Essential Facts About Hip Braces: What Every Patient Should Know

Hip pain is a fairly common reason for visiting my office. There are several different diagnoses associated with hip pain, and treatment is usually diagnosis-specific. Traditional treatments, such as physiotherapy, stretching, massage, and in some cases cortisone injections, are often effective. However, in some cases, a hip brace may also be beneficial.

In this article, I will review different hip braces and their benefits and drawbacks based on my own clinical insight and researched information.

What Is a Hip Brace?

The hip joint is the human body’s largest ball-and-socket joint. Due to the joint’s wide range of motion and its central position in the human body, hip joint-related dysfunctions are quite common. A hip brace is an external hip-supporting orthosis that aims to reduce hip mobility and compress hip structures. Some patients use a hip brace to relieve hip pain, but do they really work, how do they work, is it worth getting one, and is it worth the money?

Hip braces come in various designs, but they generally include straps, hinges, and padded sections to fit snugly. Some hip braces are rigid, made from hard plastic or metal, while others are softer and more flexible.

Common conditions include hip osteoarthritis (where cartilage wears down), femoroacetabular impingement (FAI, where bones rub abnormally), labral tears, muscle strains, and developmental issues in children like cerebral palsy or hip dysplasia.

However, it is important to remember that a hip brace is only an aid at best and does not replace appropriate multidisciplinary care, such as care provided by a doctor, physiotherapy, and rehabilitative exercise.

Types of Hip Braces

There are several types of hip braces, each tailored to specific needs. Choosing the right hip brace depends on your condition, the level of support required, and your daily activities.

It is worth remembering that, especially if you suffer from a hip problem diagnosed by a doctor, you should always discuss the suitability and design of a hip support with your doctor.

Here’s a breakdown of the main types:

1. Abduction Hip Brace: This is one of the most common types. An abduction hip brace holds the thigh away from the body’s midline, preventing inward movement that could cause dislocation. It’s often used after hip surgery, like total hip arthroplasty (THA), or for instability. The brace has adjustable hinges to control flexion (bending) and extension, and it’s worn over clothing. Benefits include stabilizing the joint during recovery, but it can feel bulky. This type of hip support is usually prescribed by a doctor.
2. Compression Hip Brace: These are softer, wrap-around devices that apply gentle pressure to the hip area. A compression hip brace may help reduce swelling and provide comfort for strains or mild arthritis. Evidence for improving blood flow or treating true sciatica is limited. They’re lightweight and can be worn under clothes, making them suitable for daily use. However, they offer less structural support than rigid options. These are typical commercial supports that patients usually obtain on their own.
3. Unloader or Offloading Hip Brace: Designed for conditions like hip osteoarthritis, an unloader hip brace shifts weight away from the painful part of the joint. By redistributing pressure, this type of hip brace can reduce pain during walking or standing. Studies show certain models may alter gait to lessen joint stress [1]. They’re adjustable and often include straps for a custom fit. These are usually only used after consultation with a qualified orthopedist.
4. Stabilization Hip Brace: These provide overall support for weak or unstable hips, such as in post-injury recovery or chronic conditions. A stabilization hip brace might extend to the knee for added control. They’re useful for athletes or active individuals but can restrict natural movement. This differs from a compression brace in that it is more structural and mechanically restricts hip movement, providing more specific support for instability or post-injury rehabilitation.
5. Post-Operative Hip Brace: Specifically for recovery after procedures like hip arthroscopy, these hip braces limit range of motion to protect healing tissues. They often have ROM (range of motion) controls to gradually increase flexibility. In contrast to abduction hip brace, this brace is intended to limit hip flexion.

Pros of Using a Hip Brace

Many patients understandably want to avoid surgical treatment. In many situations, surgical treatment is not yet appropriate, such as in hip osteoarthritis when the disease has not progressed far enough. Therefore, conservative treatments like hip braces are popular among patients. Here are the key pros of hip braces:

• Pain Relief: The most obvious benefit of a hip brace is pain relief, and studies have shown it to help with pain symptoms, at least in the short term. Clinical experience and research shows that nine out of 14 patients with hip OA experienced less pain while walking with a hip brace [1]. Similarly, for FAI or labral tears, a hip brace can improve quality of life by reducing symptoms [5]. These are short-term findings; long-term benefits remain uncertain.
  
• Improved Stability: By limiting unfavorable directions of motion, hip stability can be increased. In certain situations, this increased stability is beneficial and can make daily life easier for patients. This stability can enhance walking speed, step length, and functional capacity after just a week of use in mild to moderate OA cases [8]. In children with cerebral palsy, a hip brace significantly prevents hip displacement progression, reducing migration percentage by about 9–13 points over 12 months and improving quality of life [3].
• Customizable and Versatile: Many hip braces allow adjustments for comfort and specific needs, making them suitable for various activities. They’re also cost-effective compared to ongoing medical treatments.

In summary, hip braces may be useful in relieving pain, at least in the short term, and in some cases, they can increase hip stability when the symptoms require it. In addition, most hip braces typically have a wide range of adjustment and usually quite affordable.

Cons of Using a Hip Brace

Before you decide to get yourself a hip support belt, you should also familiarize yourself with its possible disadvantages. While a hip brace has benefits, it’s not without drawbacks. Here’s a balanced look at the cons:

• Limited Effectiveness in Some Cases: Not every patient responds well to a hip brace. For instance, after THA dislocations, abduction hip braces don’t significantly prevent re-dislocations—rates were similar with or without the brace (61% vs 64%, not statistically significant) [6]. In FAI, a hip brace might limit motion but doesn’t always reduce pain immediately or improve long-term outcomes [4].
• Discomfort and Tolerability Issues: A hip brace can feel restrictive or bulky, especially rigid types. Some users report skin irritation, pressure sores, or difficulty with daily tasks. In one trial, participants noted issues with comfort and perceived effectiveness, with three adverse events like minor injuries [5]. Prolonged wear might lead to muscle weakness if over-relied upon.
• Restricted Movement: By design, a hip brace limits range of motion, which can hinder natural activities. Studies show reductions in hip flexion, rotation, and adduction, but this might not suit active lifestyles [2]. For example, to limit flexion to 90°, the brace needs setting at 70°, which could feel overly constraining [2].

In short, the benefits of hip braces are often limited and do not help all patients. In addition, in some cases, they can even be harmful if they feel uncomfortable, are too restrictive, or are relied upon too much.

Do Hip Braces Actually Work?

The effectiveness of a hip brace depends on the condition, brace type, and individual factors. My experience and scientific evidence from peer-reviewed studies shows mixed but generally positive results for specific uses. However, most studies are small and have wide confidence intervals and therefore the findings are mostly indicative. Clearly, more research is needed to say for or against with more certainty.

For hip osteoarthritis (OA), hip braces show promise. A study on unloading hip braces found reduced hip abduction moments and pain in most participants, suggesting they lessen joint stress [1]. Another on functional hip braces in mild to moderate OA noted increased walking speed, step length, and reduced pain after a week [8]. Therefore, the unloading mechanism might be useful in treating pain caused by hip osteoarthritis.

In femoroacetabular impingement (FAI) and labral tears, hip braces can improve quality of life. One trial showed better scores in pain, symptoms, and function with a hip brace compared to no brace, though sample sizes were small [5]. Another found subtle motion limits but no immediate pain relief after four weeks [4]. However, the quality of the studies is generally quite limited, which limits the ability to draw reliable conclusions. So, at least not yet, it is not worth making recommendations based on this scientific basis.

For dislocations after total hip arthroplasty (THA), evidence is less supportive. Abduction hip braces reduce range of motion but don’t prevent re-dislocations effectively (around 61% vs 64%, p>0.05) [2][6]. Rates were similar braced or unbraced, questioning their routine use. Therefore, the use of hip braces to prevent dislocation seems pointless.

In children, hip braces excel. For cerebral palsy, a novel hip brace reduced migration percentage by approximately 9–13 points over 6–12 months and improved life quality [3]. For infant hip dislocations, success reached 79%, with risks like late treatment increasing failure [7]. The use of a hip brace in children may therefore be justified based on individual considerations.

Post-hip arthroscopy, hip bracing is common (up to 40% of surgeons use it) for motion restriction, but evidence is insufficient to show better outcomes [9]. So we don’t really know if this is a sensible procedure, despite its prevalence. It’s possible that it gives patients some sense of reassurance after surgery, although there’s not a lot of strong scientific evidence for this.

Overall, hip braces might work well for pain relief in OA, preventing displacement in kids, and supporting recovery in some cases [1][3][5][7][8]. They may not for post-THA dislocations or long-term FAI pain [4][6]. In any case, if you are planning to use a hip brace, especially in connection with a medical diagnosis, you should discuss the matter with your doctor beforehand. However, it is good to be aware that even doctors’ recommendations are often based more on clinical experience than on strong research evidence, as there is still a lack of extensive research and a clear consensus. Therefore, more and larger studies are needed in this area.

Conclusion

Some patients find hip support useful, but not all. Hip braces appear to be most promising in the treatment of hip osteoarthritis, mainly as a pain reliever, and in certain pediatric conditions. Hip braces seem to have little benefit in the treatment of femoroacetabular impingement and dislocation of the hip joint.

There is a lack of extensive research evidence on the benefits of hip braces. Most studies are small with wide confidence intervals, and there has been little research on long-term benefits. Moreover, a hip brace should not be used as a substitute for physiotherapy and appropriate multidisciplinary rehabilitation.

Individual assessment is essential, and brace selection should ideally be discussed with a healthcare professional. Though professional recommendations are based on clinical experience rather than extensive research evidence.

In summary, I cannot recommend hip supports based on the evidence until more extensive research evidence is available on their effectiveness. On the other hand, many hip braces, such as compression belts, rarely cause serious side effects, and effectiveness is always individual. Therefore, in a difficult pain situation, trying them may be justified, at least in the short term.

Bibliography

1.  Nérot A, Nicholls M, Santini A, et al. Clinical study on the unloading effect of hip bracing on gait in patients with hip osteoarthritis. Prosthet Orthot Int. 2017;41(2):127–133. https://journals.sagepub.com/doi/full/10.1177/0309364616640873

2.  Michalik R, Lyons J, Frodl A, et al. Do hip-abduction braces work? – A biomechanical evaluation of a commercially available hip brace. Arch Orthop Trauma Surg. 2022;142(6):1275–1281. https://pmc.ncbi.nlm.nih.gov/articles/PMC9110475/

3.  Kim BR, Yoon SH, Lim JH, et al. Efficacy of a Hip Brace for Hip Displacement in Children With Cerebral Palsy: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(11):e2240383. https://pmc.ncbi.nlm.nih.gov/articles/PMC9636519/

4.  Newcomb NRA, Hall M, Burchard R, et al. Effects of a hip brace on biomechanics and pain in people with femoroacetabular impingement. J Sci Med Sport. 2018;21(2):111–116. https://pubmed.ncbi.nlm.nih.gov/29074345/

5.  Eyles JP, Murphy NJ, Virk S, et al. Can a Hip Brace Improve Short-Term Hip-Related Quality of Life for People With Femoroacetabular Impingement and Acetabular Labral Tears: An Exploratory Randomized Trial. Clin J Sport Med. 2022;32(3):e243–e250. https://pubmed.ncbi.nlm.nih.gov/34516433/

6.  Dewal H, Maurer SL, Bonnaig N, et al. Efficacy of abduction bracing in the management of total hip arthroplasty dislocation. J Arthroplasty. 2004;19(6):733–738. https://pubmed.ncbi.nlm.nih.gov/15343533/

7.  Upasani VV, Bomar JD, Matheney TH, et al. Evaluation of Brace Treatment for Infant Hip Dislocation in a Prospective Cohort: Defining the Success Rate and Variables Associated with Failure. J Bone Joint Surg Am. 2016;98(14):1215–1221. https://pubmed.ncbi.nlm.nih.gov/27440570/

8.  Steingrebe H, Schrednitzki D, Greuel H, et al. Effects of Hip Bracing on Gait Biomechanics, Pain and Function in Subjects With Mild to Moderate Hip Osteoarthritis. Front Bioeng Biotechnol. 2022;10:888775. https://pmc.ncbi.nlm.nih.gov/articles/PMC9309805/

9.  Mavrommatis S, Paladugu P, Chen A, et al. Postoperative Brace Use After Hip Arthroscopy: A Systematic Review. HSS J. 2024;20(4):550–555. https://pubmed.ncbi.nlm.nih.gov/39494436/