In this video, I'll be covering the top ten worst exercises for painful bone on bone hip
arthritis. Now this video is an update I did to a video that I did two years ago,
covering five exercises that worsen hip arthritis.
But since then, I've discovered five more things that I commonly hear patients are
doing and we've got rationale for all of this, and these are reasons why
you should be doing these exercises. I'm going to give them all to you right now.
But before I go into that, I just want to give you a heads up. These exercises are commonly given to
patients by health care professionals like doctors and physical therapists.
But please realize that not all health care professionals specialize in helping
you heal from hip arthritis. To avoid a hip surgery like a joint replacement surgery.
Most health care professionals are great at helping you get short term pain relief from
hip arthritis. Using pain medications in pain injections and exercises like
you might do in general. Physical therapy. And of course, surgery is done by surgeons.
They go to school for that kind of thing.
In physical therapists, they are exercise specialists, but they tend to work with
patients that have had a surgery already. So they're used to working with people that are
recovering from surgery to get them back to doing normal things. But when it comes to helping them
heal from arthritis, like hip arthritis and avoiding surgery, they tend to not see that.
And they're not always 100% certain with how to help this individual. In fact,
they'll usually give them the same exercises that they give somebody who has had surgery. And if
that doesn't work, send them back to the surgeon so that they can get the joint replacement done.
So just know that when you're seeing one of these health care professionals,
they're doing the best they can with how they were trained and what they know. And
their experience, what has helped their patients.
And they're not trying to do wrong by you. But if you've done any of
the exercises on this top ten list right here and you feel that they've hurt you.
The exercises have hurt you. They need you to know that you need to stop doing that
exercise. It's probably not good for you when it comes to healing hip arthritis.
There's nothing that should hurt to do. In fact, if it's hurting you,
it's making your hip arthritis worse. Very likely. The only time that people should
experience pain from exercise is if they're recovering from a surgery that's very normal
because you have incisions, you have things were cut on, you have joints
that were replaced. So you're still healing very much from the actual surgical process.
So that's going to be painful.
in order to heal hip arthritis naturally, it's necessary to fix the root problem. I've got tons
of videos to talk about that you can find a link to them down in the description below.
I just want to make sure that you know that I give you ways to improve your hip arthritis.
Here on this YouTube channel. You can go and find them and I'll tell you more
about them by the end of the video. But let's get into the top ten worst
exercises that you shouldn't be doing. If you have bone on bone, hip arthritis,
or even if it's not bone on bone, this is going to make your hip arthritis worse.
The first exercise is standing leg raises, so it looks just like this. Usually stand up,
typically holding on to a chair or something that's stable and sturdy,
and then you're picking up your leg out to the side like this, or picking it up forward like
so. Sometimes people go across their body this way, and then another one is going backwards.
Just like this. Now, the reason why this exercise is not good is because
there usually is no training on what muscles to be using.
now of those three directions that I move my leg in, only one I would say is reasonably okay,
but it's often not coached very well and it's going backwards.
Here's what I mean. When you go backwards like this, you should be using the glute muscle. But
very often I see people doing the exercise and they're extending their back like this
and they're using their hamstrings and their back muscles and skipping using their glute muscles.
And if you're not using your glute muscles and you're not going to be addressing the root
problem that causes hip osteoarthritis, that means it's a wasteful exercise.
They're going the other way, going outwards to the side, forwards or across your body.
Those movements cause you to use muscles that tend to feed into the hip arthritis problem.
And so if you're strengthening those muscles in the front of the thigh and the hip flexors,
it actually tends to add more compression to the joints, which speeds up the arthritis process.
And it allows it to progress,
leading you to eventually get a hip surgery sooner than you might like.
The second exercise is just a harder version of this one, but it's very commonly done. It's leg
lifts, so you might be lying down on your back like this, and then you're picking up your leg
straight like this. There's alternative ways to do it where you're picking up
your leg sideways like this. Or you might be working this leg and you'll move your leg.
This way and pick up your leg like this or behind like this. And the reason for that one is to work
out the inner thigh muscle, and then you might lie on your stomach and pick up your leg this way. The
same reasoning with the standing exercises. This is probably the better of the three.
But if you're not using your glute muscles and you're using your back
muscles or the back of your thigh, and you're skipping this muscle in the back of the hip,
then it's not going to be good for you.
It's going to feed into the problem and the other three directions,
same as the standing exercise. You're using the same muscles that actually
add more pressure to the hip joint. So it's not a good exercise to be doing.
The third exercise is leg extensions. So this one is done many different ways. Let me show
you the most common one. Usually you're on a machine of some sort and you're working
out the muscles in the front of your thighs. Right here. You're picking up your feet and
straightening out your knees like this. Now, if you're doing this against a lot of weight,
against a lot of resistance, it tends to be very bad for you.
You're going to be using your quad muscles in the front of the thighs here. And one of those
muscles, the rectus femoris muscle, it actually crosses up past the hip joint. It attaches to your
pelvis bone up here. And because it crosses the hip joint, it's technically a hip flexor muscle.
That muscle in particular likes to overcompensate for other muscles that aren't doing their job.
And because of the position of that muscle in the way that it attaches to everything, it adds
a lot of extra compressive forces into the hip joint and can speed up the hip arthritis process.
Now there's lighter versions of how this is done. Sometimes in physical therapy,
you might have like a towel or a ball under your knee and you're
told to push your leg down right here against the towel or the ball.
And that's going to make you use this muscle. Sometimes you're using a theraband like one of
those rubber bands to straighten out your leg against it. Any of
these versions that make you use your leg muscles, right here on the front,
are all exercises that tend to speed up the hip arthritis progression.
Number four is marching. Now. This one is exactly like what it sounds. You're usually
sitting in a chair and you're just picking up your legs like this. Like you're doing
marching. We call it seated marches. I have seen people do this in standing as well, where
they're holding on to something with balance, and then they're marching like so in place.
This exercise uses your hip flexors
and when health care professionals are giving you this exercise,
what they usually have in mind is they're just trying to be exhaustive with working
out every muscle around the hip joint. And one of those is the hip flexor muscles. It's
a group of muscles in the front of your hip joint that makes your knee come up like this.
It flexes the hip. Those muscles, all the muscles in that group,
tend to add that extra compressive force to the hip joints and make it grind in a not so good
way. Where's the joint down inappropriately? If it's bad forces to the joint. So it doesn't
make sense to be doing this marching exercise, because it tends to make the hip joint worse.
Number five is ball squeezes. Now, I don't have a big enough ball, but usually people
will have like a bouncy ball. That's about this big. I'm just using this one here. I
never do this exercise with my patients, so I don't have the equipment to do it. But the idea
is you're squeezing the ball between your knees, usually lying down with your back.
Put the ball between your knees right here, and you're trying to bring your thighs together and
hold it for a few seconds, or maybe just repeatedly opening and closing on the ball.
And it's supposed to work out the muscles of the groin here on the inner thigh. The
reason why this is not good is because those muscles work along with the thigh muscles.
They actually cross the hip joint and they can cause bad forces through the ball and socket joint
in the hip joint as well. This is not a good exercise to be doing overall. Now let me just
take a quick side note here. This exercise the ball squeezes along with the thigh exercises and
even the standing leg raises. And the lying leg raises don't usually hurt right then and there.
They can. Sometimes you do, especially if it's very inflamed or irritated. Hip
arthritis. But what you tend to find is they hurt later. They might actually and
feel better to do these exercises up front. You might feel good while you're doing them,
but usually later that day, definitely the next day. Especially if you're more aggressive
with these exercises, like if you're doing them harder, you're doing them with more resistance.
You're not resting as much in between. It tends to irritate the cartilage,
and cartilage tends to have a delayed pain effect. So you feel the pain hours later,
even a 24 hours later a day later. That's how typically the pain from
this is experienced. It's not in the moment right then and there. If you do
feel it right then and there means that your cartilage is already very inflamed.
The next exercise is not technically an exercise because by definition, when I think of exercise,
I'm thinking of muscles contracting and elongating or even just holding a contraction. This is more
of a stretch, but it's one that definitely makes things worse. So this is a hip to a stretch.
people will usually cross their leg over like this sitting, and then they'll put their elbow
on their knee and twist their hip over like so, and they'll do it quite aggressively.
And what happens is when you move your knee across your body like that right here in the
groin where the hip joint is, it causes the ball to move against the edge of the
socket and can compress it quite a bit. And that's where usually the arthritis happens,
where the bad forces are going through the hip joint. And so it just aggravates it.
It just adds insult to injury or pressing on an already injured spot.
Now, if you're doing this stretch lightly and it's not hurting you,
it may actually be okay. What I wouldn't want you to think, though,
is that this stretch is going to heal your hip arthritis. Because if we're talking about solving
the root cause of hip arthritis, the muscle imbalance is where we need to be focusing on.
And this stretch is not directly addressing the muscle imbalance. And it may help you get
some mobility. You may actually feel a little more loose and flexible afterwards if you're
stretching lightly, not aggressively, but if you're stretching aggressively,
you're actually going to cause your muscles around your hip to tension up. It's probably going to
hurt inside your hip joint, and it does not tend to be a productive thing for you to be doing.
Number seven is a hip flexor stretch. Now, also a stretch. Not technically an exercise,
but it's still adds that compressive forces to the hip joint. Here's what
this looks like. You're going to get like so. And then people lean
forward to stretch out the front of their hip. Now lightly this is actually okay.
And there are circumstances where I do tell my patients to do this exercise or this stretch,
I should say, but it's for a small part of the recovery process and it's not done
very aggressively at all. What I'm talking about is when people get in this position
and they really push into it, they put a big stretch in the front of their hip, and they
make this a regular thing that they're doing throughout their treatment for hip arthritis.
The reason why I don't think this is a good thing, to be doing it that way,
is because the hip flexors in the front of the hip, they do get short, so they
do get overuse and they're over there. They compensate a lot for the back side of the hip,
where usually the the weaknesses. And so stretching them out does make sense at face value.
But here's the problem. When you go to stretch out those hip flexors because you're already short,
they tend to be a shorten muscle because you're using them too much. When you tension them,
it's going to add compression to the ball and socket joint. And so if you're
stretching aggressively, you're going to be pushing the ball against the socket too much.
And if it hurts afterwards, well, that's why it hurt because you just overdid it on
the stretch. So what I would recommend if you really want to do this stretch,
is to do it lightly. On a scale of 0 to 10, intensity wise, I would stick to like one to not
more than a three intensity, and you really don't need to stretch for more than a minute or two.
After two minutes you go what's called diminishing returns,
so you're not getting that much more benefit for adding more time. Stretching. But I see people
that do this stretch aggressively. They're getting they're getting to like an eight,
9 or 10 on intensity. They're getting very aggressive. And then they're doing
this for 5 or 10 minutes and then they're having hip pain later on.
That's what how they're doing this wrong.
The exercise is a sit to stand exercise. In other words a squat. But everyone in
physical therapy calls this sit to stand. So you're sitting down and then you stand
up just like so. And you repeatedly do this sit to stand. And the idea is to practice
getting up out of a chair, because you might have difficulty with that.
You might feel stiffness afterwards or might just you may feel weak getting up from a
chair. You might be using your hands quite a bit. And so you're trying to get the your
legs to do this. Now at the beginning of doing this, it tends to be very productive because
you're getting used to the motion. You might actually be getting stronger with standing up,
but in the long term, the reason why I don't like this exercise is because without proper
coaching on which muscle groups to use, as you're standing up and sitting down,
you're going to default to using the muscles that are already dominant.
Usually the hip flexors and quad muscles. And you get this false feedback of getting a workout
in because you're feeling these muscles work, you're feeling sore, you're feeling tired in
these muscles. And so it's feedback to you saying, oh, I'm getting a workout in. I'm doing something
good. This is helping my hip joint. And you're the health care professional, your physical therapist.
Your doctor might agree with you. They might say, great, you're feeling the burn. Fantastic.
But over time, as you keep going, you're strengthening the wrong muscles. And that's
just adding more compression to the hip joint. And you're going to end up with worse hip arthritis
later. So this is not a good exercise to be doing unless you've gone through proper training ahead
of time to use the right muscles and you're confident that you're using the right muscles.
So what I teach my treatment approach.
Number nine, this is going to surprise you. Number ten is even more surprising. Number
nine is biking using a stationary bike or an outdoor bike. Any kind of bicycle. This one
is so commonly done in every physical therapy clinic. I mean, you're almost guaranteed to
get on a bicycle or a stationary bike if you're going into a physical therapy clinic, the warm
you up and it'll pull you down and it'll be there for ten minutes, 15 minutes, sometimes longer.
And sometimes people have bikes at home, two stationary bikes, and they'll use the
bike. And the rationale that they'll give the health care professionals will give patients on
this exercise is that you're lubricating the joint, you're getting lots of movement in,
and it's good for the hip joint. And that is good information. It actually is true. You do
lubricate the joints and high repetitions for a joint for a cartilage problem is generally good.
The problem comes from what muscles you're using when you're on the bicycle. So if you're
thinking if you're not thinking about what muscles you're using,
you're probably going to default to using the same muscles that you've been overusing already,
the ones that have been compensating those quad muscles and hip flexors. And think about
it when you get on the bike next time, pay attention to what muscles get tired.
And if it's all these in front right here and not as much on the back over here,
especially back here on the on the glutes, then you're feeding into the
problem. And the sneaky thing about this is you're not going to feel it right away,
because you're going to feel the benefit of the repeated motion and the lubrication of the joints.
But over time, as you cycle more and you do other exercises that feed into the strength
of the front of this muscle, then you're going to gradually add more compression to
the joints and kind of undo all the benefits that you got of lubricating the joint.
Now, I do teach people how to use a bicycle correctly,
and it needs to be a glute dominant motion.
In other words, when you push down the pole,
you need to feel your glutes tension up on each side. So you need to be alternating glute
contractions correspond with every time you push the pedal down the glute fires.
You're still going to feel your thigh muscles work,
but if you can use your glutes more than your thigh muscles and you're going to
be in a better position to help heal your hip arthritis for the long term.
Right. Number ten here. This one's a shocker. Walking. Walking is one of
the worst things you can do for hip arthritis. It's similar to the bike people say, you know,
go walk for exercise. Easy thing to do. All you need is a pair of shoes and get out and walk
around the block on a treadmill. Everybody needs to walk you to walk within your home.
Here's the problem if you're not fixing the root muscle imbalance, if you don't have good
activity in the right muscles, usually the glutes, then you're going to be walking using
the wrong muscles. And what people often find is that when they start a walking program for
their hip arthritis, they actually get better. At the beginning of it, they say, oh, you know what?
I could only do ten minutes of walking. Now I can do 20 minutes a walk and have
progressed to 30 minutes. I feel I'm feeling a lot better. But as they get
more intense with the walking and they're requiring their muscles to work harder,
those dominant muscles that are causing the extra compression in the hip joint get stronger,
because those are the ones you're using more, so you're training those more, and over time,
those hip flexors and quad muscles add more compression to the hip joint.
You get worsening hip arthritis. So people hit this wall, usually where they say,
you know what, I just can't make it past 25 minutes. I just can't make it
past 40 minutes because then my hip starts to hurt
or they'll start to say this. It may not be. It hurts during the walking. That does
happen quite a bit, but they'll say, you know what, I've been walking 30 minutes.
That's about my cap. I'm okay.
But you know what? The more I've been doing it, I went up from doing it three times a week to 4
or 5 times a week. By the end of the day, my hips are killing me and I'm having more pain at night.
That's the experience people get when they're getting pain from walking.
And it's that false feedback again, like with the
bike and like with other exercises like these, where you feel good in the moment,
but you're actually making the problem worse in the
long run because you're sneakily working out the wrong muscles.
Now, if you're looking for guidance on what exactly you should be doing to correct the
root problem of hip osteoarthritis, even if it's bone on bone and no one invite you
to check out our YouTube playlist, it's called the Hip Arthritis Help Playlist.
There's a link in the description down below. You can hit that See More button or Show More button,
and you'll find our description pop up and you'll see all the links that we have.
I've also got a program that walks you through step by step, our treatment approach. I packed
it all into 30 videos that you can find where you are in in your healing of hip arthritis
and know exactly what exercises to be doing, and then know how to change those exercises as you
progressed through the healing process to get to the point where you're feeling happy and healthy
and active again, and you can avoid having a hip replacement surgery, it's very possible.
We see we'll do it all the time. It's just a matter of tweaking what you're
doing so that you're doing the right thing to help your hip arthritis,
rather than hurting it. It's called the Hip Arthritis Recovery Program. There's
a link for the description below along with that YouTube playlist.
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I'll see you in the next video! Bye bye!