If you are reading this section, it means that your injury is included in the wide chapters of the degenerative pathologies, involving the processes of wear of the articular heads, the so called arthrosis.
Together with the wear, natural attempts or reparation occur, but these only improve the possibility of periaticular ossifications, the so called osteophytes, provoking limitations in movement which could become eriously invalidating. Arthritis can arise both on healthy articulations of malformed or traumatised ones. It is more common in women and overweight patients. There are also particular type of jobs that seem to favorit the pathology.
Symptoms are clear and include: groin pain (which tends to worsen when walking or moving after a period of inactivity),pain that irradiates to the knee (that is why any patients who complain about knee pain will have their hip joints examined, especially when there is no history f trauma to the knee) and a weakness, wasting, and imbalance of the hip and thigh muscles.
Diagnosis is clinical and radiographic, with X-rays being used to reveal alterations to the bone structure and CT and MRI scans are used to detect the presence of cartilage irregularities.
A proper rehabilitation plan aims at reducing pan, increasing range of motion, returning the patient to his active daily life and most importantly, slowing the progression of the disease is effective only when performed early and correctly. Patients may also benefit from a reduction in their physical work or changing to more suitable physical and sporting activities.
You should remember that articulations are movement organs and when one of these does not work properly, the body’s natural response is to protect damaged areas, especially those involved in movement. Therefore rehabilitation exercises to restore efficient range of motion, reduce the levels of muscle weakening and imbalances, eliminate bad postural behaviours and maintain good coordination are of great importance here. These exercises can significantly help in pain control and improving quality of life and should not be underestimated.
When the pain in the hip is persistent and there are severe limitations of the joint function with a very compromised X-ray pattern, your specialist will propose a joint replacement surgery with prosthesis.
Generally, it is recommended to perform these operations in patients over 60 years, both in consideration of the duration of the prosthesis, and because with age, the demand for physical performance is lower. The hip replacement surgery allows the recovery of a good quality of life, and the resolution of pain with a duration of the prosthesis that exceeds 10 years in 90% of cases.
Hip prostheses can be of 4 types:
– total replacement or arthroplasty, in which both the femoral and pelvic components are replaced;
– partial replacement of the single femoral part or endoprosthesis that does not replace the component of the pelvis
– the covering prosthesis that covers the worn femoral head without removing it. The latter when it is possible is for a modest wear and for younger patients and allows in the following years in anticipation of the replacement of the prosthesis to resort to a new intervention less complex than in the case of a normal prosthesis
– the revision prosthesis, or reprotization, which involves the replacement of a previously implanted device.
The rehabilitation after prosthetic surgery has as objectives the recovery of joint movement, muscle strength, coordination, and the path diagram. Your doctor will organize the start already in the hospital from the first days after the operation, with limb mobilization assisted by the re-educator. The period following discharge from the hospital is used to restore the strength, motility and functionality typical of that district, with considerable effort from you and your re-educator.
You will be followed in the gym and in the pool, where recovery is particularly rapid, and finally in the field where a specific work is carried out to recover gestures that have not been carried out more correctly for some time and that are part of normal daily life.
The patient who comes to our center for rehabilitation after undergoing surgery for hip replacement is usually sore, fearful and afraid, so the first act of the physician will be to reassure the patient and explain exactly what the therapeutic procedure consists in, pointing out that during the early stages will have much pain.
The rehabilitation aims are: to prevent the implant dislocation, regain the range of motion as possible while maintaining a prudent attitude (avoiding internal rotation and circling hip), preventing hazards that can arise from prolonged immobility and retrieve a gradually increased functionality to achieve autonomy.
The first phase of the therapeutic program is focused on reducing pain through analgesic therapies (TENS, laser, ultrasound) and the range of motion recovery (with the aforementioned devices) through massage therapy relaxant to the buttocks, hip abductors, quadriceps and tensor specific stretching fascia lata and paying attention to algic positions and respecting the psychological and structural rigidities.
Eliminated the pain and improved joint mobility can begin the second phase of the protocol focused on muscle recovery. You will be proposed specific exercises for the reinforcement of the buttocks to assist in the proper upright posture and gait, and quadriceps muscles of the core first in isometric form and then progressively in manual against resistance, with ballast and with the use of Bobath balls.
Once you have objectively recovered the strength and the correct walk pattern without pain, it is appropriate to conclude the rehabilitation cycle with the last step on the field with the aim of recovering the motor pattern and return to move safely through proprioceptive exercises on unstable surfaces or reduced base support for neuromotor control and other, more cautious, to retrieve the sport specific gesture (running, soccer, jump).