Wondering why hip arthritis is still painful after weeks of physical therapy? Researchers at the University of Melbourne have some discouraging news for you: Physical Therapy does nothing to relieve pain or increase function of hips afflicted with arthritis. A university news release reports that researchers at the school randomly assigned patients with hip osteoarthritis to 10 sessions of either active physiotherapy treatment (which included education and advice, manual therapy, home exercise and walking with an aid, if needed) or placebo treatments (which included inactive ultrasounds and gel). After 24 weeks after treatment, the physio group continued unsupervised home exercise while the placebo group self-applied gel three times a week. The bad news: Patient outcomes for both groups were roughly the same at 13 and 36 week intervals. The even worse news: The treatment group actually reported a greater number of adverse events, although they were relatively mild.
Cara Lewis, an assistant professor of physical therapy at Boston University, spends a lot of time watching people walk, and worrying about how their hips will function later in life. Lewis is convinced that if people walked properly, the stress on their hips and knees could be greatly reduced, and the number if hip replacements (now 320,000 a year) and knee replacements (670,000 a year) would follow suit. Bostonians can visit her lab, suit up in what she calls a robotic hip exoskeleton, and get a computer aided analysis of their stride. The rest of us will have to rely on Lewis’ advice, published in the Boston Globe:
WALK SOFTLY As your foot hits – or better, gently contacts – the ground, your knee should be bent a little to absorb the force.
KEEP YOUR PELVIS STABLE This is the “sexy walk may not be good for your joints’’ thing. There shouldn’t be a lot of up and down movement of pelvis or hips .
TAKE SHORTER STEPS Long strides put your joints into more extreme positions, which can injure them over time.
BE SMART ABOUT FOOTWEAR Super high heels, flip-flops – some shoes just aren’t made for walking. If you’re going to be on your feet all day, wear something with less of a heel and more support.
KNEES POINT FORWARD For most, but not all, of us, knees should be pointed forward when walking. If your knees knock together, try using your buttock muscles (gluteals) to keep them pointing forward.
PUSH FORWARD WITH YOUR FEET Don’t pull yourself forward with your hips. It is a subtle distinction, but can make a huge difference.
KEEP SHOULDERS OVER HIPS Stand tall, and keep your shoulders over, not behind, your hips.
REST WHEN YOU’RE TIRED Muscles become less precise as they fatigue. This loss of precision, or klutziness, can lead to injury over time.