I've been working with osteoarthritis of the hip for more than 25 years. I see patients in their 20s who are already in the queue for hip replacement, and I see middle age and older adults who are slowly heading toward the same. Some folks arrive at my clinic already diagnosed. Others show up with a tricky hip problem, not sure what it is, and with a thorough examination and some x-rays, we make the diagnosis here. Although I treat all types of injuries from the jaw to the toes, I have a deep interest in hip pain.
Hip arthritis is best managed early, and with an active approach.
One we know your hip has arthritis, you are now on a path that potentially may end up in a surgeons office. But not necessarily. The sooner we get started, the faster we can arrest the process. I work with many patients who successfully manage their hip arthritis over many years, and are doing so well at it that they may never need to see a surgeon.
Here's what we know works
Learning how to move your hip properly is very helpful for slowing down, or stopping the wear and tear on your hip joint. Everyone is a bit different, and we'll need to find out which exercises you need. If you are in really quite a lot of pain and finding it very hard to move, we'll work on bed exercises; things you can do easily while lying down, without much effort. I'll trial different things with you over a few visits, until we find exactly the right approach. And sometimes, we have to have a difficult conversation about using a cane, which can be emotionally quite devastating for some people.
If your hip is in the very early stages, and only a bit sore, we'll spend time correcting the weakness that has developed (because weakness of the hip is one of the key factors in the progression of arthritis). Sometimes, an arthritic hip needs some very high level strengthening and balance work. And there is some research suggesting that certain types of (non-steroid) injections can reverse the arthritis process in some patients. We'll have a talk about that.
There are no "BEST HIP EXERCISES" that work for everyone.
How often you'll need to see me
That's different for everyone, but most often, you'll see me once every 1-2 weeks for a month or 2, then you'll need to see me less often. In addition to treating your hip in the clinic, I will be showing you exactly what you need to do at home, and then upgrading and changing your program as your hip is ready for it.
Eventually, we'll arrive at an ongoing "maintenance program" that you'll do on your own for months, or even a whole year. The exercises we start with are not the exercises we end with. It's like learning piano - you start with simple tunes, and once you master them, you move on to the more challenging ones.
What if you don't do your exercises?
What I'm going to ask you to do takes time and energy. If you just can't find enough of either to do these, that's ok. Just let me know. I'm a good judge of how much each person can tolerate, but if I give you too much to do, I'll adjust that. And some folks are too busy in life and can't do any exercise at all. If that's you, you need to let me know, and we'll work around that. I'm a realist, not an idealist. Sometimes exercise isn't working, and we'll have a talk about going for a steroid injection, which can be a useful tool to settle things down for some people. It's important that we think creatively, and find a way to make things work for you.
*This advice is specific to some of my patients. I will direct you to this page if this applies to you. This is not generic advice about all cases of hip arthritis.