Massage for hip dysplasia in children

Has the diagnosis of hip dysplasia ruined the beautiful future for your baby? Underdevelopment of the joint surface occurs in the womb and can lead to congenital dislocation of the femur (hip joint).

If you miss the moment and do not correct the joint in a timely manner, the child will have serious problems with gait, spine and, as a result, with internal organs and appearance. If you have a girl, then with such a diagnosis she will not be able to avoid problems during childbirth in the future, when the load on the area of ​​this joint is simply colossal...

What is hip dysplasia

Dysplasia is a congenital defect of the hip joint that appears as a result of its abnormal development and can cause subluxation or dislocation of the femoral head. This condition is also called congenital hip dislocation.

Doctors distinguish 3 types of disease:

• irregular shape of the articular cavity, head and neck of the femur while maintaining the normal ratio of the articular surface;
• the simultaneous presence of an irregular shape and a violation of the surface relationship, when the femoral head is displaced upward or located on the edge of the joint;
• congenital dislocation, which is characterized by separation of the surfaces, and the head of the femur has moved out of the articular cavity upward and to the side.

The first and second forms of the disease can be successfully treated only with massage procedures with timely consultation with a doctor. Congenital dislocation is recognized as the most severe form of the disease, which is confirmed by ultrasound diagnostics and x-rays.

Causes of the disease and diagnosis

Risk factors for the occurrence of pathology are prolonged toxicosis during pregnancy, high weight of the newborn, breech presentation, trauma during pregnancy and hereditary predisposition.

The presence of pathology in infants can be determined by the following signs:

• the angle of abduction of the hips and the angle of flexion of the legs at the knees: in healthy babies it is 160-180° and 90°, respectively, with dysplasia the angle of flexion is less;
• Marx-Ortolani symptom: it manifests itself in the first 3 months of life in the form of a click, accompanied by a shuddering of the leg when the baby’s bent legs are slowly spread apart;
• different leg lengths due to shortening of one of the thighs: determined by pressing the legs to the stomach;
• asymmetry of the inguinal, gluteal and popliteal folds.

Children should be examined for congenital dysplasia by an orthopedic doctor at the maternity hospital. If a pathology is suspected, an ultrasound examination is prescribed after discharge, and after 3 months - an x-ray.

Consequences and complications

If in the first year of life the disease is not detected and treatment is not carried out, then after a year there is a disturbance in gait and insufficient development of the gluteal muscles is observed. Children with congenital dysplasia begin to walk later and limp on one leg. This often becomes the cause of scoliosis. Lack of timely treatment in children can provoke dysplastic coxarthrosis in adulthood with the need to replace the diseased joint with an artificial one.

Consequences of dysplasia - clubfoot

Treatment

Hip dysplasia can be treated in several ways. The conservative method consists of applying a splint that holds the child’s legs in a bent position at the hip and knee joints. This is a long and difficult process. For infants, the wide swaddling method is used, when a regular diaper is folded into a rectangle and placed on a diaper. The baby's legs should be spread apart at an angle of up to 80° and bent at the knee and hip joints. The diaper is fixed on the baby's shoulders. When changing diapers, over time, the baby will begin to hold his legs in the usual position.

Additionally prescribed:

• swimming on your stomach;
• at the age of 3 weeks to 9 months - Pavlik stirrups, which are sewn from soft fabric: they consist of a chest bandage, shoulder straps and straps;
• Freyka's pillow, which is plastic shorts or trousers to support the legs in the correct position.

Surgical intervention is permissible only in case of late detection of the disease, when traditional methods do not help.

Along with any method of treating hip dysplasia in children, a course of special massage procedures is required, which are carried out both in a medical center and at home.

Description of the disease and its localization

The symptoms, course and treatment of dysplasia are determined by the structural features of the hip joints - the largest in the body. They are constantly exposed to heavy loads while walking, running, or carrying heavy things. In shape and principle of operation they are similar to classic hinges. The spherical head of the femur is located in a kind of “nest”: the cup-shaped acetabulum (acetabular) cavity of the pelvic bone.

The head of the bone and the acetabulum are covered with elastic and durable cartilage. The joint cavity is filled with viscous synovial fluid, which reduces friction, softens shock and supplies joint and cartilage tissues with nutrients. The head is supported by the strongest ligaments and muscles in the body, which ensures freedom of movement.

The hip joints of newborns, like other structures, are completely immature. The slightest disturbance in their development weakens the fixation of the femoral head by the elastic ligament and articular capsule, which leads to its displacement.

Types of disease

Depending on the lesion and the number of joints affected, the following types of dysplasia are distinguished.

• Acetabular. As a result, the acetabulum itself is destroyed;
• Rotary. The geometry of the bones in the horizontal plane is disrupted, the knees are affected, which leads to inversion of the lower limb. The gait becomes clubfoot.
• With damage to the upper thighs.

The disorders may affect one joint (unilateral) or both (bilateral). There are several forms that can flow into each other.

1. Immaturity of joint tissues. This is no longer the norm, but it is not yet a disease. Characterized by incomplete formation of articular components. Treatment of hip dysplasia involves creating favorable conditions for their development.
2. Pre-dislocation. The pathology has minimal severity. The head is unstable in the acetabulum, but there is no displacement. The hip bones are highly mobile.
3. Subluxation. The head is partially displaced from the acetabulum, but does not fall out. The movements of the joints are accompanied by a characteristic click.
4. Dislocation. The head is completely displaced relative to the acetabular socket, and mandatory reduction is required.

According to the International Classification of Diseases (ICD-10), hip dysplasia is assigned code M24.8; it refers to other specified joint lesions that are not classified in other categories.

Efficacy and contraindications for massage

Massage for dysplasia is prescribed only by an orthopedic doctor and is part of a comprehensive treatment of pathology. As a result of the massage course:

• the condition of the hip joints is stabilized;
• the process of joint reduction improves;
• the condition of muscle tissue improves;
• motor function is normalized, incl. the number of movements increases;
• muscle tone improves;
• the movement of biological fluids improves;
• child development improves.

Contraindications for the procedures are:

• epilepsy;
• exacerbation of hepatitis or diathesis;
• hernia;
• inflamed lymph nodes;
• light weight;
• violation of the integrity of the skin;
• presence of congenital heart disease;
• diseases of the nervous system;
• diseases of the kidneys, liver, blood;
• inflammation of muscle and bone tissue.

Massage procedures are not carried out in children with elevated temperature, general weakness, tearfulness, or disorders of the digestive system.

Diagnosis of dysplasia

For an experienced orthopedic doctor or traumatologist, a thorough examination and appropriate tests are sufficient to make a preliminary diagnosis. But, not a single symptom reliably indicates hip dysplasia. To confirm or refute it, the following studies are prescribed.

1. Ultrasonography. The ultrasound technique is accurate, has no contraindications, and is safe for children under 3 months. It allows you to determine the location and form of the pathology, assess the condition of bones, cartilage, tendons and ligaments. The procedure does not cause pain or discomfort and can be performed repeatedly.
2. X-ray. X-rays show a more complete picture. They can be done from 1 year only if there are strict indications. Excessive radiation provokes infertility, autoimmune disorders, blood diseases, and tumors.

The above methods are sufficient to detect hip dysplasia. To assess the condition of the skeletal system in adults, MRI and CT are additionally prescribed.

Massage technique

When performing massage for hip dysplasia in newborns, the following rules must be taken into account:

• the session is carried out only in a lying position;
• for massaging, choose a hard and flat surface, which is covered with a blanket or diaper;
• The best time for a session is morning and first half of the day;
• There should be at least an hour between massage and feeding.

A therapeutic massage course for dysplasia differs from a general massage:

• Purpose. If a general massage is carried out to relax or improve tone, then therapeutic sessions are localized.
• Techniques. For children under one year old, the main technique is stroking. Therapeutic massage for dysplasia uses a more intense effect, which is often accompanied by the baby’s dissatisfaction and even crying.
• Difficulty of carrying out. The first massage sessions should be entrusted to a doctor or massage therapist who can determine the physical condition of the baby. Home sessions are possible only after training.

The first massage for hip dysplasia is performed by a doctor.
The session is divided into 2 stages. At the first, or preparatory stage, contact and tactile, psychological communication are established, and comfortable conditions are created. The massage therapist uses soothing stroking and light rubbing techniques. The second stage is a local massage, which requires deep and intense impact on the affected area.

Usually the course consists of 10-15 sessions, which are carried out daily. Between courses there is a break of 1.5-2 months to monitor the dynamics of the disease and recovery. A repeated course, techniques, intensity and duration are always selected individually.

Classical technique

The session begins with stroking the front of the body from hands to feet, always with light movements along the stomach and chest. When massaging the hip, you can work both the entire joint and part of it. Smooth and light spiral or straight movements begin from the lower leg and gradually reach the thigh. The inner surface of the thighs cannot be touched, because... the lymph nodes are located there. Stroking usually takes 2-4 minutes.

Then they move on to rubbing the thighs with the pads of their fingers in a spiral or circular motion. It is carried out with slight pressure on the deep muscles and tendons, and when affecting a joint, strong pressure is unacceptable.

Safe areas for massaging your baby's thighs

The massage while lying on the tummy begins with stroking and rubbing the back of the thighs and buttocks. The affected joint is additionally treated with light pinching and tapping. After this, the joint is clamped in one hand, and the other one gently and smoothly clasps the knee. Begin slow inward rotation of the hip. After several repetitions, return to stroking. For 3-5 minutes, massage the thigh with the palm or only the fingers of the palm using spiral movements.

After this, the baby is turned over on his back and the thighs are actively rubbed for 10 minutes. Then the legs are bent and spread apart, making circular movements.

To perform the next technique, fold your palms into a boat and perform the felting technique for 1-2 minutes. The exercise is completed with the “bicycle” technique, followed by flexion and extension of the legs.

The baby is again turned over on his stomach and stroked with light rubbing on the thigh. Spread your legs to the sides. The back and lower back are massaged by stroking and gentle rubbing. Spiral kneading and sawing are done on both sides of the spine. The area of ​​the hip joint on the outer side of the thigh is stroked, rubbed and kneaded. At the end of the session, the feet are massaged.

Intensive complex

Intensive massage for dysplasia is carried out from a position on the stomach (massage of the joint and hip with light stroking) and on the back. Begin by stroking the hip joint area with circular and spiral movements. Then they hold the knee with one hand, and with the other they massage the thigh and joint with 4 fingers of the palm. The reception is carried out with increasing intensity for 4-6 minutes. Next, rub the skin with circular or spiral movements using the pads of the thumbs or forefingers. During the workout, it is important to affect deep muscle tissue, and the duration of exposure is at least 10 minutes.

The next technique is rubbing the lower back, buttocks and back on both sides of the spine. The technique is carried out with the palm or its edge, and all movements take place from the bottom up. The session ends with intense foot massage.

Massage lines for hip dysplasia

Hip dysplasia in newborns can be diagnosed already in the first weeks of life, and timely treatment avoids the development of complications and is limited only to massage sessions and a set of exercises. Massage can also be performed at home after completing training. The purpose of the sessions is to return the joint to its place, increase muscle tone and strengthen the ligamentous apparatus. The duration of the course, as well as its intensity and frequency, is selected only by the attending physician based on the dynamics of the disease, the physical condition of the baby and the form of the disease.

Why do joint problems occur?

Some experts believe that abnormalities in joint tissues begin to form in the first trimester of pregnancy. This is facilitated by unfavorable environmental factors, the influence of toxins, and infectious diseases.

According to others, hip dysplasia is provoked by oxytocin, a hormone that stimulates labor. Its concentration increases in the 3rd trimester of pregnancy, which leads to increased tone of the fetal femoral muscles and the gradual development of subluxation. It is possible that this explains the high prevalence of this pathology in female infants. Maternal hormones have a greater influence on them than on boys.

Other reasons

These include the following:

• hereditary predisposition;
• genetic abnormalities;
• hormonal imbalances in the mother;
• pelvic diligence of the fetus, its large size, oligohydramnios;
• multiple pregnancy, in which the mobility of the fetal joints is limited;
• late toxicosis;
• gynecological abnormalities: fibroids, adhesions, cysts that interfere with the normal motor activity of the fetus;
• viral and bacterial infections in the mother during pregnancy;
• unbalanced diet of the mother, which lacks vitamins E, B, phosphorus, iodine, calcium, iron;
• small weight of a newborn - up to 2500 g;
• premature birth.

Symptoms of dysplasia often appear in infancy. The reasons for their appearance are:

• pathologies of the nervous system (mainly hypertonicity);
• rickets, dysbacteriosis;
• excessively tight swaddling, improper feeding.

If signs of hip dysplasia did not appear in childhood, but there are prerequisites for it, they will appear at an older age.

In an adult, the disease can be caused by:

• poor environmental conditions;
• household and sports injuries of the femur;
• lack of physical activity;
• incorrectly selected therapy in childhood;
• pathologies of the spine;
• hormonal disorders;
• taking hormonal medications;
• excessive physical activity.

The manifestation of symptoms of hip dysplasia may be a consequence of chronic arthritis, arthrosis, bone growths in the immediate vicinity of the acetabulum.

Recommendations for performing gymnastics

The number of repetitions should be gradually increased. This is important, because at first the baby will be new to such movements and may not like it right away. You need to get used to them by gradually increasing the load and adding a variety of exercises.

During the session with the child, be sure to talk gently and calmly, sing songs or recite poems and jokes in order to relieve the child’s stress and turn therapeutic exercises into an exciting game. When the child is healthy, it is better not to take breaks in classes.

The main success of exercise therapy is its regularity. Exceptions include fever, illness, heart and nervous system problems. Before performing gymnastics, you should consult with specialists.

You need to monitor the baby's condition. If he is nervous and crying, then you can stop the gymnastics. Perhaps he was tired and the proposed load was too much for him. There is only one piece of advice: give the child a rest and continue classes another time.

Exercise therapy is part of the entire treatment. It is recommended to add massage performed by a specialist and physiotherapeutic procedures to the course.

With a serious degree of dysplasia, when the child is given a special splint or is prescribed wide swaddling, some types of exercises may not be possible to perform. You should not perform them if the splint or bandage becomes dislodged during their execution.

Treatment methods

The treatment regimen is compiled individually for each patient. What matters is the degree of impairment, the age of the patient, and the individual characteristics of the body.

Physiotherapy

The exercise therapy program for the treatment of hip dysplasia must be performed several times daily for 2 weeks. It stabilizes the functioning of joints, restores motor activity, and improves blood supply.

The set of exercises is selected individually. When hip dysplasia occurs in children, parents do exercises with it. The main thing is accuracy and slowness, so as not to cause pain or aggravate the situation. The first sessions are conducted by the doctor, demonstrating all the nuances of physical therapy.

Physiotherapy

It is aimed at improving tissue trophism, activating blood flow, normalizing muscle tone, ensuring the correct position of the head of the bone, and stimulating the development of joints.

The following procedures are recommended:

• ozokerite (paraffin) applications;
• electrophoresis with medicinal substances (nicotinic acid, calcium, phosphorus, iodine);
• magnetic therapy and/or laser therapy;
• fresh or salt warm baths;
• mud therapy.

Therapeutic massage demonstrates good effectiveness. It helps eliminate the defect and prevents complications in the future.

Medications

Drug therapy for the treatment of hip dysplasia is aimed at adult patients. Suitable purpose:

• chondroprotectors - drugs that improve function and restore joint tissue, as well as stimulate the production of synovial fluid;
• painkillers for severe pain, including in the form of external gels and ointments;
• vitamin complexes.

Uncontrolled use of medications is unacceptable. Each of them is selected by the doctor depending on the specific situation and the rest of the medical history. Vitamins or analgesics alone are not enough - it is not enough to relieve pain, you need to eliminate the cause and ensure normal functioning of the joints. Artradol, a new generation chondoprotector, effectively copes with this task. Its use suppresses the destruction of joint and cartilage tissue, quickly restores cartilage and joint tissue, and also stabilizes the quality of joint lubrication.

Operation

Surgery is necessary if there are no positive results from conservative treatment. If after treatment the pain persists or intensifies, or there is noticeable limitation in movement, the doctor may prescribe the following manipulations:

• open reduction of dislocation;

• correction of the proximal femur and acetabulum;
• palliative surgery.

Sometimes dysplasia is complicated by rapidly progressing coxarthrosis (arthrosis) with disruption of metabolic processes in the cartilage, which leads to its depletion and destruction. In such cases, endoprosthetics - hip replacement - is recommended.

The type of operation is determined by the doctor. Not in every case there is a complete recovery. The functions of the joint may not be fully restored. Postoperative complications are possible, mainly in older patients. Whatever the nature of the operation and whatever its results, Artradol is prescribed during the rehabilitation period. It ensures rapid restoration of operated tissues and enhances the effect of surgical intervention.

Preparing for gymnastics

Before the lessons themselves, the child needs to be prepared. Warming up will allow the main gymnastics course to be more effective .

First, they begin to massage the outer thighs, then the rest of the legs, including the ankle and feet themselves. The inner surface of the thighs near the genitals should not be touched. Second stage: lightly rub in a circle or with direct movements (without moving the skin or squeezing strongly) the most damaged joint.