Hip Pain

Definition

What is hip pain?

Hip pain is pain that occurs in the area of the hip joint or the surrounding structures such as muscles, tendons, nerves and connective tissue. When the hips hurt, this can have various causes and manifest itself in different ways. The causes are varied and range from overloading and misalignment to degenerative or inflammatory diseases. Hip pain can be classified according to various criteria:

• Duration: acute hip pain, chronic hip pain
• Occurrence: Hip pain at rest or hip pain when lying down, hip pain on exertion, hip pain after exertion
• Localization: internal hip pain (pain in the groin or hip joint area), external hip pain (pain on the outside of the hip), radiating pain (pain that radiates to the back or legs)
• Cause: mechanical (e.g. misalignment), inflammatory, neurological, traumatic, functional (e.g. muscle tension)
• Type of pain: dull pain, stabbing pain, burning pain

The different types of hip pain

This section briefly describes the different types of hip pain. This is a selection of the most common types, but the list is not exhaustive.

• Hip fracture (femoral neck fracture)

  A hip fracture, also known as a femoral neck fracture, is a fracture of the femoral neck, which connects the head of the femur to the shaft. This fracture often occurs in older people with osteoporosis and is usually caused by a fall. Those affected suffer severe pain and can no longer move their leg. Treatment is usually surgical, either by fixing the fracture fragments or by inserting a hip prosthesis.
  

• Hip dislocation (hip dislocation)

  A hip dislocation occurs when the femoral head slips out of the hip socket. This serious injury is usually caused by strong forces, for example in traffic accidents or falls from a great height. It leads to severe pain, a significant misalignment of the leg and limited mobility. Prompt medical treatment is required to restore the hip joint and prevent consequential damage such as nerve damage or circulatory disorders of the femoral head. In some cases, surgery may be necessary, especially if there are concomitant injuries such as bone fractures.
  

• Hip dysplasia

  Hip dysplasia is a congenital or acquired malformation of the hip joint socket where it is too small or not deep enough. As a result, the femoral head cannot find a stable position, which can lead to pain and restricted movement. If left untreated, hip dysplasia can lead to permanent damage such as osteoarthritis of the hip and walking difficulties.
  

• Hip contusion

  With a hip contusion, the soft tissue under the skin is injured, which leads to typical symptoms such as swelling, bruising and pain. A contusion often occurs after a fall or blow. Depending on the location of the impact, unilateral hip pain (right hip pain or left hip pain) can occur. In the case of a single fall, the upper part of the thigh bone (colloquially known as the hip bone) is often bruised as it protrudes outwards. If the bruise is severe, the hip pain can also be felt when lying down. The pain can also radiate to the pelvic area.
  

• Fatigue fracture (stress fracture)

  A fatigue fracture, also known as a stress fracture, is an incomplete bone fracture caused by repeated overloading without acute trauma. It often occurs in athletes or people with high physical exertion, particularly in bones subject to stress such as the tibia, metatarsus or femur. The first sign is a load-dependent pain in the hip joint, which intensifies over time. If left untreated, the fracture can break through completely.
  

• Muscle strain or torn muscle fiber

  A muscle strain or muscle fiber tear occurs when the muscle fibers are overstretched or even torn, usually due to sudden, intense strain or unusual movements. In a pulled muscle, the muscle fibers are only partially damaged, which can lead to pain, restricted movement and swelling. A torn muscle fiber is more serious and involves a complete tear of muscle fibers, resulting in more severe pain, bruising and significant functional impairment.
  

• Hip flexor tendinopathy (tendinitis)

  Hip flexor tendinopathy, also known as tendinitis of the hip flexor, is an inflammatory disease of the tendons that connect the hip flexor muscles to the thigh bone. This condition is often caused by overuse or repetitive strain, as occurs during running, cycling or other sporting activities. Typical symptoms are pain and tenderness in the area of the hip and upper thigh, which can increase with movement.
  

• Trochanteric major pain syndrome (tendon attachment irritation)

  Trochanter major pain syndrome is a painful condition caused by irritation or inflammation of the tendon insertions on the thigh bone, particularly on the greater trochanter. These complaints are often caused by repeated overloading, incorrect loading or incorrect movements, which lead to inflammation of the tendons. Those affected have pain on the outside of the hip, which is particularly severe during activities such as climbing stairs, walking or lying on the affected side.
  

• Labral lesion (tear of the joint lip)

  A labral lesion is a tear in the labrum, which surrounds the hip joint and ensures its stability. This injury is often caused by repetitive strain, overstretching or acute trauma, such as sudden movements or falls. Those affected usually experience pain in the groin region, which can become worse with certain movements or during sport. There may also be a feeling of instability or clicking in the hip joint.
  

• Hip impingement

  Hip impingement, also known as femoroacetabular impingement (FAI), is a painful restriction of movement in the hip joint caused by an incorrect fit between the femoral head and the acetabulum. This can cause soft tissue and cartilage to become trapped, which can lead to long-term damage and osteoarthritis. Typical symptoms include pain in the groin, limited hip mobility and discomfort during certain movements such as sitting, turning or sport.
  

• Bursitis trochanterica

  Bursitis trochanterica, also known as bursitis of the hip, is a painful condition that affects the outer part of the hip. This inflammation occurs when the bursa, a small fluid-filled sac that acts as a cushion between bone and soft tissue, becomes irritated or damaged. Typical symptoms include pain on the outside of the hip that may radiate into the thigh, tenderness to the touch and difficulty with movements such as walking or climbing stairs.
  

• Iliopsoas bursitis

  Iliopsoas bursitis is an inflammation of the bursa located under the iliopsoas muscle. This muscle is located at the front of the hip and consists of two muscles that are responsible for hip flexion. The bursa acts as a cushion to reduce friction between muscles, tendons and bones. Typical symptoms include pain at the front of the hip, which may radiate into the thigh or buttock, and stiffness, especially in the morning.
  

• Hip osteoarthritis

  Hip osteoarthritis, also known as coxarthrosis, is the progressive wear and tear of the hip joint cartilage. Due to wear and tear or incorrect loading, the protective cartilage is increasingly broken down, causing bone to rub against bone. This leads to pain in the hip joint, stiffness and restricted movement, which makes everyday life increasingly difficult. Those affected often complain of hip pain when walking; the first few steps after a long period of rest are particularly painful. Furthermore, hip osteoarthritis can also cause pain at night. Uneven weight-bearing can cause unilateral hip pain (hip joint pain on the right or hip joint pain on the left).

Causes of hip pain

When the hip hurts, there can be numerous causes - from acute injuries and chronic illnesses to incorrect or excessive strain. The most common causes can be divided into three main categories: injury-related causes, degenerative diseases and inflammatory processes. While injury-related pain is often caused by strong forces such as collisions, rapid changes of direction or stop-and-go movements, degenerative and inflammatory diseases are mainly caused by lifestyle and environmental conditions. In the past, our ancestors were forced to move much more intensively in order to obtain food. Hunting, berry picking and farming are just a few examples. These activities were often carried out barefoot on natural ground, which led to a good and natural strain on the foot and leg muscles. However, lifestyles have changed considerably over the millennia. In modern civilization, many people suffer from a lack of exercise and a predominantly sedentary lifestyle. When we move, we often do so on hard, flat surfaces such as concrete or asphalt and in supportive, immobile shoes. These changes in the way we move lead to adaptations in the body. The following explains how these changes can contribute to the development of hip pain.

Lack of exercise and a sedentary lifestyle

Modern lifestyles, which are often characterized by a lack of exercise and a sedentary lifestyle, lead to incorrect strain on the musculoskeletal system. This lack of exercise and sedentary lifestyle cause physical changes that can contribute to hip pain. The following changes play a decisive role in the development of hip pain:

• Weakened muscles

  A lack of exercise and a sedentary lifestyle cause these important muscles to atrophy. The foot and leg muscles play a central role in hip health. The muscles around the hips in particular, such as the gluteal muscles (buttock muscles), the iliopsoas (hip flexor muscles) and the abductors and adductors, make a significant contribution to stability. If these muscles are weakened, the hip lacks the necessary support, which can result in uncontrolled movements and incorrect loading. This increases the risk of long-term hip pain. In addition, strong muscles relieve the hip joint by absorbing the impact loads when walking, running or jumping. Weak muscles cannot perform this task effectively, which leads to the joint surfaces coming into greater contact with each other. This promotes cartilage wear and can lead to hip osteoarthritis. A muscular imbalance, for example between the iliopsoas and the gluteal muscles, can also change the position of the pelvis and cause misalignments in and around the hip. Not only the muscles around the hip joint are important, but also those of the feet, which are the first point of contact with the load. Functioning foot muscles play a key role in hip health. They support the longitudinal arch of the foot, which is the first instance of reducing the force exerted on the hip when standing and walking. In addition, intact foot muscles ensure a natural rolling movement of the foot, which prevents uncontrolled foot drop after heel strike. Uncontrolled rolling of the foot means that the hip is subjected to additional strain with every step instead of being guided physiologically. This incorrect and excessive load contributes to overloading the hip.
  

• Foot malpositions

  Weakened muscles can encourage foot misalignments, which have a significant influence on the development of pain in the hip area. As the feet form the basis of the musculoskeletal system, any misalignment along the entire leg axis affects the knees, hips and back. For example, foot misalignments often lead to a change in the position of the thigh bone and hip joint, which can promote long-term pain and joint wear and tear (osteoarthritis).
  Weakened foot muscles can cause the longitudinal arch to collapse and lead to flat or fallen arches, resulting in a loss of the natural shock absorber function. As a result, the force exerted when walking and standing is no longer optimally cushioned, but transmitted directly to the hips via the feet and knees - an increased load that can lead to hip joint pain.
  

• Restricted blood flow

  Restricted blood flow can promote the development of hip problems, as the hip joint and its surrounding structures are dependent on a continuous supply of oxygen and nutrients. If this supply is impaired, healing processes slow down, the tissue is weakened and inflammation can develop. Furthermore, restricted blood flow slows down the removal of metabolic waste in the tissue. This promotes inflammatory reactions, which can increase pain and swelling in the hip.
  
  The hip joint is surrounded by cartilage, tendons, ligaments and muscles - structures that require good blood circulation to remain healthy. Inadequate blood supply leads to poorer tissue quality and increases the risk of cartilage damage, tendon irritation and degenerative diseases such as hip osteoarthritis.
  After injuries or overuse, optimal blood circulation is essential for healing, as it supports the transportation of oxygen and the breakdown of damaged cells. If blood circulation is impaired, regeneration is delayed and minor damage does not heal properly. In the long term, this can lead to chronic pain in the hip area and persistent discomfort.
  

• Fascia dysfunction

  Fasciae are connective tissue structures that envelop and connect muscles, tendons, ligaments and organs. If they are stressed irregularly or unphysiologically, they can change their original structure. As a result, the fascia network loses its elasticity, which impairs its function. Fasciae play a central role in the body's movement, stability and power transmission. If their elasticity is lost, the tension around the hip joint increases. The increased tension pushes the femoral head and acetabulum closer together. On the one hand, this additional pressure from the closer bones wears down the cartilage layer excessively and, on the other, leads to unnatural tension, which can promote injury and inflammation.
  
  Hardened or adhered fascia can negatively affect the blood vessels and thus lead to poor circulation, which slows down the regeneration of muscles, tendons and cartilage. Furthermore, hardened or adhered fascia can restrict the mobility of the hips and lead to incorrect loading. More on this in the next section.
  

• Joint stiffness

  A lack of exercise and a sedentary lifestyle mean that the joints are not used to their full range of motion, resulting in natural stiffening. Immobile joints in and around the foot in particular prevent a natural rolling movement and increase the load on the hip joint, which can consequently lead to pain in the hip.
  The hip joint also stiffens through inactivity. Sitting for long periods shortens the hip flexor, among other things, causing the pelvis to tilt forward. This shift reduces the mobility of the hip joint and leads to incorrect and excessive strain on the surrounding structures. Tension, shortening and blockages in the connective and supporting tissue further increase the restriction of movement. This puts muscles, tendons and ligaments under incorrect and excessive strain, which causes permanent pain in the hip area. The restricted mobility also reduces the supply of nutrients to the cartilage, which increases the risk of osteoarthritis and joint damage. The stiffening of the hip joint also means that the surrounding muscles are used less and break down. As these muscles stabilize the joint, their breakdown leads to instability and an increased risk of injury. To compensate for the restrictions, those affected often switch to unhealthy movement patterns, which overloads other joints such as the knee or lower back and causes additional discomfort there.

Hard, flat floors and stiff, restrictive footwear

Hard, flat floors and immobile, supportive shoes have a significant impact on the hip joints and can cause or exacerbate hip pain. The following factors play a significant role in the development of hip pain.

• Reduced shock absorption and increased force effect

  When walking on hard, flat floors and in immobile, supportive shoes, higher forces act on the musculoskeletal system, especially during heel strike. Due to the firmness of industrial floors and the stiffness of conventional shoe soles, the forces that occur cannot be absorbed, which leads to increased strain on the body. This increased force hits the feet first and is then transferred to the hips via the knees. The less well the feet can absorb the forces, the greater the strain on the hip joint, which increases the risk of osteoarthritis, overuse pain or inflammation in the hips. Furthermore, the increased and early application of force shortens the possible reaction time of the responsible muscles. If the muscles cannot tense up in time, the joint in question is insufficiently stabilized, which also leads to incorrect and excessive strain. Insufficient muscular tension in the feet results in uncontrolled folding of the midfoot after heel strike. This results in what is known as a hinged foot and leads to an additional impact on the hip joint, which places incorrect and excessive strain on it. The hip-stabilizing gluteal muscles, the hip flexor (iliopsoas) and the abductors and adductors also react with a delay due to the increased force. The lack of muscular stabilization makes the hip joint unstable and increases the load on the hips and surrounding structures.

• Limited foot function and muscle weakness

  Due to hard, flat floors and immobile, supportive shoes, the feet can no longer roll fully. This favors the development of a drop foot, where the foot folds down uncontrollably after heel contact. Immobile, supportive shoes in particular significantly restrict mobility in the ankles. As a result, important muscles and tendons that help to stabilize the leg and hips are less activated. This can lead to increased stress on the hip joints and surrounding structures, which increases the risk of injury, inflammation and wear and tear in and around the hips. Studies show that immobile, supportive shoes reduce muscle activity in the calf and thigh muscles. Weakness in these muscle groups increases the risk of incorrect and excessive strain on the hips.
  

• Unnatural sequence of movements

  Natural movement sequences are designed to react dynamically to changing surfaces. Hard, flat floors and immobile, supportive shoes make a physiological sequence of movements much more difficult. On the one hand, the lack of muscle activation during heel strike causes the foot to fold downwards in an uncontrolled manner. The folding foot and its consequences for the hip joint were described in the previous section. On the other hand, the hardness and inflexibility of industrial floors and the stiffness of conventional shoe soles prevent the foot from rolling naturally. This restricted foot movement limits the distance covered by each individual step. In order to move forward, the required movement must now be taken from the hips, resulting in a hip-oriented gait. This puts significantly more strain on the hip joint and surrounding structures with each individual step, which can lead to injuries, inflammation and wear and tear in and around the hips.
  
  Furthermore, immobile, supportive shoes reduce the sensory feedback from the foot, which leads to a reduction in the exchange of information and therefore a reduction in adaptability. Movement control is therefore impaired, resulting in incorrect and excessive strain on the connective and supporting tissue. This can lead to pain in the hip and radiating knee and back pain.

Symptoms of hip pain

It is important to note that the following are the most common symptoms of hip pain. However, the list of symptoms is not complete and exhaustive. Atypical symptoms are also possible and are not listed here. The symptoms often depend on various factors such as pain perception, cause of the injury, degree of injury, physical constitution, etc. In order to obtain a clear diagnosis, a doctor should be consulted.

• Stiffness in the morning: feeling of limited mobility after getting up, often an indication of osteoarthritis or inflammation.
• Pain in the groin: Often indicates problems in the hip joint itself, e.g. hip osteoarthritis, hip impingement or tendon irritation.
• Pain on the outside of the hip: Can be caused by inflammation of the bursa (trochanteric bursitis) or irritation of the tendon insertions (e.g. iliotibial tract). A contusion can also lead to external hip pain, although this is often referred to as hip bone pain. The hip bone is actually the strong projection of the upper part of the thigh bone.
  
• Pain radiating into the leg or buttocks: Often occurs with nerve irritation, disc problems or sciatica.
• Pain on exertion: Often indicates osteoarthritis, overloading or muscular imbalances.
• Hip pain at rest or at night: Hip pain when lying down can indicate inflammatory diseases (e.g. rheumatism) or advanced osteoarthritis.
• Cracking or rubbing in the hip joint: Can be caused by cartilage wear or instability in the joint.
• Pain when climbing stairs or standing up: Typical of weakness in the gluteal or hip flexor muscles and joint disorders.
• Gait irregularities or limping: Typically occur as a consequence of pain, muscle weakness, or joint transformations.
• One-sided hip pain after prolonged sitting: Often caused by a shortening of the hip flexor or irritation of the iliopsoas muscle. Sciatica or disc problems can also be the cause of one-sided hip pain.
• Restricted hip mobility: May indicate structural changes in the joint, e.g. hip osteoarthritis, hip impingement or hip dysplasia. Muscular tension or shortening can also occur.
• Sudden, severe pain with restricted movement: Could indicate acute inflammation, muscle strain, joint blockage or even necrosis of the femoral head.
• Sensitivity to pressure in the hip: May be an indication of bursitis, tendon irritation or trigger points in the muscles.
• Feeling of instability in the hip: Often occurs with muscular weakness, especially if the stabilizing muscles such as the gluteal muscles, the abductors or the hip muscles are insufficiently activated.
• Burning or tingling pain in the hip region: Can be caused by nerve irritation.
• Hip pain after sporting activity: Overloading the muscles can lead to tendonitis or the onset of osteoarthritis. Overstimulation of the hip joint capsule can also be the cause.
• Hip pain in combination with back pain: May be due to a dysfunction of the sacroiliac joint, muscular imbalances or a lumbar disc problem.
• Drawing pain on the front of the thigh: Often a sign of shortening of the hip flexor, inflammation of the iliopsoas or hip osteoarthritis. Nerve irritation (e.g. of the femoral nerve) can also be the cause.
• Feeling of blockage in the hip: Can be caused by joint bodies, cartilage damage or hip impingement. Sometimes the cause also lies in muscular imbalances.
• Hip pain when walking or standing for long periods: Typical for osteoarthritis, muscular overload or a misalignment of the hip. An uneven load due to differences in leg length or foot misalignment can also be the cause.

Help with hip pain - Conventional therapy

If the hip hurts, there are several approaches to tackling the discomfort. Some therapies for hip pain are listed below. The list of these therapies is not exhaustive. Various measures can also be combined to treat hip problems. A medical consultation is recommended to determine the appropriate therapy for hip problems.

• Physiotherapy: With special exercises and forms of therapy, the aim is to improve mobility, strengthen the muscles and relieve the joint so that the hip pain is reduced during exercise and the hip pain is reduced at rest.
  
• Targeted strength and mobility training: Pain in the hip area can be alleviated with regular and targeted strength and mobility training.
  
• Water therapy (e.g. aqua gymnastics, swimming): Exercise in water relieves the joints, promotes blood circulation and strengthens the muscles without heavy strain.
  
• Barefoot training & Gait training: walking barefoot strengthens the foot muscles and natural movement mechanisms. By optimizing the gait pattern, incorrect and excessive strain can be reduced.
  
• Relaxation techniques & Stress management: Methods such as yoga, meditation or breathing techniques can reduce muscle tension and have a positive effect on pain in the hip joint.
  
• Weight reduction: Relief of the hip joints and surrounding muscles by reducing body weight.
  
• Fascia training/therapy: loosening of adhered fascia to improve mobility and relieve pain.
  
• Electrotherapy (e.g. TENS, EMS): application of electrical impulses to reduce pain, relax muscles or strengthen weakened muscles.
  
• Massages: Massages to relieve tension and blockages around the hips.
  
• Chiropractic or osteopathy: manual adjustments and holistic treatments to restore joint mobility and muscle balance.
  
• Shock wave therapy: Application of high-energy sound waves to promote blood circulation, regeneration and pain reduction, particularly in the case of tendon irritation.
  
• Acupuncture: Traditional Chinese treatment method that can relieve pain in the hip joint and release muscle tension through targeted needle pricks.
  
• Posture correction and ergonomics: Adjustment of sitting and standing postures and workplace ergonomics to avoid incorrect strain.
  
• Cold and heat applications: Cold (e.g. ice packs) to reduce inflammation and swelling, heat to relax muscles.
  
• Magnetic field or electrotherapy: stimulation of blood circulation and pain relief.
  
• Dietary adjustments and supplements: Anti-inflammatory diet (e.g. omega-3 fatty acids) and supplementation of cartilage-building substances (e.g. glucosamine, chondroitin).
  
• Orthopaedic aids: supports or orthoses to support and stabilize the hip joint. Shoe insoles to correct misalignments and relieve pressure on certain joint areas.
  
• Drug treatment: pain and anti-inflammatory medication.
  
• Joint injections: Hyaluronic acid to improve joint lubrication and relieve pain. Cortisone to reduce inflammation during acute flare-ups and relieve pain.
  
• Autologous blood therapy: This method uses the healing properties of the body's own blood to reduce inflammation, relieve pain or regenerate cartilage.
  
• Surgical measures: In cases of severe hip disease (e.g. advanced osteoarthritis, necrosis of the femoral head), minimally invasive surgery or an artificial hip joint may be necessary.

Unfortunately, the majority of these measures often do not lead to a long-term reduction in pain in the hips, as the causes of hip problems are not eliminated. The aim of any treatment for hip problems should therefore be to eliminate the causes. As described above, the lack of exercise, sedentary lifestyle, hard, flat floors and immobile, supportive shoes should be addressed. The kybun mode of action proves to be a suitable therapy for hip pain, which can eliminate the causes mentioned.

Help with hip pain - How kybun works

Kybun products aim to eliminate the harmful effects of hard, flat floors and immobile, supportive shoes and actively tackle the lack of exercise and sedentary lifestyle. The elastic, springy properties of kybun products relieve and activate the musculoskeletal system. The relief ensures that the pain in the hip area is reduced as a first step. Activation is intended to tackle the causes of the hip problems so that the complaints become a thing of the past in the long term. This makes kybun shoes ideal for hip pain, as they help to treat hip problems through the following modes of action:

• Natural foot roll and increased range of motion thanks to elastic, springy material

  Thanks to the compression capacity of the kybun sole, the heel slowly sinks into the elastic, springy material when you step on it. This allows the foot muscles to prepare for the upcoming load. The activated muscles prevent an uncontrolled, stress-intensive folding foot and support a natural rolling movement up to the push-off over the toes. By fully utilizing the range of motion of the feet, a considerable distance is already covered without this movement having to take place via the hip joint. Instead of a hip-oriented gait, the result is a foot-oriented gait that relieves the hip joint and surrounding structures and reduces the risk of hip joint pain.
  In addition, the natural foot roll minimizes the impact load on the hip joint, as the forces acting on it are efficiently redirected to the forward movement. Active rolling on the elastic, springy kybun material utilizes the entire range of movement of the foot and at the same time promotes more movement in the knee and hip joints. This means that the hip joint is not subjected to one-sided stress, but is used over its entire possible range of movement - which prevents inflammatory and degenerative processes and reduces the point load. At the same time, the extended range of movement activates and strengthens the muscles and improves blood circulation.

• Muscle activation and stabilization of the hip joint

  When walking in kybun shoes, the heels sink deep into the elastic, springy material thanks to the compression soles. As a result, the full load is built up slowly and in a controlled manner, giving the body more time to tense the relevant muscles. The tensed leg muscles stabilize the hip joint and relieve both the joint itself and the surrounding structures. In contrast, when walking on hard, flat floors and in immobile, supportive shoes, the load is applied to the body in an undamped manner. The increased force and shortened reaction time prevent the relevant muscles from tensing in time. This leads to inadequate stabilization of the hip joint and thus to incorrect and excessive strain on the hips and adjacent structures.

• Reduction of the force exerted by hard, flat floors due to damping effect

  When the heel strikes the ground in kybun shoes, the elastic, springy material of the sole is compressed so that the rear foot can sink in deeply. This controlled cushioning reduces the force exerted and reduces the load on the hip joint and surrounding structures. Similar to an airbag in a car, the kybun sole absorbs the impact forces and ensures a gentle, joint-relieving movement. This can significantly reduce hip joint pain from the very first steps.

• Activates and strengthens the muscles thanks to its elastic and springy properties

  When walking and standing on the elastic, springy kybun surface, the body must constantly make small compensatory movements to maintain balance. The deliberate instability of kybun products challenges the balance system and specifically activates the stabilizing deep muscles, which are responsible for stability and posture. As a result, the hip joint and adjacent structures are better stabilized and protected by the surrounding muscles. At the same time, coordination skills are improved as the interaction between the nervous system and muscles is promoted. This leads to better body awareness and more precise movements, protecting the hip joint and the surrounding connective and supporting tissue from incorrect and excessive strain.

Equilibrium and EMG

The ability to maintain balance was measured with a force plate by moving the body's center of gravity from front to back (ant-post) and sideways (med-lat) when standing. At the same time, muscular activity was recorded using electromyography (EMG).

• Improved circulation through increased movement activity

  The hip joint as well as the connective and supporting tissue require a variety of nutrients to nourish, maintain and regenerate them. These nutrients are transported to the corresponding tissue by both the blood and the synovial fluid. As the blood supply to cartilage in particular is limited, increased blood circulation can promote regeneration and support the healing process. Better blood circulation also helps to remove metabolic waste and inflammation-promoting substances more quickly. This reduces swelling and can alleviate pain in the hip, particularly in the case of chronic complaints such as osteoarthritis. Inflammatory processes that damage the joint in the long term can be slowed down in this way. The production of synovial fluid is also stimulated, which improves mobility and protects the cartilage from wear and tear. The muscles around the hips also benefit: muscles that are well supplied with blood are more efficient, more relaxed and less susceptible to tension that could strain the hips. This promotes natural movement and can reduce pain caused by incorrect loading. The elastic, springy kybun materials promote movement and thus activate the muscles around the hip joint. This increases blood circulation, which in turn promotes the benefits mentioned above.
  

• Promoting physical activity and reducing sedentary behavior

  The elastic-springy kybun products increase the pleasure of movement, as their unique material relieves the hip joints and surrounding structures. At the same time, the movement activates and strengthens the muscles while promoting blood circulation - both with the positive effects already described. In addition, the use of kybun products can reduce the time spent sitting, which prevents harmful shortening and blockages of the myofascial structures. Increased walking and standing stretches the often shortened hip flexor muscles in particular, as well as the posterior chain of calf and thigh muscles. This improves mobility and supports natural, healthy movement of the hip joint and its surrounding structures.
  

• Care and protection of the facia

  The fasciae stabilize the hip joint and ensure that the load is evenly distributed with every step. They therefore protect against inflammation, injuries and wear and tear. Healthy fasciae are elastic and free of adhesions and tension. This elasticity promotes mobility of the hip joint and supports blood circulation, which is crucial for the nutrient supply and regeneration of the hips and surrounding structures. The kybun shoes enable a natural sequence of movements that maintains the elasticity of the fasciae.
  

• Optimized pressure distribution

  When walking and standing in kybun shoes, the entire sole of the foot is surrounded by the elastic, springy material, which leads to an even distribution of pressure. This reduces punctual pressure on the hip joints. In addition, the constant slight movement in kybun products increases the load-bearing surface, which also reduces pressure points.

Advice on wearing shoes for hip pain relief

Before you wear kybun shoes for the first time, you should consider a few tips on how to use them. Correct use can help to relieve hip pain. You can also treat hip pain with targeted hip pain therapy, which is explained in the next section.

• At the beginning, only wear the kybun shoes for as long as your body allows. Take breaks if the hip pain becomes more severe or the musculoskeletal system becomes tired. Treatment for hip joint pain takes time. The activating properties of kybun products train the muscles, which can lead to so-called initial reactions, especially at the beginning.
  
• If your hips hurt, you should generally walk more often than stand. When standing, the constant pressure can put more strain on the hip joints and lead to further tension and blockages. Movement promotes blood circulation, loosens tense muscles and fascia and distributes the load over the entire hip joint. In the case of inflammation around the hip joint, the amount of exercise must be adapted to the individual conditions.
  
• Press your heel into the elastic-springy material. Try to find an elastic point at which the pain in the hip joint and surrounding structures is reduced or does not occur.
  
• Try to roll as actively as possible over the forefoot and toes. An increased range of motion in the feet already generates a greater distance via the foot roll, which relieves the hips. The goal is a foot-oriented gait instead of a hip-oriented gait.
  
• After a certain period of time, try changing your walking speed. Switch from walking to trotting and back again. Stay at one speed for about 15 seconds. Changing speeds can help to relieve tension in and around the hip joint. Find out at which speed you have the least or no pain in the hip area.
  
• Try the following exercises to boost the effectiveness of kybun shoes and increase the chances of recovery. These are intended as a complementary therapy for back pain and should form part of the treatment for back pain.

What to do for hip pain? Helpful exercises

To enhance the effectiveness of kybun shoes and increase the likelihood of recovery from hip pain, we recommend performing the following exercises for hip joint pain. The selection of exercises is not exhaustive and can be supplemented by other exercises. The basic rule for all exercises is that the pain in and around the hips must not increase. If one of the exercises increases the pain, it must be discontinued. Soothing and relieving "pain" outside of the pain point is desirable.

The exercises are divided into the following areas: "Correct walking in kybun shoes", "Muscle length training", "Fascia rolling" and "Strengthening". Ideally, the different areas are used as complementary therapy for hip problems.

Walking the right way in kybun shoes

The quality of each individual step is crucial in the treatment of coxarthrosis in order to reduce hip pain caused by osteoarthritis and to eliminate incorrect and excessive strain. The kybun shoes therefore offer an ideal therapy for osteoarthritis of the hip joint and can be worn for incipient hip osteoarthritis symptoms as well as for severe hip osteoarthritis.The quality of each individual step is crucial in the treatment of hip pain in order to reduce the discomfort and eliminate the incorrect and excessive strain. The kybun shoes therefore offer an ideal therapy for hip pain.

Controlled heel strike

• Gently press the heel into the elastic-springy material to find the load pressure and point at which it is possible to step without experiencing pain.
• Lower your midfoot and forefoot slowly and in a controlled manner.
• Controlled foot position so that the foot does not tilt inwards or outwards.
• Roll slowly and in a controlled manner with the forefoot.
• Slow exercises help to rebuild the stabilizing muscles.
• Consciously carry out daily exercises when using kybun products.

Quick step frequency

• Movement sequence identical to exercise 1.
• Now incorporate short steps with a high step frequency that lead to movement in the hip joint. However, always use the full range of motion of the feet.
• If you have pain in the hip joint, increase the stride length and reduce the frequency.
• Important! Maintain an upright posture when standing and walking.
• Consciously carry out daily exercises when using kybun products.

Muscle length training

Muscle length training is of crucial importance in the treatment of hip problems, as the complaints are often caused by shortening, tension and blockages in the myofascial structures. Targeted stretching exercises can actively tackle the shortening, tension and blockages and are therefore an ideal therapy for hip joint pain.

Hip opener

• Begin in an all-fours position.
• Place left foot forward next to arms.
• Stretch your right leg back and place your foot flat on the floor. Make sure that your hips and spine are in line.
• To increase the stretch, push the hips forwards and downwards. Depending on your individual mobility.
• Perform 1-2 times daily.
• Hold the exercise for 3 x 30 seconds.

Buttocks

• Start lying on your back.
• Stretch both arms out to the side at a 90-degree angle and place your left leg bent on your right side.
• Press the bent knee down with your right hand.
• Make sure that both shoulder blades remain on the floor.
• Perform 1-2 times daily.
• Hold the exercise for 3 x 30 seconds.

Fascia roller

Fascia training with the fascia roller is important in the treatment of hip joint pain, as this is often caused by shortening, tension and blockages in the myofascial structures. By regularly rolling out the shortened and tense myofascial chains, the fascia roller is suitable as an active therapy for hip problems.

Gluteal muscles

• Bend both legs and roll out the corresponding half of the buttock with the fascia ball. Increase the pressure by placing the leg on one side. If pain occurs in the wrist, the exercise can also be performed on the forearms.
• Perform the exercise slowly and in a controlled manner.
• Adjust pressure to personal feeling, but go up to the tolerable pain threshold.
• Roll out any localised adhesions or hold the position at this point.
• 3 minutes each side.
• Perform 1-2 times daily.

Lateral thigh muscles

• Starting position in side-lying position.
• Place a large roller between the outer thigh area and the floor.
• Position the upper leg at a right angle for stabilisation and to guide the movement.
• Actively roll out the lateral thigh from the hip to above the knee joint.
• Perform exercises slowly and controlled.
• Adjust pressure to personal feeling, but go up to the tolerable pain threshold.
• Roll out any localised adhesions or hold the position at this point.
• Exercise can be strengthened by straightening the upper leg.
• 3 minutes each side.
• Carry out 1 - 2 × daily.

Strengthening

Targeted strength training helps to strengthen the leg and pelvic muscles and thus relieve the hip joints and their surrounding structures. Strengthened muscles can better absorb the forces acting on the hip joints with every movement. Furthermore, the muscles stabilize the hip joints and thus protect them from incorrect and excessive strain. Strengthening exercises are an effective therapy for hip problems and help to alleviate pain in the long term.

Hip thrust

• Starting position: lying on your back with your legs bent (hip-width apart). Arms are stretched shoulder-width apart at the feet.
• Actively lift your hips off the floor and move them towards the ceiling (hips should be fully extended at the top of the exercise).
• Hold the position at the highest point for 4 seconds.
• Make sure that the force comes from the buttocks (not from the heels or the back of the thighs).
• Slowly lower your hips again without your buttocks touching the floor.
• 3 sets of 8 - 12 repetitions.
• Perform 2 - 3 × weekly.

Squats

• Starting position: standing, feet slightly wider than hip width and slightly rotated outwards.
• Squat down slowly and in a controlled manner. Push your buttocks back and shift your weight onto your heels.
• Ensure that strength comes from the buttocks. Stabilise your knees so that they do not bend inwards or outwards.
• Stand up again slowly and in a controlled manner. If you have balance problems, you can hold on to a stable object with your hands.
• 3 sets of 8 - 12 repetitions.
• Perform 2 - 3 × weekly.