Why strong hips matter

Strong hips, improved longevity

Photo by Manny Moreno on Unsplash

According to the American Association of Hip and Knee Surgeons, there were an estimated 2,064,642 hip and knee replacement surgeries in the US in 2022. More than 7 million people were living with some type of artificial knee or hip according to American Academy of Orthopedic Surgeons as of 2014. As of 2023, the average cost of a total hip replacement in the US is $39,000 based on CareCredit information.

Recovery after a hip replacement varies but on average, expect 2-3 months to return to most activities and a full year for full recovery. Typically, post-op care includes some form of rehab which may include an inpatient rehab stay, a skilled nursing facility stay, home health and/or outpatient therapy followed by continued exercise for months after formal therapy ends.

Typically, an artificial joint will last 15-20 years, so about 10-15% of people will need a revision, according to The Lancet. During and after surgery, there is risk of blood clot, infection, fracture, dislocation, leg length difference, and nerve damage according to The Mayo Clinic.

What can you do to help support the health of your hips?

1. Stay strong. Aim for resistance training 2-3 x per week. As we age, if we don’t strength train, we lose 3-8% of our muscle mass each decade and this rate increases after age 60¹

2. Stay mobile. Internal rotation is one of the most restricted motions with joint issues related to the hip, then flexion(bending the hip bringing the knee toward the chest) and then abduction(moving the leg out to the side). Practice moving through your full available range of motion daily with a consistent mobility practice or yoga practice.

3. Get into the habit of moving frequently. Some type of daily movement like walking, running, swimming, cycling, dancing or a mix of all for cross training is great. Aim for 150 min/week.

4. Nutrition plays a role in joint health as well. A diet rich in vegetables, fruits and anti-inflammatory foods can help maintain the health of your cartilage and prevent arthritis. The Mediterranean diet is a great example of a way of eating that can be helpful to your joints²

How can you check your hip strength?

1. Hip flexors- stand and lift one knee higher than hip level. Try to hold it here for 15 seconds. If you can hold it without flexing in the lower back and without letting the knee drift below the hip level, you have good strength.

2. Hip extensors- squat with both legs and notice how low you can go and how difficult it is to come back up. This can also give you some clues into mobility with hip flexion as well.

3. Hip abductors- single leg stance and single leg squat. Stand on one leg for 30 seconds. If you can keep your pelvis level, you have good strength in the abductors with sustained, static activity. Squat on one leg and come back up. During functional movement like this, the abductors are very active. Notice if you lose your balance, if you keep your pelvis level, and/or if your knee drops in. These are clues about how well your abductors work during movement.

4. Hip adductors- lay on your side, straighten the bottom leg. Lift 2-4 inches off the surface and hold. Have someone try to push your leg back down and see if you can hold it. Another way is to squat and notice if your knees turn outward as you squat. If so, the hip abductors may be working harder than your inner thigh or adductors.

5. Hip external rotation- in sitting, try to slide the heel up the shin letting the knee roll outward as you lift the leg. Check both sides and notice any differences.

6. Hip internal rotation- in sitting, place a yoga block between the knees. Keeping the hips and knees bent, lift the foot outward and hold for 5 seconds. Check both sides and notice if you can lift one higher than the other or if you can hold one for longer. Keep the pelvis level as you lift the foot.

Functional hip strength to improve longevity

1. Squat- how low can you go? And, then, can you get back up without using your upper body to help? While keeping the hips, knees and feet pointing straight ahead, and keeping the pelvis level and trunk in midline, squat down and come back up. Practice 5 reps x 3-5 sets and add weight as you are ready.

2. Single leg standing- practice for both balance and keeping the pelvis level. Practice static holds for up to a minute. Also practice with head turns side to side and up and down. Practice single leg squats. Aim for 5 reps of 3-5 sets and add weights when you’re ready.

3. Get down on the floor and practice getting back up without using your upper body to help.

Greater hip strength throughout your life can reduce both the need for a joint replacement and also risk of mortality.

Check out your strength and reach out of you have any questions!

Take good care,

Sharon

1. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care. 2004 Jul;7(4):405-10. doi: 10.1097/01.mco.0000134362.76653.b2. PMID: 15192443; PMCID: PMC2804956.

2. https://www.health.harvard.edu/nutrition/an-anti-inflammatory-diet-may-be-good-for-your-joints