Hip Arthritis Question

[Grumpypeon]

As a trainer, I recently picked up a new client who has very bad osteoarthritis in his left hip. Flexion plus external rotation (although both very limited) produces the most pain. He can't internally rotate at that left hip at all, and he says it feels as though he hits a wall, but no pain.

What is most puzzling for me is that he constantly suffers from varying degrees of tight quads, tight hip muscles, and very, very tight and painful calf muscles on that one side of his body. This single digit cold weather has been making the pain at his hip worse, and in turn, adding to the pain in the muscles listed above. I taught him a few basic banded distractions for his hip, and bought him a LAX ball to use on his butt, hips, quads, and bottom of feet -- temporary solutions to alleviate some of the symptoms from his hip.

My question to you guys is -- what is causing his quad muscles, particularly his vastus med. and vastus lat., his hip muscular, particularly his sartorius and glute med, and his gastroc, to always be at some degree of tightness? Are there any solutions to this besides the inevitable replacement?

Thanks for your help!

[Jordan Feigenbaum]

He's weak, detrained, and has poor soft tissue quality, among other things. Luckily, in a squat or a deadlift you don't need to internally rotate the femur at the hip. Can he squat relatively pain free? O/A is a bugger, honestly. Medications, getting stronger, and fixing lifestyle issues like diet/sleep/stress tend to help but not eliminate O/A, as it's more of a wear and tear pathology resulting in some people having structural changes to the joint itself. If he can't squat- then perhaps he can deadlift.

Weakness, in general, can be mistaken as "tightness"- as weakness tends to correlate with less volitional control of the skeletal muscles- including relaxing through a passive ROM or moving through an active ROM.

[Brodie Butland]

Might be a good candidate for leg pressing for a few weeks...

[Jordan Feigenbaum]

Might be a good candidate for leg pressing for a few weeks...

Indeed.