Is osteoarthritis causing a real pain in your hip? With osteoarthritis, the cartilage in the hip joint gradually wears away over time eventually causing bone rubbing on bone in the joint. This sounds painful, but what is actually causing the hip pain and stiffness and is there anything you can do about it? In this blog we will discuss the relationship between tight hip muscles and hip arthritis pain.
Osteoarthritis of the hip causes pain and stiffness. It can make it hard to do everyday activities like bend over to tie your shoe, get up from a chair or take a short walk. Because osteoarthritis worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage your pain and stay active.
You would think that the connection between hip arthritis and pain would be fairly straightforward: a person with a great degree of arthritis visible on an x-ray would complain of a significant amount of pain. Surprisingly, this is not always the case. Many people with severe arthritis are relatively symptom free while others with slight arthritis suffer from disabling pain. That doesn’t seem to make much sense and researchers set out to find out the reason why an arthritic hip hurts!
First, let’s review some hip terminology. Hip extension is moving your hip backward away from your body. A person has to extend their hip while walking. Hip flexion is moving your hip forward in front of your body. Hip internal rotation is rotating your leg inward toward your body. The hip flexor muscles are on the front side of your hip and they work to move your hip forward. If you are suffering from hip osteoarthritis the first motions you probably noticed pain and tightness in were hip extension and internal rotation.
A research study was done in which the internal pressure of the hip joint was measured in individuals with arthritis in their hips. What the researchers discovered is that people with the highest levels of internal pressure in their hip joint also had the highest amount of pain. So what causes this increased pressure in the hip joint? When a person extends or internally rotates their hip this stretches the hip flexor muscle on the front of the hip. When the hip flexor muscle is stretched in presses down on veins in the hip and impairs drainage from the hip joint resulting in increased pressure in the hip. This increased hip pressure correlates with increased hip pain. The analysts concluded that tight hip flexor muscles were a significant contributing factor to pain in arthritic hips. The researchers also showed that the loss of hip extension and internal rotation that people with hip arthritis experience was due to tightness in the hip flexor muscles not due to the arthritic changes in the hip joint.
Individuals with arthritic hip pain who have had surgery to lengthen the hip flexor tendon produced a dramatic reduction in hip pain. This supports the theory that hip arthritic pain is related to tightness in the hip flexor muscles. However, simply stretching first would be a better option than jumping into surgery!
Unfortunately, some people continue to have pain following a total hip replacement. Tightness in the hip flexor muscles is also a common cause of pain following surgery.
As you can see, tightness in the hip flexor muscles is often a significant factor in hip arthritis pain, but what can you do about it? Specific stretches to target the muscles on the front of the hip completed very frequently (up to 10 times per day) can improve the flexibility of the hip flexor muscles and therefore help decrease pain. In many cases, chronically tight muscles need to be strengthened as well as stretched. This is due to the fact that a weak muscle stiffens when it is strained.
In addition to stretching and strengthening the hip flexors, we also need to prevent the hip flexor muscles from shortening throughout the day. A person with tight hip flexor muscles should avoid prolonged sitting by getting up to move frequently or even switching to a standing desk if possible. Also, they should try not to sleep in a fetal position or curled up in a ball, because this keeps your hip flexor muscles in a shortened position for a long period of time. It is very difficult to improve flexibility in the hip flexor muscles if you are spending most of your day sitting and then sleeping in a curled position.
The promising news is that even if an x-ray shows significant arthritis in your hip joint the pain you are feeling maybe more related to tightening of the hip flexor muscles than the arthritic changes in your hip. There are many treatment options available to decrease your pain levels and improve your quality of life! Dr. Iodice at Advanced Healthcare and Sports Injury can work with you to create an individualized treatment plan and help you maintain an active lifestyle.
*information and illustrations courtesy of Dr. Tom Michaud and humanlocomotion.com.