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Hip: a joint subjected to great stress

The hip has a hard task

Supporting and offloading the weight of our body, with balance, under stress and continuously.

It does not only work when we are on the move, but even when we are sitting. It therefore functions for at least 16 hours a day under continuous stress. It only rests when we are lying down. This hard work means that it suffers greater wear than other joints.

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Let's start with some introductions

The hip is the bone-joint that joins the "north" and "south" of our body, namely our trunk to our legs. It consists of the femur, our body's longest and most hard-wearing bone, with two protuberances at the ends: the lower one is attached to the knee ligaments, whilst the upper one, or femur neck, hooks to the iliac bone thanks to the coxofemoral joint. It is therefore the largest joint of our body, but not the most complex (this award goes to the shoulder). The hip joint is bilateral and has the stressful task of offloading our bodyweight in as balanced a fashion as possible, to enable both walking and all the movements of the lower limbs (forward-backward, sideways, rotation and circumduction).

 

There are two main causes of hip problems

1

Hip trauma

Generally caused by falling or an accident, can happen at any age, even if it is more frequently seen in the elderly. The trauma can involve the femur bone or the joint. In both cases, treatment is surgical: the insertion of plaques in the first case, and hip replacement prosthesis in the second.

2

Hip degeneration is a more underhand process

It may begin at 45/50 years of age and is generally connected with a reduction in joint cartilage, which is responsible for the production of synovial fluid that lubricates the joint capsule. The gradual thinning of the cartilage causes pain that is often ignored, compensating for it with incorrect postural habits and movements, to avoid offloading the weight onto the painful part. When continued over time, this conduct, however, causes fatigue and extra stress on the healthy joint and, above all, can give rise to irreversible problems with the lumbosacral part of the spinal column. In this case too, treatment is surgical, with the implant of a hip prosthesis. Thanks to modern technology and the new generation of long-lasting prostheses, surgery can be used to restore correct offloading of weight before the problem also involves other parts of the body, like the back, for which there are no prostheses.

70% of those suffering from hip degeneration are women. The reason for this lies in physical conformation: the wider pelvis than men makes for a greater offloading of weight and demands on the joint when walking, which is consequently more exposed to degeneration.

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riabilitazione post chirurgica

Post-surgical rehabilitation

Regardless of patient age, post-surgical rehabilitation is the same process: very early movement with physiotherapy sessions from the 4th/5th day and a return to walking within 15/20 days. Clearly timing is also connected to patient age and muscle mass. Early rehabilitation in a thermal centre is almost "futuristic": recovery kinesitherapy in thermal water almost halves the time necessary to heal, helping improve elasticity; in a cabin or in a gymnasium, physiotherapy helps improve, relax and relieve fatigue in muscles.

 

Prevention: has to be our favourite keyword

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Now we have seen the possible scenarios of joint wear, let's try to understand what causes them and how they can be avoided. We previously saw that this joint is subject to constant stress. Genetics also play an important role, but cannot be avoided.

Posture is essential to keeping the hip in good long-term health. The foot "commands" posture: if it is not positioned correctly (such as in "flat-footed" people), this affects our gait and therefore the way weight is offloaded, involving, from the bottom upwards, the knee, hip and lower spine. When talking about feet, the first thing has to be to declare war on the use and abuse of high heels by women, who, in wearing them significantly alter their natural posture and gait, harming not only feet but also ankles, knees, hips and backs.

It is therefore important to allow yourself regular physiotherapy and postural re-education sessions with qualified staff, take part in corrective-postural gymnastics and gait re-education. If you start feeling pain it can be your friend, since it represents a warning sign.

Toned muscles: our body is supported by a skeletal structure and a muscular structure. As a general rule, a good skeleton can be maintained through having good muscles.
Paravertebral muscles are important and rarely mentioned: they in fact have the task of supporting the spinal column, avoiding disc pathologies, anterolisthesis, hernias, etc. Keeping these muscles toned, therefore, also thanks to exercise in water, can ensure a healthy back and balanced offloading of weights on the hip and lower limbs.

Thermal mud therapy is an excellent preventive treatment. It acts on the production of endorphins and lipopeptide materials that can stimulate cartilage reconstitution. So come and stay at the thermal baths: amidst relaxation and baths in the thermal water, massages and physiotherapy with qualified staff, applications of mud and rest, you might just go home feeling brand new!

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Abano.it thanks, for the in depth information:

Dott. Gianfranco Calfapietra
Specialist in disease of the liver
Specialist in anesthesia and reanimation
Primary doctor at AbanoRitz Hotel Terme

 
 
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