Hip Pain

Definition

What is hip pain?

Hip pain refers to discomfort located in the hip joint area or the surrounding structures such as muscles, tendons, nerves and connective tissue. When the hips hurt, there can be various causes and different ways the pain can present. Causes range from overload and misalignment to degenerative or inflammatory conditions. Hip pain can be classified according to several criteria:

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

Different types of hip pain

This section briefly describes the different types of pain in the hip area. It presents a selection of the most common forms but is not exhaustive.

• Hip fracture (femoral neck fracture)

  A hip fracture, also called a femoral neck fracture, is a break of the femoral neck that connects the femoral head to the shaft. This fracture often occurs in older people with osteoporosis and usually results from a fall. Affected individuals suffer severe pain and often cannot move the leg. Treatment is usually surgical, either by fixation of the fragments or by hip replacement.
  

• Hip dislocation

  A hip dislocation occurs when the femoral head slips out of the hip socket. This severe injury usually results from high-force impacts such as car accidents or falls from significant heights. It causes intense pain, an obvious misalignment of the leg and limited mobility. Rapid medical treatment is necessary to relocate the joint and prevent secondary damage such as nerve injury or impaired blood supply to the femoral head. In some cases surgery is required, especially if accompanying fractures are present.
  

• Hip dysplasia

  Hip dysplasia is a congenital or acquired malformation of the hip socket where the socket is too small or too shallow. This leads to inadequate support of the femoral head, causing pain and restricted movement. If untreated, hip dysplasia can lead to permanent damage such as hip osteoarthritis and gait impairments.
  

• Hip contusion

  A hip contusion injures the soft tissues beneath the skin, leading to typical signs such as swelling, bruising and pain. A contusion often follows a fall or blow. Depending on the impact location, unilateral hip pain (right or left hip pain) can occur. In a single fall, the upper part of the femur (commonly referred to as the hip bone) is often bruised because it protrudes outward. With a severe contusion, hip pain can also be felt when lying down. Pain may also radiate into the pelvic area.
  

• Stress fracture

  A stress fracture is an incomplete bone fracture caused by repeated overload without an acute trauma. It frequently affects athletes or people with high physical demands, particularly in load-bearing bones such as the shin, midfoot or thigh. The first sign is activity-related pain in the hip joint that increases over time. If untreated, the fracture can progress to a complete break.
  

• Muscle strain or tear

  A muscle strain or tear occurs when muscle fibers are overstretched or ripped, usually due to sudden intense load or unfamiliar movements. A strain involves partial damage to fibers, causing pain, restricted movement and swelling. A muscle tear is more severe, with complete fiber rupture, resulting in stronger pain, bruising and significant functional impairment.
  

• Hip flexor tendinopathy (tendon inflammation)

  Hip flexor tendinopathy, an inflammation of the tendons connecting the hip flexor muscles to the femur, commonly results from overuse or repeated stress such as running or cycling. Typical symptoms include pain and tenderness in the hip and upper thigh area that worsen with movement.
  

• Greater trochanteric pain syndrome (tendon insertion irritation)

  Greater trochanteric pain syndrome causes pain due to irritation or inflammation of tendon insertions on the femur, especially at the greater trochanter. These complaints often arise from repeated overload, malalignment or incorrect movement patterns leading to tendon inflammation. Patients experience pain on the outside of the hip, worsened by activities like climbing stairs, walking or lying on the affected side.
  

• Labral tear (tear of the joint lip)

  A labral tear is a rupture of the labrum, the rim of cartilage around the hip socket that contributes to joint stability. This injury often results from repetitive stress, overstretching or acute trauma such as sudden movements or falls. Affected individuals typically have groin pain that worsens with specific movements or during sports. A feeling of instability or clicking in the hip joint may occur.
  

• Hip impingement

  Hip impingement, also called femoroacetabular impingement (FAI), is a painful restriction of hip motion caused by improper fit between the femoral head and the hip socket. Soft tissues and cartilage can become pinched, leading over time to damage and osteoarthritis. Typical symptoms are groin pain, limited hip mobility and discomfort with certain movements such as sitting, twisting or during sports.
  

• Trochanteric bursitis

  Trochanteric bursitis, inflammation of the hip bursa, affects the outer part of the hip. The bursa, a small fluid-filled sac that cushions between bone and soft tissue, becomes irritated or damaged. Typical symptoms include pain on the outside of the hip that can radiate into the thigh, tenderness to touch and difficulty with movements like walking or stair climbing.
  

• Iliopsoas bursitis

  Iliopsoas bursitis is inflammation of the bursa beneath the iliopsoas muscle, which lies at the front of the hip and consists of two muscles responsible for hip flexion. The bursa reduces friction between muscle, tendon and bone. Typical symptoms are pain at the front of the hip that may radiate into the thigh or buttock and morning stiffness.
  

• Hip osteoarthritis

  Hip osteoarthritis (coxarthrosis) is progressive wear of the hip joint cartilage. Through wear or malalignment, the protective cartilage diminishes and bone can rub against bone. This leads to hip joint pain, stiffness and reduced mobility, increasingly affecting daily life. Patients often report hip pain when walking, especially the first steps after rest. Nighttime pain may also occur. Uneven loading can cause unilateral hip pain (right or left hip joint pain).

Causes of hip pain

When the hip hurts, there can be numerous causes — from acute injuries to chronic diseases and from mis- or overuse. The most common reasons can be divided into three main categories: injury-related causes, degenerative diseases and inflammatory processes. Injury-related pain often results from strong forces such as collisions, sudden direction changes or stop-and-go movements. In degenerative and inflammatory conditions, lifestyle and environmental factors play a major role. Historically, our ancestors had to move much more to obtain food: hunting, gathering berries or farming are examples. These activities were often performed barefoot on natural ground, which provided a natural stimulation for foot and leg muscles. Lifestyle has changed dramatically over millennia. In modern society many people suffer from lack of movement and predominantly sedentary daily routines. When we move today, it is often on hard, flat surfaces like concrete or asphalt and in supportive, rigid shoes. These changes lead to bodily adaptations. The following explains how these changes can contribute to the development of hip pain.

Lack of movement and a sedentary lifestyle

The modern lifestyle, often characterised by inactivity and prolonged sitting, causes misloading of the musculoskeletal system. This lack of movement and sedentary behavior lead to physical changes that can favour the development of hip pain. The following changes play a decisive role in the emergence of hip pain:

• Weakened muscles

  Lack of movement and a sedentary lifestyle lead to the weakening of important muscles. Foot and leg muscles play a central role for hip health. Especially the muscles around the hip, such as the gluteal muscles (buttocks), the iliopsoas (hip flexors) as well as the abductors and adductors, contribute significantly to stability. When these muscles are weak, the hip lacks necessary support, which can result in uncontrolled movements and misloading. This increases the risk of long-term hip pain. Strong muscles also relieve the hip joint by absorbing impact when walking, running or jumping. Weak muscles cannot perform this task effectively, causing joint surfaces to press more directly together. This promotes cartilage wear and can lead to hip osteoarthritis. Muscular imbalance, for example between the iliopsoas and gluteal muscles, can also alter pelvic position and cause malalignments in and around the hip. Not only the muscles around the hip are important but also the muscles of the feet, which form the first contact point for load. Functional foot musculature supports the longitudinal arch of the foot, which reduces the impact on the hip during standing and walking. It also ensures a natural rollover of the foot after heel strike, preventing uncontrolled dropping of the foot. An uncontrolled collapse of the foot causes additional load on the hip with each step instead of a physiologically guided motion. This mis- and overload contributes to hip overuse.
  

• Foot malalignments

  Weakened muscles can promote foot malalignments, which have a major impact on the development of pain in the hip area. Since the feet are the base of the musculoskeletal system, any malalignment affects the entire leg axis including the knee, hip and back. For example, foot malalignments often change the positions of the femur and hip joint, favouring long-term pain and joint wear (osteoarthritis).
  Weak foot musculature can cause collapse of the longitudinal arch leading to flatfoot, eliminating the natural shock-absorbing function. Forces that should be absorbed by the foot are then transmitted via the knees to the hips — an increased load that can promote hip joint pain.
  

• Reduced blood circulation

  Reduced blood flow can contribute to hip complaints because the hip joint and surrounding structures depend on a continuous supply of oxygen and nutrients. If this supply is impaired, healing processes slow down, tissue weakens and inflammation can develop. Reduced circulation also slows the removal of metabolic waste from tissue, promoting inflammatory reactions that can increase pain and swelling in the hip.
  
  The hip joint is surrounded by cartilage, tendons, ligaments and muscles — tissues that require good blood supply to remain healthy. Poor blood supply leads to reduced tissue quality and increases the risk for cartilage damage, tendon irritation and degenerative diseases like hip osteoarthritis.
  After injuries or overload, optimal blood flow is essential for healing, as it supports oxygen transport and removal of damaged cells. When blood circulation is impaired, regeneration is delayed and small damages may not heal properly, potentially leading to chronic hip pain and persistent complaints.
  

• Fascial dysfunction

  Fascia are connective tissue structures that surround and connect muscles, tendons, ligaments and organs. If they are loaded irregularly or non-physiologically, they can change their original structure and lose elasticity. This compromises their function. Fascia play a central role in movement, stability and force transmission. When their elasticity declines, tensions around the hip joint increase. Increased tension can press the femoral head and socket closer together. This extra pressure wears the cartilage and creates unnatural tensions, promoting injury and inflammation.
  
  Hardened or adhered fascia can impair blood vessels and lead to poor circulation, slowing regeneration of muscles, tendons and cartilage. Hardened or adhered fascia can also restrict hip mobility and cause misloading. More on this in the next section.
  

• Joint stiffness

  Lack of movement and a sedentary lifestyle lead to underuse of joints and a natural stiffening. Especially immobile joints in and around the foot prevent a natural rollover and increase the load on the hip joint, which can cause hip pain.
  The hip joint itself stiffens due to inactivity. Prolonged sitting shortens the hip flexor, tilting the pelvis forward. This shift reduces hip mobility and causes mis- and overloading of surrounding structures. Tension, shortening and blockages in connective and support tissue further restrict movement. Muscles, tendons and ligaments are subjected to mis- and overload, causing chronic hip pain. Reduced mobility also lowers nutrient supply to cartilage, increasing the risk of osteoarthritis and joint damage. As the hip joint stiffens, surrounding muscles are used less and atrophy. Because these muscles stabilise the joint, their loss leads to instability and higher injury risk. To compensate, affected individuals adopt unhealthy movement patterns, overloading other joints such as knees or lower back and creating additional complaints.

Hard, flat floors and rigid, supportive shoes

Hard, flat floors and rigid, supportive shoes have significant effects on the hip joints and can cause or worsen hip complaints. The following factors play a major role in the development of hip pain.

• Reduced shock absorption and increased force impact

  When walking on hard, flat floors and in rigid, supportive shoes, higher forces act on the musculoskeletal system, especially at heel strike. Because industrial floors are firm and conventional shoe soles are stiff, the occurring forces cannot be absorbed and lead to increased loading of the body. This increased force first affects the feet and is then transmitted via the knees to the hips. The less the feet can absorb forces, the more the hip joint is loaded, increasing the risk of osteoarthritis, overload pain or inflammation in the hips. Furthermore, higher and earlier force impact shortens the reaction time available to the responsible muscles. If muscles cannot contract in time, the joint is insufficiently stabilised, leading to mis- and overload. Insufficient muscular activation of the feet results in uncontrolled collapse of the midfoot after heel strike. The so-called collapsing foot occurs and delivers an additional impact to the hip joint, mis- and overloading it. Hip-stabilising gluteal muscles, the hip flexor (iliopsoas) and the abductors and adductors respond with delay due to the increased force impact. Lack of muscular stabilisation makes the hip joint unstable and increases load on the hips and surrounding structures.

• Impaired foot function and muscle weakening

  Hard, flat floors and rigid, supportive shoes can prevent a full foot rollover. This promotes the collapsing foot where the foot uncontrollably drops after heel contact. Particularly inflexible, supportive shoes limit mobility in the foot joints and reduce activation of important muscles and tendons that stabilise the leg and hips. This can result in increased load on the hip joints and surrounding structures, raising the risk of injury, inflammation and wear. Studies show that rigid supportive shoes reduce muscle activity in calf and thigh muscles. Weakness in these muscle groups increases the risk of mis- and overload of the hips.
  

• Unnatural movement sequence

  Natural movement patterns are designed to react dynamically to changing surfaces. Hard, flat floors and rigid, supportive shoes make a physiological movement sequence much harder. On one hand, lack of muscle activation at heel strike causes the foot to drop uncontrollably — the collapsing foot described earlier. On the other hand, the hardness and inflexibility of industrial floors and stiff shoe soles prevent a natural foot rollover. This restricted foot movement shortens the travel distance of each step. To move forward, the required motion must then be taken over by the hip, resulting in a hip-oriented gait. This increases load on the hip joint and surrounding structures with every step, potentially causing injuries, inflammation and wear in and around the hips.
  
  Rigid, supportive shoes also reduce sensory feedback from the foot, diminishing information exchange and adaptability. Movement control is impaired, resulting in mis- and overload of the connective and support tissue. This can cause hip pain as well as radiating knee and back pain.

Symptoms of hip pain

It is important to mention that the following lists common symptoms of hip pain. The list is not exhaustive and atypical symptoms can occur that are not included here. Symptoms often depend on factors such as pain sensitivity, cause and severity of the injury, physical constitution, etc. For a clear diagnosis, consult a physician.

• Morning stiffness: Feeling of reduced mobility after getting up, often an indicator of osteoarthritis or inflammation.
• Groin pain: Often points to problems within the hip joint itself, e.g. hip osteoarthritis, hip impingement or tendon irritation.
• Pain on the outside of the hip: Can be caused by trochanteric bursitis or irritation of tendon insertions (e.g. iliotibial tract). A contusion can also cause lateral hip pain, commonly referred to as pain of the hip bone, which actually refers to the prominent upper part of the femur.
  
• Radiating pain into the leg or buttock: Often occurs with nerve irritation, disc problems or sciatica.
• Pain with activity: Often indicates osteoarthritis, overload or muscular imbalances.
• Hip pain at rest or at night: Hip pain when lying down may suggest inflammatory diseases (e.g. rheumatism) or advanced osteoarthritis.
• Clicking or grinding in the hip joint: May be caused by cartilage wear or joint instability.
• Pain when climbing stairs or rising from a chair: Typical for weakness of the gluteal or hip flexor muscles as well as joint disease.
• Gait disturbances or limping: Often result from pain, muscle weakness or joint changes.
• Unilateral hip pain after prolonged sitting: Frequently caused by shortening of the hip flexor or irritation of the iliopsoas. Sciatic irritation or disc problems can also cause unilateral hip pain.
• Restricted hip mobility: May indicate structural joint changes, e.g. hip osteoarthritis, hip impingement or hip dysplasia. Muscular tension or shortening can also occur.
• Sudden, severe pain with limited movement: Could indicate acute inflammation, muscle strain, joint blockage or even avascular necrosis of the femoral head.
• Tenderness of the hip: Can indicate bursitis, tendon irritation or trigger points in muscles.
• Feeling of instability in the hip: Often due to muscular weakness, especially when stabiliser muscles like the gluteals, abductors or other hip muscles are insufficiently activated.
• Burning or tingling pain in the hip region: May be due to nerve irritation.
• Hip pain after physical activity: Overuse of muscles can cause tendon inflammation or early osteoarthritis. Overstimulation of the hip joint capsule can also be the cause.
• Hip pain combined with back pain: Can indicate dysfunction of the sacroiliac joint, muscular imbalances or lumbar disc problems.
• Pulling pain at the front of the thigh: Often a sign of a shortened hip flexor, iliopsoas inflammation or hip osteoarthritis. Nerve irritation (e.g. femoral nerve) may also be causal.
• Feeling of a block in the hip: Can be caused by joint bodies, cartilage damage or hip impingement. Sometimes muscular imbalances are the reason.
• Hip pain when walking or standing for a long time: Typical for osteoarthritis, muscular overload or hip malalignment. Uneven loading due to leg length differences or foot malalignments may also be causal.

Conventional therapy - what helps with hip pain

When the hip hurts there are several approaches to address the complaints. Below are some therapies used for hip problems. The list is not exhaustive. Different measures can be combined to treat hip issues. Medical consultation is recommended to determine appropriate therapy for hip problems.

• Physiotherapy: Special exercises and therapies aim to improve mobility, strengthen muscles and relieve the joint so that hip pain during activity and hip pain at rest are reduced.
  
• Targeted strength and mobility training: Regular and targeted strength and mobility training can relieve hip pain.
  
• Water therapy (e.g. aqua gymnastics, swimming): Exercise in water relieves joints, promotes circulation and strengthens muscles without strong load.
  
• Barefoot training & gait training: Barefoot walking strengthens foot muscles and natural movement mechanisms. Optimising gait reduces mis- and overload.
  
• Relaxation techniques & stress management: Methods like yoga, meditation or breathing techniques can reduce muscle tension and positively influence hip joint pain.
  
• Weight reduction: Relieves hip joints and surrounding muscles by reducing body weight.
  
• Fascia training/therapy: Loosening adhered fascia to improve mobility and relieve pain.
  
• Electrotherapy (e.g. TENS, EMS): Use of electrical impulses for pain reduction, muscle relaxation or strengthening weak muscles.
  
• Massages: To release tension and blockages around the hips.
  
• Chiropractic or osteopathy: Manual adjustments and holistic treatments to restore joint mobility and muscle balance.
  
• Shockwave therapy: Use of high-energy sound waves to promote blood flow, regeneration and pain reduction, especially for tendon irritations.
  
• Acupuncture: Traditional Chinese therapy using needles to reduce hip joint pain and release muscle tension.
  
• Posture correction and ergonomics: Adjusting sitting and standing posture as well as workplace ergonomics to avoid misloading.
  
• Cold and heat applications: Cold (e.g. ice packs) to reduce inflammation and swelling; heat to relax muscles.
  
• Magnetic or electrotherapy: Promote circulation and relieve pain.
  
• Dietary adjustments and supplements: Anti-inflammatory nutrition (e.g. omega-3 fatty acids) and supplements for cartilage support (e.g. glucosamine, chondroitin).
  
• Orthopedic aids: Braces or orthoses for support and stabilisation of the hip joint. Shoe insoles to correct malalignments and relieve certain joint areas.
  
• Medication: Pain relievers and anti-inflammatory drugs.
  
• Intra-articular injections: Hyaluronic acid to improve joint lubrication and relieve pain. Cortisone to reduce inflammation during acute flares and relieve pain.
  
• Autologous blood therapy: Uses the healing properties of the patient’s own blood for anti-inflammatory effects, pain reduction or cartilage regeneration.
  
• Surgical measures: For severe hip diseases (e.g. advanced osteoarthritis, avascular necrosis) minimally invasive procedures or a hip replacement may be necessary.

Often many of these measures do not lead to long-term pain reduction because the causes of hip problems are not addressed. The aim of any hip treatment should therefore be elimination of the causes. As described above, lack of movement, the sedentary lifestyle, hard flat floors and rigid supportive shoes should be targeted. The kybun mode of action appears as a suitable therapy for hip pain that can eliminate the mentioned causes.

kybun mode of action - what helps with hip pain

kybun products aim to eliminate the harmful effects of hard, flat floors and rigid, supportive shoes and to actively counteract inactivity and sedentary lifestyles. Thanks to the elastic-springy properties of kybun products, the musculoskeletal system is both relieved and activated. The relief helps reduce hip pain in the short term. Activation addresses the causes of hip problems so that complaints can be resolved in the long term. kybun shoes are therefore well suited for hip pain because they help treat hip complaints through the following mechanisms:

• Natural foot rollover and increased range of motion thanks to elastic-springy material

  Due to the compressibility of the kybun sole, the heel slowly sinks into the elastic-springy material at heel strike. This allows the foot muscles to prepare for the upcoming load. The activated muscles prevent an uncontrolled collapsing foot and support a natural rollover to toe-off. By fully utilising the foot’s range of motion, a significant travel distance is generated without this movement having to come from the hip joint. Instead of a hip-oriented gait, a foot-oriented gait develops that relieves the hip joint and surrounding structures and reduces the risk of hip joint pain.
  Additionally, natural foot rollover minimises impact on the hip joint because the acting forces are efficiently redirected into forward motion. Active rolling on the elastic-springy kybun material uses the full range of the foot and promotes increased movement in the knee and hip joints. The hip joint is therefore not loaded in a single area but used across its full possible range — which prevents inflammatory and degenerative processes and reduces focal loading. At the same time, the increased range of motion activates and strengthens muscles and improves circulation.

• Muscle activation and hip joint stabilization

  When walking in kybun shoes, the heels sink deep into the compressible soles, gradually and controlled building up load and giving the body more time to activate the relevant muscles. The tensed leg muscles stabilise the hip joint and relieve the joint as well as surrounding structures. In contrast, when walking on hard, flat floors in rigid supportive shoes, loads hit the body unattenuated. The increased force impact and shortened reaction time prevent timely muscle activation, leading to insufficient hip stabilization and resulting in mis- and overload of the hips and adjacent structures.

• Reduction of force impact from hard, flat floors through damping effect

  At heel strike in kybun shoes the elastic-springy sole material compresses so the rearfoot can sink deeply. This controlled damping reduces force impact and decreases load on the hip joint and surrounding structures. Similar to an airbag in a car, the kybun sole absorbs impact forces and provides gentle, joint-relieving movement. This can noticeably reduce hip joint pain from the very first steps.

• Activation and strengthening of muscles through elastic-springy properties

  When walking and standing on the elastic-springy kybun surface, the body must constantly make small corrective movements to maintain balance. The deliberate slight instability of kybun products challenges the balance system and specifically activates stabilising deep muscles responsible for posture and stability. As a result, the hip joint and adjacent structures are better stabilised and protected by surrounding muscles. Coordination also improves because the interplay between the nervous system and muscles is promoted. This leads to better body awareness and more precise movement, protecting the hip joint and the surrounding connective and support tissue from mis- and overload.

Balance and EMG

Balance ability was measured with a force plate by tracking center-of-mass movement front-to-back (ant-post) and side-to-side (med-lat) while standing. In parallel, electromyography (EMG) recorded muscular activity.

• Improved circulation through increased movement activity

  The hip joint and connective and support tissues require nutrients to nourish, maintain and regenerate. These nutrients are transported by blood and synovial fluid to the relevant tissue. Because cartilage in particular has limited blood supply, increased blood circulation can promote regeneration and support healing. Better circulation also helps remove metabolic waste and pro-inflammatory substances faster. This reduces swelling and can relieve hip pain, especially for chronic conditions like osteoarthritis. Inflammatory processes that damage the joint over time can thus be slowed. Production of joint lubricant is also stimulated, improving mobility and protecting cartilage from wear. Muscles around the hips benefit as well: well-perfused muscles are more effective, more relaxed and less prone to tension that could burden the hips. The elastic-springy kybun materials promote movement and thereby activate the muscles around the hip joint. In this way circulation is increased, which in turn supports the advantages mentioned above.
  

• Encouraging movement and reducing sedentary time

  The elastic-springy kybun products increase the pleasure of movement because their unique material relieves the hip joints and surrounding structures. At the same time, movement activates and strengthens muscles while improving circulation — both with the positive effects described above. Using kybun products may also reduce sitting time, preventing harmful shortening and blockages of myofascial structures. Increased walking and standing especially stretch often-shortened hip flexors and the posterior muscle chain of calf and thigh muscles. This improves mobility and supports a natural, healthy movement pattern of the hip joint and its surrounding structures.
  

• Care and protection of the fascia

  Fascia stabilise the hip joint and ensure even distribution of load with each step, protecting against inflammation, injury and wear. Healthy fascia are elastic and free of adhesions and tension. This elasticity promotes hip mobility and supports circulation that is critical for nutrient supply and regeneration of the hips and surrounding structures. kybun shoes enable a natural movement sequence that preserves fascial elasticity.
  

• Optimised pressure distribution

  When walking and standing in kybun shoes, the entire sole is enveloped by the elastic-springy material, resulting in even pressure distribution. This reduces focal pressure on the hip joints. Constant slight movement in kybun products also increases the contact area, further reducing focal pressure points.

Usage tips for hip pain

Before wearing kybun shoes for the first time, consider a few usage tips. Correct use can help relieve hip pain. Hip pain should also be treated with targeted hip therapy, which is described in the next section.

• Wear kybun shoes initially only as long as your body tolerates. Introduce wearing breaks if hip complaints increase or fatigue of the musculoskeletal system occurs. Treatment of hip joint pain takes time. Because kybun products are activating, the muscles are trained and initial reactions may occur, especially at the beginning.
  
• When the hip hurts, you should usually walk more often than stand. Prolonged standing can cause higher constant pressure on the hip joints and lead to further tension and blockages. Movement promotes circulation, releases tense muscles and fascia, and distributes load across the entire hip joint. For inflammation around the hip joint, the amount of movement should be adapted to individual conditions.
  
• Press your heel into the elastic-springy material. Try to find a pressure point where pain in the hip joint and surrounding structures is reduced or does not occur.
  
• Try to actively roll off over the forefoot and toes. Increased range of motion in the feet generates a larger travel distance through foot rollover, thereby relieving the hips. The goal is a foot-oriented gait instead of a hip-oriented gait.
  
• After some time, try varying walking speeds. Switch between walking and light jogging, staying at each speed for about 15 seconds. Speed changes help release tension in and around the hip joint. Explore which speed causes the least or no hip pain.
  
• Try the following exercises to enhance the effectiveness of kybun shoes and increase the chance of recovery.

What to do for hip pain? Helpful exercises

To enhance the effectiveness of kybun shoes and increase the likelihood of recovery from hip complaints, we recommend the following exercises for hip joint pain. The exercise selection is not exhaustive and can be supplemented with additional exercises. As a rule, exercises should not increase pain in and around the hips. If any exercise worsens the pain, it must be stopped. Pleasing and releasing sensations outside the pain point are desirable.

Exercises are divided into: “Proper walking in kybun shoes”, “Muscle length training”, “Fascia rolling” and “Strengthening”. Ideally, these areas are used complementarily as therapy for hip problems.

Proper walking in kybun shoes

The quality of each step is crucial in treating coxarthrosis to reduce hip complaints and eliminate mis- and overload. kybun shoes therefore offer an ideal therapy for hip osteoarthritis and can be worn for both early symptoms and advanced osteoarthritis. The quality of each step is crucial in treating hip pain to reduce complaints and eliminate mis- and overload. kybun shoes thus offer an ideal therapy for hip pain.

Controlled heel strike

• Gently press the heel into the elastic-springy material to find the pressure point where a step is possible without pain.
• Place midfoot and forefoot slowly and controlled.
• Maintain a controlled foot position to prevent inward or outward tilting.
• Roll off slowly and controlled over the forefoot.
• Slow exercises help rebuild the stabilising muscles.
• Perform consciously every day when using kybun products.

Fast step frequency

• Movement sequence is identical to exercise 1.
• Now add short steps with a high step frequency that cause movement in the hip joint while always using the full range of motion of the feet.
• If hip joint pain occurs, increase step length and reduce frequency.
• Important! Maintain an upright posture while standing and walking.
• Perform consciously every day when using kybun products.

Muscle length training

Muscle length training is crucial when treating hip problems because complaints often result from shortening, tension and blockages of myofascial structures. Targeted stretching can actively address these issues and is therefore an ideal therapy for hip joint pain.

Hip opener

• Start on all fours.
• Place the left foot forward next to the hands.
• Stretch the right leg backward and place the foot flat. Ensure the hips and spine are aligned.
• To increase the stretch press the hip forward and downward as tolerated.
• Perform 1–2× daily.
• Hold 3 × 30 seconds.

Glute stretch

• Start lying on your back.
• Extend both arms at 90° to the sides and place the left leg bent over the right side.
• Use the right hand to press the bent knee down.
• Keep both shoulder blades on the floor.
• Perform 1–2× daily.
• Hold 3 × 30 seconds.

Fascia rolling

Fascia rolling is important in treating hip joint pain because issues often stem from shortened, tense and blocked myofascial chains. Regularly rolling out shortened and tense myofascial chains makes the foam roller an active therapy for hip problems.

Gluteal musculature

• Bend both legs and use a fascia ball to roll out the corresponding gluteal side. Increase pressure by placing one leg on top. If wrist pain occurs, perform the exercise on the forearms.
• Perform slowly and controlled.
• Adjust pressure to personal tolerance but work up to a tolerable pain threshold.
• Roll or hold at focal adhesions.
• 3 minutes per side.
• Perform 1–2× daily.

Lateral thigh musculature

• Start in side-lying position.
• Place a large roller between the outer thigh area and the floor.
• Use the top leg for stabilization and to guide the movement at a right angle.
• Roll the lateral thigh actively from the hip down to above the knee.
• Perform slowly and controlled.
• Adjust pressure to personal tolerance but work up to a tolerable pain threshold.
• Roll or hold at focal adhesions.
• Straightening the top leg increases intensity.
• 3 minutes per side.
• Perform 1–2× daily.

Strengthening

Targeted strength training helps strengthen leg and pelvic muscles and thereby relieve the hip joints and surrounding structures. Strong muscles can better absorb forces that act on the hips with every movement. Muscles also stabilise the hip joints and protect them from mis- and overload. Strengthening exercises are an effective therapy for hip problems and help reduce pain in the long term.

Hip thrust

• Start: lying on your back with legs bent (hip-width). Arms are extended toward the feet at shoulder width.
• Actively lift the hips off the floor toward the ceiling (hips should be fully extended at the top).
• Hold the top position for 4 seconds.
• Ensure the force comes from the glutes (not from the heels or hamstrings).
• Lower the hips slowly without letting the buttocks touch the floor.
• 3 sets of 8–12 repetitions.
• Perform 2–3× weekly.

Squats

• Start standing with feet slightly wider than hip-width and slightly externally rotated.
• Slowly and controlled drop into a deep squat. Push the buttocks back and shift weight onto the heels.
• Ensure force comes from the glutes. Stabilise the knees to prevent them from collapsing inward or outward.
• Slowly and controlled return to standing. If balance is an issue, hold onto a stable object.
• 3 sets of 8–12 repetitions.
• Perform 2–3× weekly.