The best exercises to prevent a hip replacement

The hips are major joints in the pelvis that support weight and are used constantly for movement and sitting. When they are impaired, it can greatly reduce mobility and cause a lot of pain. Whilst issues in the hips can be addressed by hip replacement, this procedure can be avoided altogether, or at least delayed, through a regime of exercises and stretches to protect and strengthen the hips. In this article, leading trauma and orthopaedic surgeon Mr Farid Ud-Din suggests some exercises you can try to protect your hips.

The hips are the junction where the head of the femur (the thigh bone) fits into a niche in the pelvis in a ball-and-socket joint configuration. Theoretically, it is a joint that should last a lifetime but can be worn out or damaged due to injury and arthritis. Maintaining strength and flexibility in the hips is a great, nonsurgical preventative against future major surgeries.

Exercise does not have to be extremely strenuous, and should ideally be low-impact on the hips. There may be some strain or discomfort, but severe pain is a sign that the exercise is being performed unsafely, or that something is already wrong with the hips. The exercises should be gradually incorporated into your daily routine, and over time, can increase in repetitions, durations, and effort.

Exercise and stretching help because they fortify the muscles that support the joints, helping to distribute pressure and weight. Stretching in particular is vital to flexibility, as doing it before exercise increases blood flow in the hips and makes the muscles more malleable to change.

The gluteal muscles of the rear and the flexors of the pelvis are the main muscles to target. Exercises that stimulate them include several different leg lifts, such as extensions and clamshells, and weight lifts, which can be initiated slowly. Below is a list of some exercises you can try to support the hips and hopefully avoid a hip replacement in the future:

1. Low-Impact Aerobics

Stick to low-impact activities that reduce strain on the hip joints, like aerobics, which are helpful to prevent joint degeneration in the hips – but is important to do them correctly. Instead of a long run, try walking or cycling at a moderate pace. Low-impact aerobic exercises keep your hip joints in neutral rotation and help stabilise the hip joints. To maximise low-impact aerobics, you can take the stairs in place of riding the elevator when possible.

2. Lunges

Lunges will stimulate the thighs as well as the hips. To perform them, step forward with one foot. With the other foot, stretch it out behind you, and then bend the knee of the first leg (until a 90º angle) slowly to lower the body and hips closer to the ground, but never extending the chest past the bent knee and keeping the spin straight. Hold the position and then switch legs. This exercises the flexors to stabilise the hips, and can be done anywhere.

3. Leg Presses

Leg presses require gym machinery, where in a reclined, seated position, you push against a downward platform that is weighted as part of resistance training. Positioning is key for this exercise, as a simple shift in position can benefit certain parts of the hips. Once seated at the leg press machine, spread your feet as wide as possible on the resistance plate to focus on the inner hips. To focus on building outer hip strength, simply shift your position to place your feet closer together.

4. Standing Hip Flexors

Standing hip flexors strengthen the small muscles in the hip responsible for picking up your leg, meaning that they will be better able to do their job without the help of a surgical procedure, and they can be done at home or anywhere else. To do this exercise, stand behind a sturdy chair or hip-high surface, leaving a little bit of space in between. Holding onto the back of the chair or the edge of the surface with both hands, stand up straight, and bring one knee directly up toward your chest. Slowly bring your leg back down, and then repeat with the other leg. Variations include standing hip extensions, where you lift your leg with a straight knee behind you, and sideways hip lifts, where you stand with one side facing the chair or surface and lift the opposite leg with straight knees away from the body in an arc.

5. Hip Abductors

To do this exercise, sit on a chair or surface and secure a resistance band right above your knees. Slowly spread your legs apart using your hip muscles' strength. There is a specialised machine for this in gyms, but this can also be done at home.

6. Squats

Stand with your feet shoulder-width apart and back straight. Push your buttocks back slightly and slowly go down by bending your knees (as if going to sit down on a chair), ensuring that the entirety of both feet is on the ground and that your knees do not extend past your toes. Squats can be augmented with weights.

7. Hip bridges

Lay down on the ground, with your knees and ankles together, and your feet planted on the ground but your knees bent (creating a triangle shape). Use your strength to lift your hips off the ground and into the air, ideally to the height of your knees, whilst pressing your spine and neck to the ground. Hold this position for a few seconds, and then return to rest position before repeating again as many times as needed. To make it more difficult, you can use only one leg at a time, with one leg extended straight out. Make sure you are doing this on level, even ground.

Hobbies and activities

If you don't want to do straight stretches and exercises, activities and sports like swimming and cycling are also great for strengthening the hips without high impact. When cycling, the muscles like the gluteus maximus and the hamstrings are used to propel the bike forward, without putting the full weight of the body against them. And in swimming, the muscles that are activated are the hamstrings, quadriceps, hip flexors, and gluteus maximus, for counterbalancing in the water and swimming faster. Swimming is also a great way to take the weight off the body, so if you're already experiencing hip pain, this can be beneficial. Activities may be preferrable over stretches due to the fact that these can be done socially, and be intergrated into free time as hobbies.

If you are struggling with hip pain or reduced mobility, consult with Mr Ud-Din today via his Top Doctors profile.