Best 5 Exercises for Hip Pain

Hip pain is common within the general population and increases with age, weight-gain, and sedentary lifestyles. The hip joint is one of the largest joints in the body, it is a ball and socket joint involved in everyday movements such as walking. The hip joint is very mobile and can transfer various forces/weight from the upper and lower limbs. The ball of the joint is known as the femoral head and the socket which stems from the pelvis is called the acetabulum. Cartilage surrounds both surfaces to improve motion and disperse forces. The joint is surrounded by strong fibrous tissue called the capsule; this helps with keeping the bones together. The capsule is coated by synovium internally which produces synovial fluid, providing nutrients and lubrication to the joint. The hip joint is moved by various muscles, nerves, bursa and tendons that surround it making it highly dense in anatomical structures.

Hip pain can be caused by numerous factors and structures of the hip. We can separate them into two categories, inside the joint (intra-articular) or outside the joint (extra-articular). In adolescent patients we are more likely to see hip pain relating to muscular/ligament strains or tendonitis and mild trauma. In older adults we are more likely to see osteoarthritis, fractures, bursitis, trochanteric pain syndrome (bursitis), ligament/tendon/muscular strains, labral tears and avascular necrosis.

At Surrey Physio we commonly treat underlying causes of hip pain. See below for some of the potential causes.

Osteoarthritis
Osteoarthritis is a degenerative condition that affects the joints. It can cause the cartilage in the hip joint to break down, resulting in pain and stiffness.

Bursitis
Bursitis is an inflammation of the bursae, which are small fluid filled sacs that cushion the joints. Inflammation of the bursae can cause pain and discomfort around the side of the hip.

Tendonitis
Tendonitis is inflammation of the tendons that attach muscles to bones. It can cause pain and tenderness in the hip

Labral tears
The labrum is a piece of cartilage that lines the hip socket. Tears in the labrum can cause pain and discomfort in the hip joint.

Hip fracture
A hip fracture is a break in the thigh bone near the hip joint. It can cause severe pain and make it difficult to move the hip. Mostly we see patients that have had surgery to correct a fracture.

Ligament/tendon/muscular strains
This is where the above structures have had small – severe damage to the fibers that make them. It can result in inflammation and pain making it difficult to engage in your normal activities.

Symptoms of hip pain can vary in location, duration and intensity. Most likely pain is felt around the side of the hip, inside the hip (groin), the front of the hip or around the buttocks. Some hip pain can be referred pain from the lower back and in some cases pain can steam from the lower back and hip together.

Treatment for hip pain

Treatment for hip pain depends on the underlying causes and the severity of pain. Mostly hip pain can be resolved with conservative treatment such as:

Activity modification: avoiding activities that aggravate the hip joint can help relieve pain and inflammation.

Ice and heat: applying ice or heat to the affected area can help relieve pain and reduce inflammation

Physiotherapy: Physiotherapy can help with identifying the underlying causes and address the structures that could cause your symptoms. At Surrey Physio we use a combination of exercise and hands on treatment to help you achieve your goals. We can help improve your strength, flexibility and help relive pain.

Medication: over the counter pain relief such as anti-inflammatory drugs (ibuprofen), pain relief patches or gels can also help.

Injections: injections of corticosteroids or other medications into the hip joint can help relive pain and inflammation. This is usually performed by a consultant and we do not perform these at Surrey Physio (although we do injections for knee pain, and other joints).

In severe cases where conservative treatments have failed surgery may be necessary to treat hip pain, some surgeries include:

Arthroscopy
This is a minimally invasive procedure that involves inserting a camera and surgical tools into the hip joint to diagnose and treat conditions like labral tears.

Hip replacement
If you have severe osteoarthritis that affects your daily life, it may be worth considering a hip replacement. Hip replacements involve removing the affected tissue and replacing it with an artificial one.

If you have hip pain it is important to visit us in clinic, often we can identify the underlying causes and get you onto a treatment plan. We have different approaches such as our shockwave therapy which can help with tendonitis pain and symptoms. For now, we have developed 5 exercises we think can help you with your hip pain.

Adductor Hip Mobilisation Lying

Lie on your back on a bed or the floor, bend your knee, and drop your leg out to the side. You will feel a stretch on the inside of your thigh, known as the adductor muscle group. Move your hip in and out to mobilise the hip joint.

How to stretch your glutes part 2

Lie on your back, and bend your knee to 90 degrees (i.e. pointing straight up). Place your ankle across your knee. To make the stretch stronger, pull your ankle towards you, while pushing away with the opposite knee (the side getting stretched). You should feel a stretch in your bottom.

Gluteus Medius Strengthening

Lie on your side, with your bottom straight, and your top leg flexed to 90 degrees and supported by two pillows to keep alignment with your pelvis. Lift your leg 1-2cm off the pillow. You can hold this position, or move your leg up and down. This exercise predominantly strengthens your outer hip and gluteal (buttock) muscles.

Hip Flexor Bed Stretch

Lie flat on your back, on a bed. Position yourself to the side of the bed. Place your leg off the bed. Let your leg hang down. If your foot touches the floor, do not worry that is fine, although this exercise is easier performed on a higher bed or treatment table. The exercise will help stretch your hip flexor muscle.

How to Tone Your Adductor Brevis

Sitting down, place a Pilates ball between your legs, and squeeze. You will feel a muscle contraction along the inside of your legs and into your groin. This exercise is a strengthening exercise for the adductor muscle group.

Hip pain can be a frustrating and limiting condition, with the correct treatment it is possible to manage the pain and maintain good joint health. If you are experiencing hip pain please see us in clinic, often this is the quickest way to see a healthcare professional.

(Therapists reading this page, these videos are provided by Rehab My Patient – the best exercise prescription software for therapists to prescribe exercises www.rehabmypatient.com. If you are a patient needing advice, call Surrey Physio to book a telephone/video consultation with one of our expert physios or osteopaths, or book in face-to-face for an appointment. You can call us on 0208 685 6930 or book online by clicking the link at the top of the page).