When you're living with the pain of Avascular Necrosis (AVN) in your hip, exercise can feel like a paradox. Movement hurts, but you know that being inactive will only lead to more stiffness and muscle weakness, making the problem worse.
So, what can you do?
The key is to be strategic. The right kind of exercise can help manage pain, maintain mobility, and improve your quality of life. The wrong kind can accelerate damage to the joint.
Crucial Medical Disclaimer: Before attempting any of these exercises, you MUST consult with your orthopedic doctor or a qualified physical therapist. They can assess the specific stage of your AVN and approve the movements that are safe for you. This guide is for informational purposes only.
The Golden Rule of AVN Exercise: No Impact, No Pain
The primary goal is to strengthen the muscles that support the hip joint (like your glutes and quads) and maintain the joint's range of motion without putting compressive stress on the weakened femoral head.
If you feel any sharp, pinching, or sudden pain during any movement, stop immediately.
SAFE Exercises for AVN of the Hip (The "Do's")
These exercises focus on gentle movement and muscle activation.
1. Hydrotherapy / Water Exercises
This is the #1 recommended form of exercise for AVN. The buoyancy of the water supports your body weight, taking almost all the impact off your hip joint.
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Water Walking: Simply walking back and forth in a chest-deep pool.
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Gentle Kicks: Hold onto the side of the pool and gently swing your leg forward and backward, and side to side.
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Water Cycling: Some pools have underwater stationary bikes, which are excellent.
2. Range of Motion Exercises (To reduce stiffness)
Do these slowly and gently, lying on your back on a firm surface.
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Heel Slides: Lie on your back with your legs straight. Slowly slide the heel of your affected leg up towards your buttock, bending your knee. Slide it back down.
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Hip Abduction and Adduction: Lie on your back with your legs straight. Gently slide your affected leg out to the side, then back to the center. Keep your knee pointing towards the ceiling.
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Gentle Hip Rotations: Lie on your back with your affected leg's knee bent and foot flat on the floor. Slowly let your knee fall out to the side, then bring it back to the center.
3. Isometric Strengthening Exercises (To build muscle without moving the joint)
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Glute Squeezes: Lie on your back or stomach and simply squeeze your buttock muscles. Hold for 5 seconds, then relax.
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Quad Sets: Lie on your back with your affected leg straight. Place a small rolled towel under your knee. Press the back of your knee down into the towel, tightening your thigh muscle (quadriceps). Hold for 5 seconds, then relax.
Exercises to AVOID at All Costs (The "Don'ts")
These activities create high-impact forces that can cause the weakened femoral head to collapse further and faster.
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Running or Jogging: This is the most dangerous activity for an AVN hip.
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Jumping: Any activity that involves jumping or hopping.
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Heavy Weightlifting: Especially deep squats, lunges, or leg presses with heavy weights.
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High-Impact Sports: Football, basketball, tennis, or any sport that involves sudden starts, stops, and pivots.
The Critical Role of a Physiotherapist
A skilled physiotherapist is your best ally in managing AVN. They will not give you a generic list of exercises; they will create a customized program based on your specific:
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Stage of AVN
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Pain levels
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Current range of motion
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Muscle strength
They can ensure you are performing the movements correctly and safely, maximizing the benefits while minimizing the risks.
Conclusion: Move Smart, Not Hard
Living with AVN doesn't mean you have to be sedentary. It means you have to be smarter about how you move. By focusing on low-impact strengthening and gentle range-of-motion exercises ideally under the guidance of a professional you can play an active role in managing your symptoms and preserving your hip function for as long as possible.