By Stephen Karam,  PT, DPT

It’s that aching feeling in your hip that makes you wince when you stand up, walk down stairs or get out of bed. It doesn’t have to be just another sign of getting older; you can do something to alleviate your chronic pain with the help of physical therapy.

According to KORT physical therapist Stephen Karam, inflammation caused by osteoarthritis in the joint wears down and damages the cartilage which surrounds the hip joint and acts as a cushion as the hip bone moves in the socket; without this cushion, the bones rub together resulting in pain, stiffness and a reduced range of motion in the hip.

“Osteoarthritis is painful and debilitating. The wear and tear on the joints and muscles surrounding the joint contributes to the condition. The hip is one of the more common joints affected by osteoarthritis, which is why current research is focusing on this specific area of the body,” said Karam.

A recent study by Gabriela, Reichenbach, Zhang, and Felson published in Arthritis Rheumatology discovered that hip muscle weakness can hasten the onset of hip osteoarthritis and worsen the disease progression after the initial onset, said Karam. The study concluded that adding hip muscle strengthening to a rehabilitation program is beneficial, both before and after the onset of osteoarthritis.

“Strengthening the muscles around the hip joint and increasing muscle flexibility greatly reduces pain,” said Karam. “We have a series of hands-on manual techniques and exercises that target strengthening the hip muscles for patients suffering hip pain. This combined with a low-impact exercise such as walking or swimming and light resistance training can greatly reduce pain and improve joint mobility.”

Some individuals with chronic hip pain end up requiring a total hip replacement, said Karam.

The total hip replacement procedure is a common surgical intervention where the diseased hip joint is replaced with an artificial joint that prevents that painful “bone on bone” surface contact.

“As with any surgical procedure, physical therapy is a great adjunct to the course of care in order to relieve pain, restore range of motion and function to the hip so that one can return to pain free living activities,” said Karam. “The same combination of manual physical therapy, low-impact exercises and resistance training can also help in the recovery process.”

A study in Journal of Orthopedic Sports Physical Therapy conducted by Trudelle-Jackson demonstrated that a brief postoperative course of physical therapy in the early phase of healing was not sufficient for the patients they studied.  They concluded that outpatient physical therapy service was found to be most beneficial for both return to weight bearing and postural stability, said Karam.

“Unfortunately, a large number of patients who have undergone a total hip replacement do not receive outpatient physical therapy post operatively which impacts their ability to regain their level of function,” said Karam. “It’s our goal to help patients return to the same level of activity that had before their injury or surgery. We want them to continue to do the things they enjoy and live the life they want.”

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KORT Physical Therapy Clinic Director Stephen Karam PT, DPT earned his doctorate in physical therapy from the University of Kentucky after completing a bachelor’s degree in exercise science. He is a member of the American Physical Therapy Association (APTA). He specializes in manual therapy with a strong emphasis in orthopedics and sports medicine. In his spare time, he enjoys tennis, working out, music and football.





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