CNY Orthopedic Sports Medicine, PC: Bodyzone: Hip

Body Zone: Hip

Overview
The hip joint plays a key role during almost all of our movement. Whether we notice the subtle swaying of a fashion model walking down the runway or the wide-legged walk of a cowboy in an old western movie; little changes in our hip's motion make for big changes in the rest of our body.

There's good reason for this. The hip forms the center point of the body, the region that transitions the solid torso to the mobile lower limbs. Compared to other joints, movement in the hip is surprisingly free and unencumbered. Much of this is due to the hip's ball and socket construction, which like the shoulder, provides both excellent stability and a large range of motion.

One reason the ball and socket arrangement is found only in two joints is due to the heavier and more massive structure the design requires. The hip joint is part of the large pelvic bone and can make good use of the space and solid mass surrounding it. Other joints could benefit from such a design, but would then have the compromises found within the hip.

A ball and socket arrangement for the joints in our hand might seem like a dream come true for a violinist or pianist; they could then move their fingers far sideways, as well as up and down, just like our upper leg. But instead of looking down at lithe fingers, a pianist would instead see much more bulky joints; certainly more bendable, and maybe more durable - like our solid hip - but also less nimble. Surrounded on all sides with muscles, tendons and ligaments that are required to move, position and stabilize both the leg and torso, the hip is a substantial piece of work. It's a design clearly suited to its current role, forming the foundation between the upper and lower body.


Injuries
The cartilage within the hip is usually free from tears or rips, but like other joints, the hip is susceptible to arthritis, osteoarthritis, or other degenerative conditions. Fractures of the bone or dislocations can occur, but are generally the result of very forceful impacts or accidents. The hip may also develop certain repetitive motion injuries from running, in which the tendons become inflamed or sore after over-use.

Total Hip Arthroplasty


Harmful Behaviors
  • Poor technique. Whether walking, standing, bending, or weightlifting, unnatural movement of the hip will cause wear problems on the joint.
  • Poor diet. In older adults, calcium deficiencies can weaken the normally strong pelvis and hipbones, greatly increasing the likelihood of fractures following a fall or a blow to the hip.
  • Over-work. Some people are more prone to degenerative conditions or injury than others: know your limits.


  • Good Practices
  • Keep strong. Well-developed and conditioned muscles ease stress on the hip, help add bone mass and stimulate blood flow to the entire region.
  • Keep healthy. Especially later in life, eating right, remaining active, flexible, and health conscientious will help ensure a good hip joint.
  • Prevent falls. A hip fracture after a fall can be especially debilitating for an older adult; removing hazards from around the house, installing handles or railings in bathrooms or on stairs can help insure against injury.
  • Don't over extend. Increases in exercise or training should be gradual, allowing your body to adjust to changes in routine. If a movement or exercise is painful to the hip, don't repeat it. Chances are it's hurting the joint.


  • General Conditioning
    Routines that condition the entire region of the hip will be the most effective. However, the hip is a joint that is often overlooked by many training or conditioning programs. Exercise programs commonly target the front quadriceps, and the rear gluteus, but the muscles on the inside and outside of the thigh are also necessary for flexibility and reducing the likelihood of injury.

    The hip is not commonly injured from training, but proper stretching and warm-up, and the use of appropriate shoes that help stabilize and cushion the leg are measures that reduce injuries while exercising. The intensity or duration of training should increase gradually, building-up by no more than 10% per week. Activities or exercises that place the hip at extreme angles (deep knee bends for example) should be carefully employed.



    Anatomy
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    Relative to the other major joints in the body, the hip may seem over-engineered, as if the structures that comprise the hip had been designed for a larger and longer-lasting animal. Unlike the knee, the ligaments of the hip are generally sufficient for our normal use (and abuse). The ball and socket construction of the bones provides excellent mobility, but its structure is still very robust.

    The two bones of the hip, the thighbone (femur) and the connective socket of the pelvis (acetabulum) also have the added benefits of location. Deeply buried beneath layers of muscle, ligaments, and tissue, the mechanical elements of the joint are well insulated from injury causing impacts. Unlike the knee, elbow, or other exposed hinges, the bones of the hip are usually free from the normal bumps, bruises and tiny fractures that can wear down a joint over time. Still, the hip joint is dependent upon many structures working together, and small imperfections or injuries can become exaggerated over time.

    The Body in Motion
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    Product Considerations
    NSAIDs
    NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.

  • Abduction Pillow
    An abduction pillow is used to separate or hold a patient's leg apart at the thighs after total hip replacement or revision surgery. The pillow helps position the legs correctly to properly position the hip prosthesis in the hip joint; used after surgery, this device helps to reduce the likelihood of a dislocation after a hip replacement or revision procedure.

    The pillow is used immediately post-operatively, and is particularly important for maintaining an anatomically correct position while the patient rests and sleeps. As the muscles, tendons and ligaments gradually heal, the pillow will be used less frequently, until it is eventually discontinued.

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