In this video, I'm going to answer the question, can you actually cure hip arthritis and avoid
replacement surgery? We get this question on our channel all the time. And the quick answer is yes,
for most cases, there are some cases out there that are just too far gone,
and a hip replacement surgery is going to be the best thing for that individual.
But in reality, less than 10% of hip arthritis cases that we see here in our clinic, do we
actually send out for an orthopedic surgical consult, the majority of them more than nine
out of 10 will actually do just fine and they'll heal naturally with our natural treatment options.
In this video, I'm going to explain how that works, how the hip arthritis can heal naturally.
And why the healthcare industry as a whole generally pushes people towards
getting hip replacement surgery way too soon when they possibly could avoid it.
My name is Dr. David Middaugh, I'm a specialist physical therapist at El Paso manual physical
therapy. And this channel is dedicated to helping people stay healthy, active and mobile,
while avoiding unnecessary surgery injections and pain medications. Please consider subscribing to
our channel so that you don't miss out on any of the helpful videos we post every single week.
So first, let's just get this straight. What is hip arthritis, I'm talking about osteo arthritis,
which means that joint is where the arthritis is. And it's not related to other types of arthritis
like psoriatic arthritis or rheumatoid arthritis. It's also juvenile arthritis.
And there's other hip problems out there like hip dysplasia, which does set up hip osteoarthritis.
But if you've had hip dysplasia in the past, and you're dealing with hip arthritis now,
because you're older, it's been around for a little while longer, this isn't going
to apply to you. I'm talking about good old fashioned hip osteoarthritis, which is what
the majority of people with hip problems related to chronic pain. That's what they suffer from.
So to explain hip arthritis, here's a hip joint in the skeleton, there's a ball and there's a socket,
and that ball should move in the socket to do all the movements that you've got to do for your daily
activities. But what happens in hip osteoarthritis is the surfaces of the joints are too
pressed against each other, there's too much pressure in the area
for a long period of time, you have to understand that joints are designed to take pressure.
That's why you stand on this joint you put pressure through it. But when you're putting
pressure on it inappropriately in a way that it's not designed to take those pressures,
then that's when you get an adaptation. That is a bad adaptation, it's usually arthritis.
So the first thing that typically happens is the cartilage on the ball wears down.
Also the cartilage in the socket wears down. Other injuries might happen like a labrum tear, there's
a chunk of cartilage around the socket here called the labrum. And when this keeps going on over
months and years, even decades, and you get enough cartilage worn down, you might have an x ray,
where they show that joint spacing and if it's decreased, they'll start to say you have
osteoarthritis in your hip. Or if you get an MRI, then they
can see more clearly the cartilage surfaces and better diagnose your hip osteoarthritis.
And everything I've said up to this point is what a general doctor would tell you or a healthcare
professional, a physical therapist. But what I'm going to say next is not common knowledge
and isn't something that you'll probably get at a physical therapist or doctor's office,
if you're being seen for your hip problem. The reason for the excessive pressures in a hip
joint that set up hip arthritis is that there's muscle imbalances that begin to move that ball
off center from the socket where it's supposed to be so that you can get the best motion.
And if you have that ball, say too far up too far forward too far rotated inwards,
and you live in move like that, then you're going to be irritating the tissues right where there's
too much pressure, you're not distributing the forces throughout the entire ball.
And throughout the entire sock sockets, you're focusing in one area, and it's just rubbing
way too much in that area. And the reason that it pulls in that direction is usually because of the
muscles on the front of the hip, like your hip flexors, your quad muscles or muscles on the
front of the thigh are too dominant or strong and the muscles on the back of the hip are too weak.
The most common muscle imbalance we see is that ball goes forward on the socket,
causing the front edge of the ball right here to wear down and then the inner part of the socket
to wear down right there. And associated with that we see people with very tight hip flexors,
tight quad muscles, and then no glute muscles or very weak glute muscles in the back.
Hamstrings might be compensating as well. But typically, you see a loss of muscle and
we get our clients in here that are a little older and age you know talking like 50 and up.
That's still young in my opinion. But once you're hidden 60s and 70s for sure it used to See
them not have a button. And when we see our ladies that are more voluptuous, a little more curvy,
that might have, you know, some curves back there, the muscles just are not functioning very well.
And they can't use them effectively to pull that ball into the socket correctly and get
proper movement going through the hip joints. Now let's answer the question how does hip
cartilage heal. So the way that you undo this problem is simply by taking those
pressures off the hip joints. If you take the pressure off the cartilage within the hip joint,
then you give it a chance to rehydrate to get water back in the tissues.
They give the tissue itself a chance to heal, you get the fluid within the joint that the
synovial fluid or joint fluid to nourish the inside of the cartilage. And given enough time,
which it does go slow compared to like muscle or skin tissue.
cartilage tissue just has a very low blood supply in a low metabolism,
meaning the cells don't operate very fast. They work at snail's pace rather than rapid pace,
versus like if you cut your skin or you get a muscle injury, you're healing quick within days or
weeks. For more severe injury, cartilage just takes a long time, and you have to take that
pressure off over a long period of time. Another important aspect of this is that
you need to do the right exercises going back to that muscle imbalance, where the muscles in the
front of the hip are too strong or dominance. I use the word strong and or dominant because
you might already be strong and not consider yourself to be a weak person, especially if
you've been more active or fit throughout your life. And what I'm talking about is a dominance
then in that case, where you are more dominant in the muscle in the front, even though you have
strong glutes the balance between the glutes on the back of the hip. And the hip flexors and
quad muscles in the front of the hip are a lot, it's a lot more strong in the front, meaning this
is more dominant, and you're less dominant in the back, which generates a relative weakness.
But if you admittedly say Well, I'm not the strongest person in the world, I haven't
really worked out that much over the past years, decades since high school since my younger years,
then you probably don't have a problem saying yeah, I got weak glutes. So what. And the fact
of the matter here is not about embarrassment, it's figuring out where you're at, figure out what
your problem is, and start working from there. If you know that your glutes are weak or, or
you have an imbalance where your quads and hip flexors are more dominant. That's where you got
to work. Next, I'm going to come back to what you should be doing next by the end of this video.
But next, I want to answer the question of why did the doctor recommend that you get a
hip replacement at this time, if there's a possibility that you can heal this problem,
and let me tell you the facts, most doctors training, so let me just go into some of the
background here physicians, when I'm talking about doctors, I'm talking about
physicians, I'm a doctor physical therapy. There's doctors of nursing out there, there's
all kinds of doctorate level degrees, that just means you've gone to so much education but when
we talk about doctors, generally we're talking about physicians, which are doctors of medicine,
they may go through extra training to become surgeons, neurosurgeons, pediatricians,
orthopedist, all the different specialties that you hear about, what you need to know is that
most doctors of medicine are trained in medicine. So they're thinking about how to help your hip
problem using medicine. And then their friends that have gone into orthopedic residencies and
surgical residencies, those are who they think of to refer to. So whenever they don't have success,
helping your hip arthritis, with an injection or with some sort of pain medication,
then the next thing they think of is, oh, my buddy down the street, who's an orthopedic surgeon,
can help you out with hip replacement surgery, let's send you that way.
And then orthopedic surgeons are trained to do in surgery they do, they can probably do with
their eyes closed. I mean, I'm joking, but they do that stuff all the time. They're very good
at it. And the fact of the matter is that if you do have to have a hip replacement surgery,
they're done pretty well these days, your chances are that you're going to have a good outcome.
Of course, you do open yourself up to risks of infection and dislocation. And there's all kinds
of issues that can happen. And my biggest concern, which I harp on this channel tons
is that if you don't fix that underlying muscle imbalance before you get a hip replacement
surgery or a knee replacement surgery, or any surgery for that matter, then you're going
to have that imbalance after you have your surgery, which is going to set you up for a
similar problem or a problem at a joint nearby. If you still have that dominant hip flexor and
quad muscle, it's just a matter of time before your knee starts to bother you, your back or
your other hip or other knee starts to bother you or the joint that you have replaced. If you had
a hip replacement starts to become loose, and you have issues with that. What is unusual what is not
talked about a lot is how to help prevent surgery. That's just not what surgeons do, of course,
you know, doesn't pay as much as surgery does. There's all kinds of people involved in the
process, the people that are making the surgical parts that go in your body, the replacement parts.
If you've ever been to a surgery room or heard of it, there's tons of people in the room and
he's got everybody's got to get paid the hospital, there's, there's a lot of
money to be made in surgery. I'm not saying that. That's why your surgeon is recommending surgery,
they're probably trained to do that, like I said, but that's where a lot of people
are trained people like myself that talk about preventing surgery, there's just not many of us.
In there, it's just not talked about a lot, because it's not a big money-making
thing. So not a lot of people go into it. But I want you to know that it's just not
common knowledge in the medical field, that with physical therapist, because you might have seen a
physical therapist who told you, yeah, go ahead and get a hip replacement surgery,
you might as well you're already of age, and you might as well enjoy the rest of your life.
Why suffer for the next 5, 10, 15 years, with your hip just getting worse and worse and worse.
I hear this all the time. And here's my answer to that. Being a physical therapist myself and
going to physical therapy school myself, I can tell you I've taught in physical therapy
school as well. The requirements for somebody coming out of physical therapy school is not
that you can prevent surgery, it's that you know how to handle somebody who's had surgery.
So physical therapist, generally all their general skills and knowledge are best geared towards
helping somebody who's just had a hip replacement surgery or some other surgery like that.
They are excellent. If you've had a hip replacement surgery, you need to be in physical
therapy likely right afterwards, as long as your doctor told you and when to tell you and all that.
But they're not the greatest as a whole at preventing,
getting a hip replacement surgery if you qualify if you're if you're the type of person that can
do it, which most are. So if you're looking for a healthcare expert out there to help you, you
got to do some digging, you got to look at their training and their credentials, you got to look
high and low to make sure that you have a person that's got the right training to help you out.
Now let's answer the question. What should I do next? Let's bring it full circle.
And it ties back to you know, who do you find to get help for your hip arthritis right now,
most of the time, that muscle imbalance that I've been talking about is the main thing that's
causing the hip arthritis that's progressing towards needing a hip replacement surgery.
We've got exercises here in our channel, specifically showing you where to start
exercising, if you've got a hip arthritis problem, the videos linked down in the description below.
We've also got an entire playlist that we've that we're working on, that's got hip arthritis
videos. So there's a bunch of content on there already also linked below. For hip arthritis.
We've got tons more content coming your way. So if you haven't subscribed already, do so now.
So you don't miss those videos when they come out. And give us a thumbs up if you thought this video
was helpful for you. And don't forget to share it with somebody that needs to hear
this. I know you probably know somebody out there who's thinking about getting a hip replacement,
or maybe already had one on one side. And they're thinking about the next one.
They need to see this video to see if it's possible for them to escape having surgery
and one last thing they'll leave you with, if you're trying diligently to prevent this hip
surgery from happening, and you've given it its due time you've given it you know, weeks you've
done the exercises, months even you've seen a few people you've tried a bunch of things,
you're not in bad shape. If you decide to go get a hip replacement you probably will do good.
Most people do good there's a great success rate for it. Just find yourself a good surgeon look in
the area you might travel to a bigger city. That's my best advice to you if you do have
to have the hip replacements. Thanks so much friends and we'll see in the next video. Bye