Hang on to your hips

More Canadians than ever are getting hip replacements. Here’s how to avoid it happening to you
Mar. 29, 2010 | By: Michelle Morra-Carlisle

Like a large ball and socket, the hip consists of the thighbone’s round head and the pelvic bone socket it fits into. Muscles and tendons protect the hip, but age or overuse can cause it to deteriorate – as aging Canadians are finding out.

According to the Canadian Institute for Health Information, 58,714 Canadians – many as young as 45 – received hip or knee replacements in 2004-2005, an 87 per cent increase over a 10-year period.

The two main causes of hip degeneration are osteoarthritis and injury.

Osteoarthritis (OA): Caused by the breakdown of cartilage, OA affects more women than men after age 50. Symptoms include pain or stiffness, a grating or “catching” sensation, and bony growths at the joints. OA is often hereditary, but can also result from obesity, injury, repeated overuse of certain joints, and aging.

Injury: When hips are already brittle or damaged, one bad fall can seriously affect a person’s mobility and independence. More than 20,000 Canadian seniors suffer hip fractures every year. The Centre for Hip Health and Mobility in Vancouver predicts that as boomers get older, these will reach epidemic proportions.

Is hip surgery avoidable?

Except for a genetic predisposition for osteoarthritis, there are ways to control the other risk factors affecting the hips.

Exercise: Staying active protects the hips and keeps them flexible and lubricated with synovial fluid, a naturally occurring substance in healthy joints.

Maintaining strong muscles around the hips is their best protection. Like shock absorbers, muscles in the legs, lower back and “glutes” save the hip joints from impact – especially the glutes, says Jennifer Hunter, a physiotherapist at The Urban Athlete in Toronto.

“Strengthen your bum muscles,” she stresses. “One key exercise is to lie on your side, making sure the hips are not leaning forward; slowly lift the leg, keeping it straight, and do this a few times on each side.”

Physiotherapists also recommend low impact exercises such as pilates, which strengthens the deep muscles; Tai Chi; or water exercises for gentle resistance. Besides strengthening, it’s important to stretch the muscles and ligaments in the hips and adjacent areas.

Don’t overstretch, and get professional advice before, say, training for a marathon. Hunter treats many ultra-fit people and many say, “If I didn’t exercise, I wouldn’t get hurt.” Her response? “But then you’d gain weight. And I cannot stress enough the importance of maintaining a healthy weight.”

Manage your weight: Extra pounds put extra stress on your joints. In 2004-2005, nearly eight out of 10 hip replacement patients were either overweight or obese. So before you head for the couch, well… don’t! The benefits of exercise far outweigh the risks. If you’re unsure, ask a physiotherapist what’s safe.

Seek treatment sooner than later: Hunter is a fan of nipping things in the bud. “If you have hip pain, see somebody about it,” she says.

Depending on the problem, the doctor might treat you for inflammation, or recommend physiotherapy or chiropractic care to prevent further damage. Hunter compares the hip to a sliding track door:

“If it’s slightly off but still works, it could even work for two years but will eventually fall off the track,” she says. “If the hip isn’t working properly, eventually you will create a degenerative change, a wearing in one spot... You could probably exercise through the discomfort, but you would develop compensatory movement patterns and it would get worse.”

Nutrition and supplements: Consider seeing a nutritionist to make sure you’re getting enough protein, water, omega-3 fatty acids and other nutrients for optimal joint health. For some people, glucosamine and chondroitin sulfate supplements can relieve pain and improve joint function.

Avoid injury: Researchers are exploring ways to prevent seniors from falling. Some might need hip protection devices, including a padded garment that would cushion the blow in case of a fall.

Stay healthy, be careful and keep moving. By following these tips you can get more life out of your body’s largest and most important joints.