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Коксартроз тазобедренного сустава гимнастика

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17 августа 2019

Коксартроз – дегенеративный процесс в тазобедренных суставах, характеризующийся истончением хряща и его деформацией, разрастанием остеофитов и двигательной дисфункцией сустава. Лечится эта патология комплексно, и среди терапевтических приемов большую роль играет лечебная физкультура. Упражнения при коксартрозе тазобедренного сустава призваны восстановить движения в сочленении, снять боль в суставе и вернуть мышцам физиологическое состояние.

Специфика физкультуры при коксартрозе

Важно знать! Врачи в шоке: "Эффективное и доступное средство от боли в суставах существует. " Читать далее.

Рассмотрим некоторые рекомендации к выполнению упражнений:

  1. Упражнения при коксартрозе являются статическими и не подразумевают нагрузку суставной оси. В целом, пациентам с этим заболеванием противопоказаны тяжелые нагрузки с резкими движениями во избежание усугубления патологических проявлений. Упражнения, доставляющие резкую боль при выполнении, делать нельзя.
  2. Перед началом гимнастики рекомендуется легкий массаж бедренных мышц, так же, как и после окончания занятия – это разогревает мышцы, стимулирует кровообращение и благотворно влияет на выздоровление. Неприятные ощущения в процессе выполнения гимнастики тоже снимаются массажем.
  3. Комплекс упражнений для сустава при коксартрозе дополняется плаванием, если общее состояние пациента позволяет.
  4. Упражнения пациенту желательно подбирать с лечащим врачом, учитывая степень выраженности проявлений и стадию развития коксартроза.
  5. Делать упражнения нужно регулярно, желательно ежедневно, в комфортном, плавном темпе.

Комплекс упражнений для пациентов с начальной стадией коксартроза

Незначительная степень (первая или вторая) поражения сустава коксартрозом исправляется упражнениями, стимулирующими подвижность и снимающими симптомы.

Движения выполнять нужно в среднем 3-5 раз, постепенно наращивая повторы до 10. Конечное положение фиксируется на несколько секунд. Легкая боль в процессе занятий — это норма. Дыхание в процессе выполнения не задерживается.

  1. Обе руки опущены и прижаты к телу, ноги выпрямлены. Со вдохом руки поднимаются, с выдохом — опускаются. Плавно повторить шесть-восемь раз.
  2. Обе руки опущены и прижаты к телу, ноги выпрямлены. Руки плавно сгибаются и разгибаются в локте.
  3. Согнуть колено больной ноги, вытянуть ногу и подержать несколько секунд. Согнутую ногу можно придерживать противоположной рукой.
  4. Ногу под коленом обхватить обеими руками, притянуть ее близко к животу. Другая нога в это время плотно лежит на полу.
  5. Согнуть ноги в коленях и плотно поставить подошвами ступней на пол. Напрячь мышцы ягодиц и поднять таз насколько возможно высоко.
  6. Ноги выпрямить, поворачивать внутрь, потом вернуть в исходное состояние – сделать восемь повторов.
  7. Положить руки на талию, 10-15 сек. ногами изображать езду на велосипеде, плавно и не торопясь.

  1. Опереться на локоть и ладонь здоровой стороны, больную ногу вытянуть и поднять, подошва стопы должна находиться под прямым углом к голени.
  2. Лечь на здоровую сторону на бок, голову опустить на руку, согнутую в локте. Ногу с больным суставом поднять, отвести, осторожно вернуть в исходное положение и расслабить. Всего 8 повторов.
  1. Поднять согнутую под прямым углом ногу. Подержать некоторое время.
  2. Руки положить перед собой. Напрячь на несколько секунд мышцы таза, потом расслабить.
  3. Положить руки на бедра, начать поднимать голову и плечи с удерживанием их несколько секунд. Опуститься, спустя паузу на две секунды повторить еще пять раз.
  4. Обе руки положить перед собой. Подняв голову и плечи, обеими руками выполнить три маха, по типу плавания брассом — 6 повторов.
  1. Ступни нужно плотно прижать к полу. Соединить колени и ступни с разворотом пяток наружу.
  2. Сдавить зажатую в коленях подушку или мячик.

  1. Встать на здоровую ногу, опираясь рукой о стену или спинку стула. Пораженной ногой совершить несколько неторопливых махов, амплитуда которых определяется по наличию болевых явлений.
  2. Стоя в том же положении, ступней плавно рисовать в воздухе круг — 8 повторов.
  3. Встать на обе ноги, с опорой руками о стул. Выполнить полуприседание, выпрямиться. Упражнение повторить медленно 10 раз.
  4. Подниматься и опускаться с носков ног на пятку — 10 повторов.

В случае сильной боли приведенный комплекс заменяется на физические упражнения для отягощенных стадий (третьей, четвертой) коксартроза.

Упражнения при тяжелой степени коксартроза

Даже "запущенные" проблемы с суставами можно вылечить дома! Просто не забывайте раз в день мазать этим.

При тяжелой стадии заболевания также необходимо выполнять упражнения:

  • лежа на животе, руки вытягиваются вдоль туловища или кладутся под голову. Под голеностоп подкладывается невысокий валик. В максимально расслабленном состоянии сделать несколько перекатов на животе, несильно покачивая бедрами в стороны. Если возникает боль, уменьшить амплитуду движения. Повторять упражнение необходимо в течение 10 минут, не реже трех раз в день, до приема пищи. Ослабленным пациентам рекомендуется начинать с 3-5 минут, не больше двух раз в день. После укрепления состояния довести выполнение до рекомендуемого объема;
  • положить валик под колени. Лежа на животе, поворачивать вытянутые ноги во внешнюю сторону и внутрь, по очереди. Размах движений не делать более 10 см;

  • в тканевую петлю, подвешенную на высоте в 25 см над кроватью, положить ногу. Петля должна перехватывать середину голени. Сгибать ногу в коленном суставе с небольшой амплитудой, покачать расслабленной ногой в стороны. Упражнение допустимо делать ослабленным больным с невозможностью сидеть, спускаться с кровати, выполнять гимнастику на полу;
  • сидя на стуле, колени раздвинуть на ширину плеч, стопы плотно поставить подошвой на пол. Колени в расслабленном положении начинать плавно сводить и разводить, с небольшим размахом движений;
  • встать здоровой ногой на небольшое возвышение. Ногу, пораженную коксартрозом, свесить вниз, покачивая ею вперед-назад и в стороны. Выполняется упражнение с опорой рук, до 10 минут, два-три раза в день. Боли при этом в норме быть не должно.
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Лечение гимнастикой по Бубновскому

Профессор С. М. Бубновский разработал эффективную методику лечения коксартроза, позволяющую не допускать операции и вернуть качество жизни. Методика известна под термином «кинезитерапия», основана на лечении суставов движением.

Комплекс включает следующие упражнения:

  1. Встать в коленно-локтевое положение. Делая вдох, неторопливо выгнуть спину, делая выдох – прогнуть. Упражнение расслабляет спину.
  2. Опираясь на ладони и колени, потянуться вперед, в поясничной области не прогибаться. Вернуться в прежнюю позу.
  3. Опираясь на локти, сделать выдох и опуститься на пол. Выпрямить руки на следующем выдохе, опустив ягодицы на пятки.
  4. Сменить положение – перевернуться и лечь на спину, как для качания мышц брюшного пресса. Дотянуться локтями до колен. В таком же положении таз поднять высоко, как только возможно.

Упражнения по Бубновскому выполняются по 10-30 повторов, по возможности, учитывая общее состояние.

Лечение гимнастикой по Евдокименко

Врач-ревматолог П. В. Евдокименко предлагает комплекс из 11 упражнений, эффективных для реабилитации тазобедренного сустава, пораженного коксартрозом второй степени:

  1. Поднимать каждую ногу по очереди и держать в поднятом состоянии 35 секунд. После первого выполнения сделать паузу с расслаблением, затем совершить еще 10 повторов.
  2. Поднять ноги под углом 15 градусов, выполнять махи в стороны обеими ногами одновременно.
  3. Согнуть обе ноги и поднять таз на возможную высоту.

Лежа на животе. Под прямым углом сгибать ноги по очереди, удерживая их на весу.

  1. Поднять ногу под углом 45 градусов, подержать полминуты. Перевернуться на другой бок и повторить.
  2. Выполнить предыдущее упражнение, добавив повороты стоп во внешнюю сторону и внутрь.
  1. Вытянуть ноги. Дотянуться до большого пальца ноги, оставаясь так около двух минут. Достаточно одного выполнения.
  2. Опереться спиной о стену, раздвинув обе ноги наиболее широко, согнув пораженную ногу под прямым углом.
  3. Дотянуться до стопы с пораженным суставом и тянуть ее к себе.
  1. Держать поднятую ногу на весу полминуты.
  2. В завершение провести массажные растирания невысокой интенсивности, а также поглаживания ног с мазью, с согревающим эффектом.

Комплексы упражнений лечебной физкультуры при коксартрозе возвращают подвижность тазобедренному суставу и стимулируют его восстановление, при этом применять их рекомендуется с остальными терапевтическими назначениями и под наблюдением специалиста.

Как забыть о болях в суставах?

  • Боли в суставах ограничивают Ваши движения и полноценную жизнь…
  • Вас беспокоит дискомфорт, хруст и систематические боли…
  • Возможно, Вы перепробовали кучу лекарств, кремов и мазей…
  • Но судя по тому, что Вы читаете эти строки — не сильно они Вам помогли…

Но ортопед Валентин Дикуль утверждает, что действительно эффективное средство от боли в суставах существует! Читать далее >>>

По данным печальной статистики от коксартроза (артроза тазобедренного сустава) страдает от 3 до 16% населения земного шара. Это тяжелая дегенеративно-дистрофическая патология опорно-двигательного аппарата, для которой характерно прогрессирующее течение. Обязательным компонентом терапии является лечебная гимнастика – самая простая и естественная методика избавления от суставных болезней. Однако как и любой другой способ лечения, она должна проводиться под контролем врача, так как неправильно подобранные упражнения (и их неверное исполнение) могут только усугубить развитие болезни.

Задачи и особенности ЛФК

Все лечебные мероприятия для пациентов, страдающим коксартрозом, направлены на снижение болевого синдрома, укрепление связок и мышц, замедление разрушения суставного хряща.

Регулярность занятий – важнейшее условие ЛФК. Правильные гимнастические упражнения способствуют повышению стабильности сустава, а также растяжению и расслаблению мышц-сгибателей и разгибателей бедра.

В процессе лечения используются динамические (подвижные) и изометрические (статические) упражнения, при которых мышцы напрягаются без движения самого тела. При этом амплитуда движений в тазобедренном суставе должна находиться в пределах сохранившейся подвижности (до возникновения боли). В ходе многочисленных исследований было доказано, что даже при грубых патологических изменениях в суставах у пациентов с хорошо тренированной мышечной системой вырабатываются компенсаторные (приспособительные) механизмы*. Но для их формирования необходимы длительные систематические тренировки.

* Компенсаторные механизмы – рефлекторные реакции, направленные на устранение или ослабление функциональных сдвигов в организме, вызванных окружающей средой, болезнями и проч.

Пациенту, страдающему артрозом тазобедренного сустава (ТБС), рекомендуются такие упражнения ЛФК, которые укрепляют связки и мышцы, но не заставляют сустав усиленно разгибаться и сгибаться.

Правила выполнения гимнастики

  • При артрозе ТБС рекомендованная пациенту двигательная активность не должна оказывать отрицательного воздействия на суставной хрящ. Гимнастику следует выполнять ежедневно, то есть превратить данную необходимость в полезную привычку, которая поможет обеспечить тазобедренному суставу хорошее кровоснабжение и подвижность.
  • Лечебная гимнастика при артрозе предусматривает выбор такого исходного положения, которое не увеличивает нагрузку на сустав. В ходе занятий повышение нагрузки должно происходить за счет увеличения количества повторений и общего числа упражнений.
  • Многим пациентам рекомендуется дозированное отягощение. Для этого применяется специальная манжета или резиновый жгут, фиксирующийся на голеностопе. Каждое упражнение с отягощением следует выполнять медленно, не расширяя амплитуду движений.
  • Дыхание во время занятий должно быть произвольным.
  • Любое упражнение завершается подъемом рук вверх (вдох) и опусканием вниз (выдох).
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Рекомендация. Гимнастику желательно сочетать с самомассажем мышц бедра и ягодичных мышц. Для этого можно использовать специальные массажеры, имеющиеся в свободной продаже.

Лучшие упражнения при артрозе тазобедренного сустава

1. И. П. (исходное положение) – лежа на полу, на животе. Руки вдоль туловища, ноги прямые. Выполняются медленные подъемы прямой ногой на 15 градусов от пола, задерживая её в таком положении на 30-40 секунд. Затем ноги меняют. Данное упражнение разрешается выполнять только 1 раз каждой ногой (за тренировку). Все движения производятся за счет усилия бедренных и ягодичных мышц.

Затем это же движение выполняется в динамическом варианте: выпрямленные в колене ноги медленно и плавно попеременно поднимают вверх, и задерживают на 1-2 секунды в верхней точке. За время всего занятия ЛФК должно быть выполнено 10-12 подъемов.

2. И. П. – лежа на животе, руки вдоль туловища. Правая нога согнута в колене под прямым углом, левая – прямая. Упражнение выполняется так же, как и предыдущее. В статическом варианте – по одному разу каждой ногой, в динамическом – по 10-12 раз. Затем ноги меняют.

3. И. П. – лежа на животе, на полу. Ноги выпрямлены, руки вытянуты вдоль туловища. Очень медленно прямые ноги поднимают вверх до угла 15° от пола, удерживают их на весу, а затем плавно разводят и сводят вместе (8-10 раз).

Данное упражнение не рекомендуется выполнять пациентам с повышенным артериальным давлением, а также людям после 40 лет.

4. И. П. – лежа на правом боку с согнутой в колене правой ногой, левая прямая. Около 30 секунд левую ногу необходимо удерживать на весу (45°), а затем, после непродолжительного отдыха, перевернуться на правый бок и выполнить такое же движение правой ногой.

5. И. П. – сидя на полу, ноги выпрямлены. Не сгибая ноги в коленях, нужно наклониться вперед и попытаться обхватить ладонями стопы или пальцы ног. Подтянув тело вперед, необходимо задержаться в этом положении на пару минут. Выполнять не чаще одного раза в день.

Если данное упражнение регулярно выполнять в течение нескольких месяцев – растянутся мышцы спины и бедер, а угол наклона увеличится вдвое. В результате кровоснабжение ног улучшится, исчезнет мышечный спазм в бедре и пояснице.

В физиотерапевтической практике при лечении артроза ТБС применяется много подобных упражнений, однако все они должны назначаться в индивидуальном порядке инструктором ЛФК. При этом учитывается стадия патологического процесса, а также индивидуальные особенности пациента.

Какие упражнения запрещены?

Все движения, вызывающие резкую боль, пациенту категорически противопоказаны (кстати, боль может возникать и при неправильном выполнении упражнений).

При артрозе тазобедренного сустава запрещается:

  • приседать,
  • «крутить велосипед»,
  • много ходить пешком,
  • выполнять активные сгибания и разгибания тазобедренного сустава,
  • тянуться рывком или прикладывать усилия к больному суставу.

Противопоказания для занятий ЛФК

  • Артериальная гипертензия.
  • Тяжелые сердечно-сосудистые патологии и заболевания крови.
  • Грыжа белой линии живота и паховые грыжи.
  • Острые формы заболеваний внутренних органов.
  • Повышенная температура тела.
  • Критические дни у женщин.
  • Период реабилитации после полостных операций.
  • Период обострения артроза тазобедренного сустава.

Заключение

Для того чтобы вернуть движениям былую легкость – потребуется воля и упорство. Однако прежде чем приступать к занятиям, необходимо проконсультироваться с лечащим врачом и выяснить, нет ли у вас противопоказаний для занятий физкультурой. А, главное – очень внимательно ознакомиться с правилами выполнения и особенностями рекомендованного комплекса гимнастики.

Коксартроз тазобедренного сустава – заболевание, которое приводит к постепенному разрушению хрящевых тканей. Лечится патология комплексно, при этом медикаментозная терапия призвана облегчать состояние пациента во время обострения, снимать боль. ЛФК при коксартрозе тазобедренного сустава играет главную роль. Существуют специальные упражнения. Они помогают больным восстановить двигательную активность, возвращают мышцам нормальное физиологическое состояние.

Содержание:

Лечебная физкультура

Применяется в комплексной терапии при множестве различных заболеваний. При коксартрозе тазобедренных суставов назначаются определенные упражнения и зависят они от стадии заболевания.

Гимнастика при коксартрозе 1 степени

В диагностике заболевания существует один спорный момент: часто заключение о начальной стадии коксартроза тазобедренного сустава делается ошибочно. Например, симптомы указывают на ДОА (деформирующий остеоартроз), на самом же деле причина схожих проявлений кроется в остеохондрозе пояснично-крестцового отдела позвоночника. Вот какое мнение на этот счет имеет доктор Мясников (смотрите видео ниже).

Если же в поставленном диагнозе сомнений нет, и у пациента действительно присутствует патология 1 степени, то врач назначает упражнения для укрепления мышц. Сильный, хорошо развитый мышечный каркас поддерживает суставы, облегчая нагрузку на них.

Наиболее эффективные упражнения показаны в следующем видео:

Лечебная гимнастика на 3-й стадии коксартроза

При запущенной форме заболевания любые упражнения причиняют боль, поэтому показаны лишь легкие покачивания ногами и бедрами в положении лежа. Перед началом выполнения гимнастики на 3-й стадии ДОА необходимо проконсультироваться с лечащим врачом – неправильные движения только усугубят и без того тяжелое состояние больного. После занятий ЛФК очень полезно делать самомассаж – легкое поглаживание бедер по бокам и спереди.

Важно. Нельзя заниматься лечебной гимнастикой при обострении коксартроза. Упражнения не должны причинять дискомфорт или боль. В остальных случаях ЛФК необходимо заниматься 1 час в день, разделив ее на несколько подходов по 10-15 минут.

В этой методике большая часть упражнений – статические, тем не менее, они весьма эффективны при заболеваниях суставов. Йога способствует укреплению мышц, улучшает кровообращение и восстанавливает подвижность суставов.

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Вернуть легкость движений при ДОА нелегко. Понадобится все упорство, терпение и настойчивость на пути к исцелению. Очень важно выполнять упражнения регулярно и правильно, чтобы не навредить суставам. Для усиления лечебного эффекта можно дополнить йогу элементами тибетской гимнастики. Такая зарядка должна проводиться ежедневно.

На заметку. Некоторые врачи рекомендуют при коксартрозе выполнять скрутки. Такие упражнения в большей степени полезны для поясничного отдела позвоночника, но их польза также будет заметна и при артрозе тазобедренных суставов.

Цигун

Упражнения необходимо выполнять комплексно. Практика цигун очень полезна для здоровья организма в целом. Она не только снимает напряжение в мышцах и суставную боль, но и укрепляет иммунную систему, а также улучшает работу сердца. Важно выполнять гимнастику регулярно и постоянно. Моментального эффекта ждать не следует.

Авторские методики

Из множества методик лечения остеоартроза стоит выделить 3 наиболее популярных. Это авторские разработки гимнастических упражнений, направленных на облегчение состояния больного:

  • метод Бубновского;
  • гимнастика Гитта;
  • метод Евдокименко.

ЛФК по Бубновскому

Профессор Бубновский разработал специальную методику, благодаря которой можно значительно уменьшить болевые ощущения при коксартрозе и обрести свободу движений. К сожалению, уже на второй стадии заболевания в тазобедренном суставе происходят такие изменения, которые невозможно повернуть вспять. Требуется эндопротезирование. Но к операции необходимо подготовиться, чтобы период реабилитации прошел успешно и двигательная активность сустава полностью восстановилась. При выполнении упражнений на растяжку профессор Бубновский рекомендует соблюдать определенные правила:

  1. Уделяйте особое внимание дыханию в процессе выполнения упражнений. Правильное соотношение вдох / выдох позволит насытить организм кислородом.
  2. Следите за ответом организма на выполняемые движения – при малейшем дискомфорте занятия тут же следует прекратить.
  3. Увеличивайте нагрузку постепенно. Если после занятий ощущаете сильную усталость, интенсивность выполнения упражнений нужно уменьшить.
  4. Никогда не делайте гимнастику через силу – только положительные эмоции и бодрость духа.
  5. Упражняйтесь регулярно. Терапевтический эффект наступает лишь при длительном курсе ЛФК, примерно через 1-2 месяца занятий.
  6. Всегда закрепляйте результат сеансом массажа (можно медового).

Комплекс упражнений по методике С.М. Бубновского выполняется с применением силовых тренажеров.

Важно. В ходе занятий нужно постепенно начинать задействовать и коленные суставы. Упражнениям необходимо уделять не менее часа в день. Особенно это важно для пациентов с тяжелой формой коксартроза бедра. Также профессор рекомендует на протяжении всего курса лечения соблюдать диету.

Гимнастика Гитта

ЛФК – это обязательная составляющая лечения артрозов различной локализации. Многие известные доктора, занимающиеся лечением патологий опорно-двигательного аппарата, разрабатывают авторские комплексы упражнений. Есть собственная методика и у Виталия Демьяновича Гитта – специалиста мануальной терапии. Гимнастика Гитта весьма эффективна при коксартрозе тазобедренных суставов. Упражнения показаны при любой степени заболевания и одинаково доступны для выполнения как пожилыми людьми, так и теми, кто проходит реабилитацию после травм.

Суть методики заключается в выполнении определенных микродвижений, направленных на восстановление подвижности суставов в комплексе с перкуссионным массажем и диетой с низким содержанием белков. Виталий Демьянович Гитт в корне не согласен с мнением, что артроз – болезнь неизлечимая. Разработанная им методика позволяет не только приостановить разрушительные процессы в суставах, но и обратить их вспять.

Методика Евдокименко

Лечебная гимнастика применяется в периоды ремиссий и призвана улучшить трофику тканей, а также укрепить мышцы и связки. Упражнения, разработанные доктором Евдокименко, предназначены специально для крупных суставов.

Для гимнастики есть некоторые противопоказания:

  • гипертония;
  • хронические заболевания внутренних органов;
  • паховая грыжа;
  • послеоперационный период;
  • тяжелые патологии сердечно-сосудистой системы;
  • менструации;
  • повышенная температура тела.

Заниматься разрешается самостоятельно, в домашних условиях. В качестве пособия можно использовать следующее видео:

Другие методики

Среди прочих способов лечения коксартроза стоит отметить:

  • занятия на велотренажере;
  • финскую ходьбу;
  • плавание.

Велотренажер

В отличие от езды на велосипеде такой вид тренировок при коксартрозе тазобедренных суставов полезен тем, что совершаемые пациентом движения – плавные. Здесь нельзя упасть, резко дернуться, повредить тазобедренный сустав. На тренажере можно выставить определенную программу. Основным условием для проведения тренировок является полное отсутствие болей во время занятий. При малейшем проявлении дискомфорта следует тут же прекратить тренировку.

Финская ходьба

Умеренные нагрузки при пеших прогулках благотворно влияют на состояние тазобедренных суставов, но только скандинавская ходьба с применением палок имеет целый ряд преимуществ:

  • снижается нагрузка на суставы;
  • задействованы все группы мышц, укрепляется пресс и спина;
  • снижается масса тела (особенно это важно для пациентов с избыточным весом);
  • улучшается общее состояние организма.

Метод является отличной профилактикой заболеваний суставов и довольно прост в исполнении.

Важно. Если ходьба приносит пользу и помогает при лечении коксартроза, то бег – напротив категорически противопоказан.

Плавание

Идеальный вид физических нагрузок при любой патологии суставов. Во время занятий плаванием пациент просто физически не может совершать резкие движения, которые категорически противопоказаны при коксартрозе тазобедренного сустава. Врачи рекомендуют посещать бассейн сразу по завершении сеанса любого вида лечебной гимнастики.

Водные виды спорта помогают поддерживать мышцы «в тонусе», способствуют снижению массы тела, что особенно важно при заболеваниях суставов. Особенно полезно плавать брассом, но для оздоровления вполне подойдут и простые упражнения, например, плавные приседания в воде.

Правильный подход к выполнению упражнений лечебной гимнастики при коксартрозе тазобедренного сустава позволить достичь максимального терапевтического эффекта. Больному станет легче двигаться, уйдут боли в суставах, улучшится общее состояние. В пожилом возрасте вряд ли удастся полностью восстановить пострадавший сустав, но занятия ЛФК помогут приостановить дегенеративно-дистрофический процесс, а также сведут к минимуму частоту рецидивов заболевания, сопровождающихся острой болью.

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