Kurtis Mullaney PT, DPT, ATC, LAT
As a physical therapist, I understand that exercise in itself is not always effective in treating pain, especially when it comes to the hip. A comprehensive approach that includes education, activity modification, modalities for pain, manual therapy, mobility exercise, and strengthening is usually more successful, but many individuals do not have access to this type of treatment. Because of this, below are some easy and effective ways to improve mobility and strength for those suffering from hip pain due to soft tissue dysfunction or weakness.
Stretching Exercises for Hip Pain
When patients present with soft tissue dysfunction, joint mobility deficits, muscle “tightness” and stiffness, then stretching exercises for hip pain can be an effective adjunct to help alleviate pain and improve function. In order for tissue lengthening to occur a stretch should be held for at least a total of 1 minute. It may be more effective comfortable to split this minute up and perform 2 to 3 repetitions of 30 second holds. Some of the more effective stretching exercises for hip pain are listed below.
- Kneeling hip flexor stretch (for patient’s with pain in the front of their hip or in the lower back) – Due to our current cultural standards, and to the dominance of desk jobs in our economy, many people’s hip flexors become tight, shortened, or develop increased tone that limits their ability to extend their hips which can lead to dysfunction and pain. This is an easy way to lengthen that tissue and improve mobility. This is a common lower back stretch in Physical Therapy.
- Lateral hip/IT band stretch (for patients with pain in the side of the hip) – It is also very common for people (especially runners and cycling athletes) to become tight in the muscles and structures on the outside of the hip. This can cause increased friction as the IT band moves over the greater trochanter leading what we call bursitis.
- Piriformis stretch (for patient’s with pain in the back of the hip/lower back stretch) – The piriformis is a muscle to can become dysfunction, spastic, and tight with any injuries to the lumbar spine or hip and usually presents with tenderness and pain in the buttock area. When this muscle becomes highly dysfunctional it can cause compression on the sciatic nerve, which can cause pain to radiate down the back of the thigh and leg. Some will refer to this stretch as a sciatic nerve or sciatica stretch. Read more about Piriformis Syndrome here.Image of the hip joint
Strengthening Exercises for Hip Pain:
Weakness and muscle imbalances in the body can lead to movement dysfunction that can turn into pain. When dealing with the hip, it is incredibly common to discover weakness in the gluteal muscles, especially the hip abductors (muscles on the side of the hip). This muscle group is often neglected in the gym, which can lead to imbalances that turn into pain. When strengthening the hip abductors, it is important to shoot for higher repetitions (ex: 2-3 sets of 15-20 repetitions) because these muscles are primarily made of type 2 muscle fibers, meaning they are more suited for endurance than strength. Below is a list of glute and hip abductor exercises for hip pain.
- Clams – This is a very simple exercises that it excellent at targeting possibly our most important hip abductor, the gluteus medius muscle. It can be done with no resistance, but in most cases a resistance band it helpful to get more out of the exercise.
- Step ups – This exercise have been shown to be very effective at targeting the glute max. Weights can be used it warranted. Stepping up to the side can also help target the gluteus medius.
- Lateral band walks – Excellent way to strengthen to outside of the hip. Resistance bands are needed for this exercise. It can be modified but walking with knee straight or bent, by walking forwards, or by walking backwards.
- Glute bridges with hip abduction – An exercise band is also needed for this exercise. It combines the glute max activation achieved with an regular bridge with the glute medius activation achieved with clam exercises.
- Side planks – This it an easy was to work on the hip abductor muscles while also working on core stability. This exercise can be made easier by the patient starting on his or her knees. Holds should start at 20-30 seconds and should progress as strength and stability improve to 60-90 seconds.
Anatomy of the Hip
Confused or curious about the medical terms used above? Click here to learn about the anatomy of the hip joint.
Several Approaches To Treating Hip Pain With JOI Physcial Therapy
Despite hip pain being a common complaint amongst all people, there are a few easy forms of physical therapy which can help. Exercises for core strength and stability are used to treat and prevent pain in the hips. Ergonomic education is instrumental in treating hip pain, as the source of most of the pain comes from how people sit and/or stand for long periods of time. Lastly and perhaps most importantly is keeping up with your health. Weight loss and a healthy BMI are always recommended in the treatment of hip pain.
If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045
If you want to learn more about hip pain, go to : https://www.joionline.net/trending/content/hip-pain