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Hip Pain? Should I Get My Hip Replaced?

You've had an x-ray; it shows you have hip arthritis. Now What? What can physical therapy do for you? There are a few things you should consider.

X-rays Don't Tell the Whole Story

Many people your age and activity level without hip pain show the same arthritis on a hip x-ray.

We don't recommend you rely on an x-ray alone to decide. People with arthritis, like yours, get better without a hip replacement. They strengthen their hip and restore the flexibility and their pain goes away. You can too.

Muscles - Your Hip Joint Shock Absorbers

Your muscles act like springs. Your hip muscles are your hip joint shock absorbers. If the muscles are weak, you springs don't work, and the joint gets excess force. It's like having bad shock absorbers on your car - you bottom out. The extra force on your hip joint causes the pain.

Flexibility Loss - Causes Excess Force on Your Hip

Your ball and socket hip joint is sealed up by a joint capsule. It is made up of thick tissue. If it gets tight it limits movement and causes excess force. The excess force causes inflammation. The inflammation causes more tightness. Your hip muscles will also shorten and get tight. You end up with force concentrated on a small area of your hip joint. This causes more inflammation. This causes pain. The cycle repeats.

Physical Therapy - Restore Your Hip Strength & Flexibility

Your hip strength is restored with exercise. Exercises should also work on the strength of the rest of your leg and core. Hip pain causes you to limp. This causes other nearby muscles and joints to work abnormally. It ends up causing extra hip joint force. To control your hip joint forces it is important the other leg and core muscles are strong.

Your hip flexibility is restored by stretching and hands-on treatment called manual therapy. You will get stretching exercises for your tight hip muscles and muscles of your leg and trunk. These will get rid of the extra force on your hip. Manual physical therapy is done to stretch you hip joint capsule. The stretches you can do yourself don't clear up the joint capsule tightness.

What If My Hip Still Hurts?

If your hip still hurts and limits you then you can go on to have the hip replacement. Studies show that people that have therapy to improve their hip strength and flexibility before a hip replacement recover faster.

There is no doubt that hip replacement surgery is effective at reducing pain and activity limitations. Time you spend in physical therapy trying to avoid surgery is well spent if you end up have the hip replacement later on.


Christopher DiPasquale, PhD, PT, OCS, SCS, CHT is a physical therapist at Performance Physical Therapy & Sports Medicine with offices in Hebron and Colchester, Connecticut. He is board certified by the American Board of Physical Therapy Specialties in Orthopedic Physical Therapy and Sports Physical Therapy and a Certified Hand Therapist by the Hand Therapy Certification Committee.

For more information visit or call the office: Colchester 860-537-3014 or Hebron 860-228-4883

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