Hip osteoarthritis (OA, also called degenerative joint disease) is the most prevalent pathologic condition at the hip joint and is characterized by degeneration of the articular cartilage. As the cartilage breaks down, there is pain and mobility restriction. Surgery is usually considered in advanced stages of hip OA when there is severe pain and stiffness.
The problem with sitting
In conventional sitting with the hips at a 90-degree angle, the weight of the body produces compression forces through the ischial tuberosities which transfer to the hip joint; which in turn decreases the joint space and puts pressure on the cartilage. You can reduce pressures in your hip joints up to 50% by opening the hip angle.[1] The ideal hip angle is 45-degrees (i.e., 135-degrees between thigh and torso). You can also reduce pressures in the hip by sitting with your knees apart (i.e., hip abduction).
Doctors often prescribe a “hip chair” for their patients with osteoarthritis. A hip chair is nothing more than a conventional chair on tall chair legs. Because the seat is higher than a conventional chair, you can perch on the front edge to keep your hip angle open and it is easier to get in and out of the chair from this high perch position. Unfortunately, if you sit back in a hip chair it is no better than a conventional chair, because the seat-to-back angle is still close to 90-degrees. If you perch on the front edge of a hip chair, you will quickly experience uncomfortable pressures behind your thighs that can impair the circulation and pinch nerves.
How a saddle stool helps symptoms associated with Hip Osteoarthritis
- Strengthening and mobility exercises play an important role in the treatment of hip OA. A saddle stool can provide the same benefits by helping to regain lost mobility and range of motion, and may reduce the need for surgical intervention. The high straddle posture gently stretches and strengthens the hip joint, while reducing loads and pressures on the joint cartilage.
- A saddle stool alleviates pain and other symptoms associated with hip OA; strengthens core muscles, maintains good posture and increases functional ability because it positions the hip joint in its natural neutral position. When a person is in a relaxed straddle posture on a saddle seat, the thighs rotate outwards and the legs naturally spread into an abducted (knee open) position. This position opens the hip joint (external rotation of hip), increases the joint space and decreases the compression forces on the hip joint cartilage, stretches the hip adductor muscles, and prevents backward movement of the pelvis.
- When the hip joint is in a relaxed position (as observed when using a saddle seat) the cartilage has greater ability to imbibe greater amounts of nutritional fluid, which in turn can reduce inflammation and help maintain the health of the cartilage in the long run.
- Poor sitting posture (slouched sitting) internally rotates the hips, compresses the hip joints and can increase the pain associated with hip OA.
- A saddle stool improves spinal alignment by maintaining the pelvis in a slightly anterior tilted position allowing the spine to maintain its natural ‘S’ shape as observed in standing. This position also recruits postural muscles in the back and abdomen thus improveing core stability of the body and optimizes freedom of movement for the upper limb thus improving the functional ability.
Which saddle stool is best for Hip Osteoarthris?
The simple answer, is the one that fits your bootie best. But seriously, it depends on how advanced the arthritis is and on how restricted your hip mobility.
In early mild cases, you can use any saddle seat that comfortably fits your anatomy. Any saddle stool will provide the right therapeutic benefits. And the sooner you start, the less mobility you will lose. It’s even possible to reverse the stiffness you have already acquired.
In moderate or severe cases, you may need to select a saddle stool that is more narrow or slim, at least to start. The Bambach Saddle Stool requires less hip abduction (i.e., knee spread) than do the Salli and Kanewell brands. After a year or two or three, your hips will have gradually loosened, and you may be able to use the wider saddles just as easily. Be patient. It can take a long while for your hips to regain lost flexibility.
If you have had hip surgery, it’s hard to predict which saddle will be most comfortable for you. Not all hip surgeries are the same, and your muscle and soft tissues around the hip and buttocks may not be as supple as they once were. In our experience, the Bambach Saddle Seat is preferred by most people with hip joint replacements or hip fusion. The Bambach Saddle Seat can also “cut down” to accommodate special hip problems.
[1] Jan Van Houcke, Ashwin Schouten, Koen Vermeulen, Gilles Van Acker, Gunther Steenackers, Christophe Pattyn, Emmanuel Audenaert; The Impact of Sitting Configuration on the Hip Joint Reaction Force and Hip Flexion Angle, Journal of Hip Preservation Surgery, Volume 3, Issue suppl_1, 1 September 2016, hnw030.075, https://doi.org/10.1093/jhps/hnw030.075