquatic Therapy in private heated pools (at  98°F) where only one patient at a time is permitted. Heat and water therapy helps decrease inflammation and increase hip joint mobility by improving blood flow and reducing scar tissue. 

  • Additional Hip Rehabilitation Techniques:

Many proven gadgets or machines are used during physical therapy to reduce pain, decrease inflammation, and accelerate healing. Common modalities recommended for hip injuries include:

  • Ultrasound: Sound waves penetrate deep into tissues, promoting healing and reducing inflammation.
  • Electrical Stimulation: Mild electrical currents target pain signals, offering relief and promoting muscle activation.
  • Cold/Heat Therapy: Alternating cold and heat packs can reduce inflammation, alleviate pain, and improve blood flow.
  • Functional Training: Beyond basic exercises, functional training focuses on preparing the hip for daily activities. This might involve:
  • Gait Analysis: Evaluating and correcting walking patterns to ensure even weight distribution and reduce strain on the hip.
  • Balance and Proprioceptive Training: Exercises on unstable surfaces, like wobble boards, to enhance balance and joint awareness.

The hip replacement recovery time through physical therapy varies based on injury severity and individual progress. While some may see improvement in weeks, others may require several months. Your physical therapist will work with you to establish a customized timeline.

Common Exercises During Hip Physical Therapy 

  1. Range of Motion and Flexibility Exercises

Restoring hip mobility is essential after an injury. The hip is one of the body’s most versatile joints, allowing many movements. A hip injury can, therefore, limit this, causing pain, discomfort and over all making normal daily activities more difficult to perform. Physical therapy focuses on enhancing this range and flexibility through specific exercises:

  • Hip Flexion and Extension: This involves bringing the knee towards the chest and extending the leg, aiding the hip’s forward and backward movement.
  • Hip Abduction and Adduction: Lifting the leg sideways while lying on one’s side strengthens the inner and outer thigh muscles, enhancing the hip’s lateral movement.
  • Hip Rotations: Rotating the hip inwards and outwards, either seated or standing, improves its rotational flexibility.
  • Bridges: Lifting the hips while lying down strengthens the glutes, promoting better hip extension.
  • Quadruped Hip Circles: Making circular hip movements while on hands and knees aids overall hip mobility.
  • Hamstring Stretches: Stretching the back of the thigh, either seated or standing, ensures better hip flexibility.
  1. Strengthening the Hip Muscles

Hip flexors, glutes, and abductors are the primary hip muscles which support movement in various directions and provide stability to the joint. The hip strengthening exercises recommended by physical therapists are: 

  • Glute Bridges: Lying on the back with knees bent, lifting the hips targets the glutes.
  • Leg Raises: Lying on one’s side and lifting the leg upwards strengthens the abductors.
  • Hip Flexor Stretches: Standing and pulling the ankle towards the buttocks targets the hip flexors.

Resistance equipment like weights and bands are added to exercises to increase intensity. Physical therapists also opt for progressive overload sessions, gradually increasing the repetitions or resistance, ensuring the muscles continue to grow and strengthen over time. 

  1. Balance and Stability Training

Improved balance supports a smoother rehabilitation process, ensuring the hip joint is not subjected to undue or uneven stress. A few exercises suggested by expert physical therapists for hip balance and stability training are:

  • Single Leg Stands: Standing on one leg helps improve balance and strengthens the muscles around the hip.
  • Heel-To-Toe Walk: Walking in a straight line, placing the heel of one foot directly in front of the toes of the other foot challenges balance and enhances stability.
  • Balance Pad Exercises: Standing on an unstable surface, like a balance pad, and performing various movements can enhance proprioception (one’s sense of limb position and movement). 

Regular balance and stability training can prevent recurrent injuries by ensuring the hip joint and surrounding muscles are robust and resilient. 

  1. Gait Training and Functional Movements

After a hip injury, an individual’s walking pattern or gait can be altered, leading to compensatory movements that might cause strain on other parts of the body. Gait training focuses on re-establishing a natural walking rhythm, ensuring even weight distribution, and promoting a symmetrical stride. 

Other exercises like chair squats, step-ups, or lateral leg movements mimic everyday actions, ensuring the hip joint and surrounding muscles are prepared for real-world demands.

Assistive Devices and Orthotics For Quick Recovery From Hip Injury 

Walking assistive devices like canes, crutches, and orthotics are effective measures that should be included along with hip physical therapy for a faster recovery. 

  • Crutches: Crutches are long sticks with cross heads placed below armpits. Often recommended immediately after a hip injury or post-surgery, crutches help offload the weight from the injured hip, allowing for reduced pain and preventing further injury. They are essential for individuals who must avoid placing their full weight on the affected leg.
  • Canes: As the recovery progresses, a slender walking stick “cane” might be introduced. It provides support and balance, primarily when the weakness or instability exists. The cane helps distribute weight more evenly, ensuring the hip joint isn’t overloaded.
  • Orthotics:  Orthotics are custom-made inserts that are placed inside shoes. For those with hip injuries, orthotics can be crucial in ensuring proper hip joint alignment with the knee and foot. Another thing to note is that customized orthotics can address biomechanical discrepancies, ensuring the hip joint is positioned optimally during weight-bearing activities. It also provides cushioning and shock absorption, reducing the impact on the hip joint during walking or running.

Preventing Future Hip Injuries

An effective hip therapy treatment ensures proper and complete healing of the hip injury. It also helps to improve posture and lifestyle, which guard or prevent future injuries. 

  • Postural Training: Our physical therapists help you to identify the proper posture and know your body alignment, thus reducing undue stress on the hip joint.
  • Ergonomic Guidance: We offer advice on setting up workspaces to minimize hip strain, from choosing the suitable chairs to optimally positioning computer screens and keyboards.
  • Regular Assessments: Periodic sessions with a physical therapist can identify potential issues before time. We can recommend interventions before minor issues become significant problems by evaluating movement patterns and strength.
  • Nutritional and Weight Management Guidance: While physical therapists aren’t nutritionists, our expert physical therapists at Total Performance understand the biomechanical implications of excess weight on the hip joint. We often collaborate with nutritionists or provide essential guidance on the importance of weight management concerning hip health.

Conclusion

In the journey of hip injury rehabilitation, the holistic approach of physical therapy is very important. It’s not just about healing; it’s about equipping individuals with the tools and knowledge to prevent future injuries and lead an active, pain-free life. The expertise of a physical therapist ensures tailored treatments, from posture correction to strength training, all aimed at restoring optimal hip function. 

And when it comes to opting for the best physical therapist services, Total Performance Physical Therapy sets the gold standard. With our state-of-the-art facilities and a reputation as one of the best clinics in the country, our expert physical therapists offer hands-on, individualized care beyond recovery. 

It’s your body, so be sure to treat it wisely. Schedule a FREE consultation today with one of our expert physical therapists to learn more!

Disclaimer – This blog post is intended to provide general information about hip injuries and hip physical therapy. It is not a substitute for professional medical treatment. If you are experiencing hip pain or injury, please consult a qualified physical therapist or other healthcare provider.

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