Coxarthrosis is a disease of the hip joints, characterized by their destruction. The pathological process can affect one or both joints. Treatment of coxarthrosis using exercise therapy methods is an important part of the treatment of degenerative lesions of the hip joint. At the Yusupov Hospital, rehabilitation specialists take an individual approach to the selection of exercises for each patient. Exercise therapy for coxarthrosis is prescribed only after a comprehensive examination using modern equipment from the world's leading manufacturers. Exercise therapy instructors take into account the stage of the pathological process, the degree of destruction of the articular surfaces, the patient’s age and the presence of concomitant diseases.
Exercise therapy classes begin after functional tests. Rehabilitation specialists constantly monitor blood pressure and pulse rate. Doctors perform Holter monitoring of the electrocardiogram. During classes, the patient’s health status and their reaction to physical activity are assessed by an experienced doctor. Rehabilitation specialists correct the range of movements and the pace of exercises.
Features of the course of the disease and distinctive features.
In terms of frequency of occurrence, coxarthrosis (arthrosis of the hip joint) ranks second among all degenerative joint diseases. It is difficult, with the patient losing the ability to work and becoming disabled in the absence of timely treatment. Like any other, it has a chronic course, with gradual progression. At the same time, specialists are most often turned to when conservative therapy alone may be ineffective. That is why knowledge of this problem and the use of prevention opportunities is important to prevent an increase in the number of patients with this pathology.
What exercises should you avoid?
Patients with coxarthrosis are advised to refrain from physical activity, during which the joints experience increased stress. In particular, this is running. The running process itself can be divided into two phases - flight and landing. During flight, both legs leave the ground, and upon landing, weight is transferred to one supporting limb. Running on uneven surfaces is especially undesirable. The same goes for jumping. It is recommended to refrain from playing tennis and some types of dances that require jumping.
However, this does not mean that patients with coxarthrosis are prohibited from jumping at all. In the early stages of the disease (first, second), such exercises are allowed. However, preparation is first necessary, for example, increasing the flexibility of the joint, increasing the power of the muscular system. After this, you can start light jogging.
Contraindications to exercise therapy
There are no absolute contraindications to physical therapy for coxarthrosis. If the process worsens, the doctor may recommend refraining from physical activity for a while, but when the condition stabilizes, it is still better to return to exercise.
In addition, classes should be stopped in case of acute or decompensated cardiovascular pathologies (heart attack, stroke, hypertensive crisis, heart failure) and in the acute period of infectious diseases, when the temperature rises. Also, gymnastics is not performed in the early postoperative period. You should start exercising when your doctor recommends it.
Causes.
Coxarthrosis is not hereditary, but can occur at a young age. The causes can be congenital or acquired.
Congenital ones include:
- Congenital hip dislocation.
- Hip dysplasia.
- Metabolic disorders.
- Hereditary connective tissue diseases.
Acquired reasons include:
- Traumatic injuries.
- Endocrine system disorders.
- Infectious joint lesions (including rheumatoid arthritis).
- Aseptic necrosis of the femoral head.
Predisposing factors also include:
- Loads on joints in professional athletes.
- Overweight.
- Circulatory disorders.
- Age-related changes.
- Physical inactivity.
- Scoliosis, different lengths of the lower limbs.
Complex exercise therapy for coxarthrosis of the hip joint
Patients suffering from coxarthrosis of the hip joint perform the first group of exercises while lying on their back:
- Stretch your legs forward, upper limbs along the body, while inhaling, raise your arms up and lower them down as you exhale (repeat the exercise at a slow pace 6-8 times);
- Without changing the starting position, bend and straighten your arms at the elbows 6-8 times;
- from the same starting position, bend and straighten your knees 8-10 times in turn, without lifting your heels from the mat;
- without changing the starting position, rotate the straightened legs inward, then return them to their place (repeat the exercise 8 times).
We keep our hands on our belts, spread our legs to the sides without lifting our heels from the mat, and return them at a slow pace. With your hands on your belt, at a slow and calm pace for 10-15 seconds, do the “bicycle” exercise with your legs. Having lowered our arms along the body, we raise our straight arms up as we inhale and lower them as we exhale.
The following set of exercise therapy exercises for coxarthrosis is performed lying on the stomach:
- placing our hands on our hips, raise our head and shoulders, hold for a few seconds, and return to the starting position (perform the exercise smoothly every 2 seconds);
- hands on hips, one by one, smoothly raise straight legs;
- placing the upper limbs in front of the chest, raise the upper shoulder girdle, make 3 movements with the arms, reminiscent of swimming in the breaststroke style.
We hold our hands in front of our chests and contract the muscles of the pelvic girdle. Then we hold them for a few seconds and relax. As you practice, you can hold the position for 10-12 seconds. Next we turn onto our healthy side.
and place your head on your arm bent at the elbow. We lift and abduct the affected leg, then carefully lower it and relax the muscles.
We stand on our healthy leg and lean on the back of the chair with our hand on the side of our healthy limb. We make gentle swings back and forth with the affected leg 10 times. In the same starting position, we perform circular movements of the sore lower limb 8 times.
Then we stand on both legs and lean with both hands on the back of the chair. We do a half squat and return to the starting position. This exercise should be performed 10 times.
Symptoms.
Depending on the degree of development, symptoms and their severity vary. The following stages of the disease are distinguished:
First stage of coxarthrosis
Patients may complain of periodic pain in the hip joint, usually occurring after physical activity or long walking. Already at this stage, X-ray examination reveals a decrease in the thickness of the articular cartilage and compaction of bone tissue. An ultrasound examination may show moderate thickening of the synovial membrane, signs of synovitis, and deformation of the subchondral plate of the femur. It is important to begin conservative treatment and prevent further progression of the pathology. It is necessary to establish the cause of coxarthrosis and, if possible, eliminate it. Drug therapy with anti-inflammatory drugs orally and intra-articularly, injections of hyaluronic acid, and PRP therapy are also carried out. The goal of rehabilitation measures is to unload the joint.
Second
Pain syndrome occurs during walking and exertion and persists for some time after it; restrictions on mobility in the joint (abduction, rotation) are observed. X-ray shows uneven narrowing of the joint space, the appearance of osteophytes, ultrasound diagnoses synovitis, destructive changes in the femoral head. In addition to therapy aimed at reducing synovitis and alleviating the condition in the form of oral and injectable medications, arthroscopic surgery may be recommended to restore motor function and eliminate intra-articular pathological formations (osteophytes, altered synovium, cartilage fragments).
Third stage
The pain is constant. In addition to the hip joint area, it radiates to the lumbosacral region, leg, and knee. Lameness appears. Motor activity is severely limited. X-rays can reveal a narrowing of the joint space, incongruity of the articular surfaces, changes in the head of the hip bone, subchondral cysts, and exophytes. Surgical intervention is required - endoprosthetics. If surgery is delayed or impossible, treatment is prescribed to alleviate the condition.
Recommendations that need to be followed simultaneously with classes in the gym
In order to consolidate the effect obtained when performing exercise therapy, experts recommend that patients adhere to several rules, such as:
- Wearing a stable but low heel to reduce pain and maintain a center of gravity.
- Use only a flat surface for sleeping, excluding the presence of a pillow.
- Perform a short warm-up every half hour.
- Maintaining a straight back when driving or using a computer.
Also, the patient should not forget about consolidating the results of exercise therapy through physiotherapeutic methods.
Treatment methods for coxarthrosis.
This complex disease is treated by an orthopedic surgeon. The sooner you contact him, the greater the chances of slowing down the process. Therapy for coxarthrosis is a course, lifelong; It is recommended to see a doctor at regular intervals. If possible, the impact of provoking factors is eliminated or reduced. In this regard, lifestyle adjustments can be made. Symptomatic treatment is aimed at reducing pain symptoms, the frequency of exacerbations, and improving function. Conservative treatment is indicated at all stages. Surgical, usually from the second stage. Rehabilitation activities (physical therapy, physiotherapy, massage) accompany the treatment. Among the additional measures, at the beginning of the development of the disease, the patient is offered moderate exercise, which improves blood circulation in the hip joint and does not overload it. For example, classes in the pool, cross-country skiing. In advanced cases, it is necessary to unload the diseased joint and use additional support when walking.
What types of sports and exercise equipment for the treatment of arthrosis are performed on simulators under the supervision of doctors
In modern gyms equipped with special exercise equipment, for example, in the Kuntsevo Medical and Rehabilitation Center, patients engage in physical therapy. With arthrosis, not all sports are allowed, so running is permissible only in the initial stage of this disease. If the inflammatory process is accompanied by changes in the limbs and severe pain, then running is strictly prohibited. In each case, the patient can begin to engage in one or another sport (walking, running or swimming) only with the permission of a doctor.
Using a stepper
For arthrosis of the knee joint, exercises using a stepper speed up the recovery of the sore knee. This small exercise machine consists of two moving platforms designed to fit the feet. The exercises simulate climbing stairs, but with less stress on the knee thanks to the shock absorption created by the pedals. Exercise therapy on a stepper has a number of advantages:
- strengthening the muscles of the legs and knee joints;
- increasing endurance;
- weight loss without harm to health.
Using a Smith Machine
The Smith machine is a bar that moves along guides attached vertically to the floor. Thanks to this equipment, the patient has the opportunity to safely perform all kinds of exercises for all muscle groups.
Fitness for arthrosis
Any type of fitness has a positive effect on the condition of the muscular frame, increases endurance and improves blood circulation. In particular, experts recommend stretching exercises using exercise machines.
Kinesiotherapy for arthrosis
Kinesiotherapy is the latest method that helps relieve pain, inflammation, stress on the joint, and also strengthen muscles. All exercises are performed on special machines that reduce the load on the spine. An individual kinesitherapy program for arthrosis is prescribed by a specialist.
Strength training for arthrosis
Arthrosis and strength exercises are compatible with moderate exercise that does not overload the body.
General principles of strength training for arthrosis
There are a number of rules that must be followed when performing strength exercises:
- start with minimal weight, gradually increasing the load;
- do not straighten your joints completely;
- develop muscles in the area of sore joints;
- avoid activities that cause pain;
- use elastic bandages;
- take medications containing glucosamine.
