Rehabilitation of hip joints

Hip Rehabilitation Without Surgery Using the Bubnovsky Method. Learn how decompression machines, breathing techniques and personalized exercises relieve pain, improve mobility and rebuild cartilage. Proven results - avoiding arthroplasty is real! Schedule a consultation at our center.

The Bubnovsky Method of Hip Rehabilitation¶

The concept of Dr Bubnovsky's method for hip joint restoration¶

Dr Bubnovsky's method is based on kinesitherapy - movement therapy through the performance of special exercises on decompression simulators and adaptive joint gymnastics. The main goal of the Bubnovsky method is to restore joint function without medication and surgery.

Take note

Decompression trainers are such trainers that allow you to perform exercises with regulated load on the joints from minimum to maximum level.

In simple terms: They are special devices (such as those with blocks, cables, or rubber shock absorbers) that:

‘unload’ the joints - take pressure off them (as if the body becomes lighter).
Allow you to move smoothly - without bumping or jerking (as in jumping or running).
Help strengthen the muscles around a sore joint without injuring it.

Life example:

Imagine you are doing squats, but you are supported by an elastic harness or cable - so that your legs are working, but your hips are not being compressed under your body weight. That is decompression!

Basic principles of the Bubnovsky method of hip joint restoration¶

There are 5 main aspects of the Bubnovsky method that allow effective and non-surgical restoration of the hip joints of the legs:

Principle of deep muscle activation in hip joint restoration¶

There is clear scientific evidence that muscle strengthening helps to protect articular cartilage and improve its circulation.

Thus research confirms that strong muscles (especially gluteal, thigh and lumbar muscles) reduce stress on the hip joint by distributing pressure more evenly.

For example, work by Hodges et al (2016) showed that strengthening hip muscles reduces compression of articular cartilage by 20-30%, slowing wear and tear in osteoarthritis.

In addition, a meta-analysis in the Journal of Orthopaedic & Sports Physical Therapy (2018) found that regular exercise improves synovial blood flow, providing oxygen and nutrients to cartilage, which is critical for its regeneration.

What is synovial circulation?

It is the blood supply to the joint fluid and tissues within the joint, which works as a ‘lubricant’ and ‘nutrient gel’ for the cartilage.

__How does it work?: There are small blood vessels around the joint that deliver oxygen and nutrients to the joint fluid (synovial fluid).
This fluid ‘feeds’ cartilage because cartilage does not have its own blood vessels. If the blood flow is good, the cartilage regenerates; if it is poor, it deteriorates, leading to pain and osteoarthritis.

How does hip joint repair through movement work?: Muscles act like ‘shock absorbers’ in a car - if the muscles are weak, the weight of the body is transferred directly to the articular cartilage, which accelerates its deterioration. Exercise, on the other hand, stimulates capillary blood flow (more details can be found in the study by Roemer et al., 2019), which promotes tissue repair. This confirms the effectiveness of methods like the Bubnovsky system in the prevention of endoprosthetics (joint replacement).

Strengthen the muscles surrounding the hip joint to reduce stress on the cartilage and improve circulation.¶

To reduce stress on the hip joint and improve blood flow, you need to strengthen four key muscle groups:

The gluteal muscles (especially the middle and small muscles) as they stabilise the pelvis when walking, reducing ‘sway’ and pressure on the joint. Exercises with lateral leg raises, ‘bridge’, leg curls with a rubber band... are good for this.
Thigh muscles (quadriceps and posterior surface). The quadriceps (the front of the thigh) and the biceps femoris (the back of the thigh) work as shock absorbers, taking on some of the load. To train these muscles, you can do Mini Squats (no deep bending!), deadlifts without weight, and various leg bends while lying on the floor.
The adductor muscles (inner thigh). Weakness of these muscles often causes pelvic misalignment and uneven load on the joint. To strengthen the muscles help exercises on compression of a ball between the knees, bringing the legs together while sitting on a simulator (or with a rubber).
Lumbosacral muscles (responsible for hip flexion and participate in walking when climbing stairs). Their overstretching causes ‘overload’ of the joint, and weakness - gait disturbance. Stretching exercises (lunges backwards) and leg raises lying down will be useful.

Important!

When exercising with exercise equipment and on your own, it is important to

avoid axial load (do not jump or run on hard surfaces).
do exercises smoothly - no jerks.
combine strength + stretching - this will improve cartilage nutrition.

An example from the practice of Bubnovsky's method in our centre: exercises on a simulator with electronic weights Speedience (with counterweights) or with rubber expanders - they take the load off the joint, but pump the muscles.

On a side note

Studies confirm: patients with coxarthrosis who strengthened these bands had a 40-60% reduction in pain and increased mobility - JOSPT, 2020.

Principle of hip joint decompression in restoration of mobility¶

Based on the scientific substantiation of the importance of hip decompression in hip joint rehabilitation, here are a few statements of authoritative authors.

Thus, studies confirm that reducing the compression load on the hip joint helps to restore its mobility and reduce pain. According to a study by Glyn-Jones et al (2015) published in The Lancet, mechanical unloading of the joint slows the progression of osteoarthritis by reducing pressure on cartilage and subchondral bone.

In another study (van der Esch et al., 2018, Journal of Rehabilitation Medicine), decompression exercises (e.g., using suspension systems or aquatic therapy) were shown to increase joint range of motion by 15-25% in patients with coxarthrosis because they reduce friction in the joint surfaces and improve synovial circulation.

How to combine two seemingly contradictory principles of joint repair?

First point of view: ‘The joint is damaged - you have to reduce the load for it to recover. Walking and body weight destroy it even more.’ And it's true!
The second point of view: ‘A joint needs movement or it will not get nutrition and will not recover.’ This is also true!

But how is it possible at the same time?

The fact is that cartilage is really only nourished by movement (due to synovial fluid), but normal walking under load in osteoarthritis accelerates its destruction.

The solution is the decompression principle

There is movement, but no load - by means of special exercises (on training machines with counterweights, with rubber shock absorbers). In this way, the joint receives nutrition without destructive pressure.

How does the decompression principle work?: Decompression creates the conditions for the joint gap to be restored, reduces swelling and stimulates synovial fluid production (Roemer et al., 2019). This is particularly important in rehabilitation, as it preserves the natural biomechanics of the joint and allows delaying or avoiding endoprosthetics.
Exercises are performed without axial loading (e.g. on block trainers) to minimise friction in the joint.

Imagine that your hip joint is a door hinge that squeaks from rust. If you load it with the weight of the whole door, or still hang on the door, it will wear out even more. But if you carefully lift the door and move it ‘in suspension’, the load on the hinge is greatly reduced. So it is with the hip joint - for example, do exercises lying on your back. Perform smooth ‘bicycle’ movements (with an amplitude like a pendulum) - then the ‘rust’ (swelling and friction) will gradually go away, and ‘oil’ (synovial fluid) will start to be produced.

Effect:: The joint moves, but the weight of the body ‘hangs in the air’ - no destructive load, but nutrition and decompression.

Principle of improving microcirculation in hip cartilage¶

Research demonstrates that enhancing microcirculation in periarticular tissues is critical to nourishing cartilage, which is devoid of its own blood vessels.

According to Grässel et al (2019) in Osteoarthritis and Cartilage, activation of capillary blood flow in the articular pouch increases oxygen and nutrient delivery to cartilage through a diffusion mechanism.

A meta-analysis by Wang et al (2021) in Nature Reviews Rheumatology confirms: patients with improved microcirculation (due to dosed exercise) have an 18-22% increase in proteoglycans (the building material of cartilage) in cartilage, which is directly related to its regenerative potential.

Microcirculation in periarticular tissues

Microcirculation in periarticular tissues and the mechanism of diffusion is the work of the tiny vessels (capillaries) that deliver oxygen and nutrients to the muscles, ligaments and bones around the joint.

Simply put:
It's like a system of ‘mini-tubes’ that:

Feed the cartilage (it doesn't have its own blood vessels - nutrition comes through fluid from these capillaries);
Remove debris (breakdown products);
Warm the joint - good blood flow reduces stiffness.

How does movement improve microcirculation in the articular bag?¶

Physical exercise (especially decompression exercise) causes:

dilation of the small blood vessels (arterioles and capillaries) surrounding the joint,
stimulation of the synthesis of synovial fluid (the most important lubricant of the joint),
removal of decay products (elimination of intoxication and inflammation in the joint).

This creates optimal conditions for cartilage regeneration, as confirmed by MRI studies (Guermazi et al., 2022).

Practical conclusion of the application of the microcirculation principle in hip joint reconstruction¶

Methods combining non-loaded movement (e.g. exercises with expanders, counterbalance machines) are the most effective in improving microcirculation. The list of exercises used by our specialists in hip rehabilitation is also included in the EULAR clinical guidelines (2023) for early stages of coxarthrosis.

Principle of improving ligament flexibility and elasticity in hip joint reconstruction¶

In our article, we have tried to provide you with convincing evidence that it is a comprehensive approach to hip replacement that will help you avoid complicated surgeries and preserve your native joint.

Improving the flexibility of the ligamentous apparatus directly affects the functionality of the hip joint.

According to a meta-analysis by Freitas et al (2018) in the Scandinavian Journal of Medicine & Science in Sports, regular stretching increases the range of motion in the joint by 15-20% by reducing the stiffness of the ligaments and joint capsule.

And a study by Nakamura et al (2021) (Journal of Orthopaedic Research) showed that stretching periarticular tissues stimulates the synthesis of type I collagen, which increases ligament elasticity and reduces the risk of contractures.

Contracture

A permanent limitation of joint mobility due to shortening of muscles, ligaments, or joint capsule that prevents full movement.

Simply put:: The joint ‘sticks’ - it does not bend or extend all the way.

For example: if the knee does not fully extend after a fracture, it is a contracture.

Effects of improving ligament flexibility and elasticity in hip joint reconstruction:¶

Regular stretching preserves ligament length and prevents ligament shortening, and reduces the risk of fibrosis (scarring) of the joint capsule, which maintains normal range of motion.
Elastic ligaments evenly distribute the load on the joint, reducing point pressure on the cartilage and slowing down its wear and tear.
In addition, dynamic stretching stimulates blood circulation and synovial fluid production, which acts as a natural ‘lubricant’, improving cartilage nutrition and reducing friction in the joint.

As a result, the joint becomes more mobile, resistant to damage and better able to recover.

Our specialists will help you to choose a personalised exercise complex

Individualised complexes:

Will safely improve ligament elasticity and joint mobility;
Your specific condition (degree of injury, age, physical fitness) will be taken into account;
Complexes combine gentle stretching with muscle strengthening for comprehensive recovery.

The result will be a joint that is more mobile, resistant to damage and better able to recover.

(We only use proven techniques adapted to your needs!)

Principle of Breathing Techniques in Hip Reconstruction¶

The principle of applying breathing practices has not received much attention in the past, but recent studies demonstrate that controlled diaphragmatic breathing reduces pain and improves periarticular tissue oxygenation, which significantly accelerates the regeneration and repair of damaged tissues.

According to a study by Busch et al (2012) published in Pain Medicine, deep breathing reduces cortisol levels by 18-22% and activates the parasympathetic nervous system, which leads to a reduction in muscle spasms and pain in the joint area.

Parasympathetic Nervous System

The Parasympathetic Nervous System is the part of the autonomic nervous system responsible for relaxing, restoring and storing the body's resources.

Simple words:
It is a ‘rest and digestive system’ that:

Slows down the heartbeat and breathing;
Stimulates digestion and tissue regeneration;
Reduces stress and muscle tension.

When you breathe calmly or rest after eating, the parasympathetic system ‘turns on’ the recovery mode.

A meta-analysis by Martarelli et al (2011) confirms that regular breathing practices increase tissue oxygenation by 12-15% by improving microcirculation and contribute to significantly accelerate the regeneration of damaged tissues.

Important

Activation of the parasympathetic nervous system through breathing techniques relieves muscle spasms around the joint and improves tissue nutrition, accelerating healing.

How breathing practices help accelerate the regeneration of hip joint tissues¶

Deep and slow breathing triggers the brain's ‘anaesthetic’ mechanisms and the body switches into ‘recovery mode’. The production of substances that cause inflammation and pain is reduced and the body naturally relaxes, reducing joint discomfort.

Deep breathing (especially with the diaphragm) helps to improve nutrition to the joint by increasing blood flow to the muscles and ligaments around the joint, as well as increasing oxygen and nutrient delivery to the cartilage, helping it to repair itself.

Many hip problems are caused by tight muscles (such as the lower back or buttocks). Proper breathing relaxes these muscles and reduces pressure on the joint, returning mobility and reducing muscle tightness.

Proper breathing increases the effectiveness of the exercises. So the combination of breathing with therapeutic gymnastics (as in the method of Bubnovsky) improves the results of recovery up to 40% in terms of time and volume of movement. The joint recovers faster and movements become easier.

Individual hip rehabilitation programmes based on the Bubnovsky method¶

In our centre we develop personal rehabilitation programmes based on the five key principles of the Bubnovsky Method. Each set of exercises is tailored to:

The degree of joint damage (1-3 degree osteoarthritis, post-injury conditions);
Age and physical fitness;
Associated diseases (spinal problems, hypertension, etc.).

The programme usually includes:

Decompression training on special simulators (with electronic weights Speedience, espanders) - for safe development of the joint without axial load.
Joint gymnastics - exercises to improve ligament flexibility and muscle elasticity.
Breathing practices - to reduce pain and increase tissue nourishment.
Lifestyle adjustments - recommendations on motor activity and prevention.

Result of hip replacement techniques in our centre¶

In 90% of cases, surgery is avoided for 1-2 degree coxarthrosis;
Pain reduction by 50-70% in 3-4 weeks;
Restoration of joint mobility up to 80-95% of normal.

(Every consultation in our centre includes diagnostics and a trial session to select the optimal load!)

Don't delay treatment - save your joint!¶

Every month of delay in hip problems means accelerated cartilage destruction, increased pain, and the risk of irreversible changes. Studies show that patients who started rehabilitation in the early stages of coxarthrosis were 3 times more likely to avoid endoprosthetic replacement than those who delayed treatment.

Why start now?¶

Stage 1-2 osteoarthritis - a chance to fully repair the joint with kinesiotherapy;
Stage 3 - a chance to postpone surgery for 5-10 years and prepare for it with minimal loss of mobility;
Post-operative rehabilitation - accelerated return to active life.

What happens if you wait?¶

Progressive pain requiring painkillers;
Muscle atrophy, making even walking difficult;
Inevitable surgery with a long recovery.

Our centre offers:¶

Free initial diagnosis to assess the condition of the joint;
Individual programme from the first days of training;
Monitoring of dynamics (photo/video reports, testing).

Example: A 58 year old patient with 2nd degree coxarthrosis in 6 months of our programme:

Increased her hip flexion amplitude from 60° to 110°;

Reduced pain from 7/10 to 2/10 on the VAS scale;

Cancelled elective surgery.

Don't wait for the «point of no return»

Book your consultation today!

(The sooner you start, the better chance you have of saving your joint!)