Massage therapy · Kitchener–WaterlooDevelopmental Dislocation (Dysplasia) of the Hip (DDH)
Hip & Thigh
What It Is
The hip is a ball-and-socket joint. In a normal hip, the ball at the top end of the thighbone (femur) fits firmly into the socket, which is part of the large pelvis bone. In babies and children with developmental dysplasia of the hip, the hip joint has not formed normally. The socket is too shallow, so the ball cannot fit firmly into it, and sometimes the ligaments that hold the joint together are stretched. This makes the hip loose, so it can move out of position (dislocate) easily (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2026). DDH can affect one or both hips (NHS, 2026).
Although DDH is most often present at birth, it can also develop later (American Academy of Orthopaedic Surgeons, n.d.).
Research shows that babies whose legs are swaddled tightly with the hips and knees straight have a higher risk of developing DDH after birth (American Academy of Orthopaedic Surgeons, n.d.). As swaddling has become more popular, it is important for parents to know how to swaddle safely. If you want to swaddle your baby, swaddle only the upper body and leave the legs free to bend. The healthiest position for a baby's legs is the "frog leg" position, with the hips bent and the knees apart (American Academy of Orthopaedic Surgeons, n.d.).
Hip Anatomy
Ligaments hold the hip joint together. The ball (femoral head) is at the top of the thighbone (femur). The socket (acetabulum) is part of the pelvis. The head nestles snugly into the acetabulum to create the hip joint. The joint is held securely in place by the joint capsule and surrounding ligaments.
Other Information
- DDH tends to run in families. Having a parent, brother or sister with DDH makes it more likely (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2026).
- Girls and first-born children are more likely to have it than boys (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2026).
- Babies who were in the breech position (bottom or feet first) in the womb are more likely to have it than those born head first (American Academy of Orthopaedic Surgeons, n.d.; NHS, 2026).
- Low levels of amniotic fluid in the womb (oligohydramnios) are also linked to this condition (American Academy of Orthopaedic Surgeons, n.d.).
Not a diagnosis — for more information, contact me or another trusted healthcare provider.
Treatment
Self-Care & Treatment
How DDH is Treated
DDH is treated by a specialist bone doctor (orthopaedic surgeon) and their team. The right treatment depends on your child's age and how loose the hip is, and treatment usually works well (NHS, 2026; American Academy of Orthopaedic Surgeons, n.d.). The hospital team will show you how to care for your baby during treatment and tell you how long it will last. Always follow their instructions, and go to all of your baby's check-ups (NHS, 2026; American Academy of Orthopaedic Surgeons, n.d.).
Treatments you may want to discuss with your family doctor, nurse practitioner or your child's specialist
Treatment
My Approach
DDH is treated by your child's hospital team, and their plan always comes first. I never remove or adjust a harness, brace or cast, and I need the team's okay before any hands-on work around the hip, especially after a closed reduction or surgery. I support your child, and you, around that care.
I start by asking what the team has cleared, then gently look at how your child moves, sits, crawls or walks. For a baby or young child, you approve the care and are welcome to stay throughout; with older children, you're welcome to sit in if they agree.
During Treatment
- Gentle, soothing massage for areas outside the harness, brace or cast, only if your child's team agrees
- Easing the neck, shoulder and back strain that lifting and carrying a baby in a harness or cast can bring for parents
After the Harness, Brace or Cast
What to Expect
Typical Course
What I Focus On
Please read
When to See a Doctor First
Signs to Look Out For
DDH is not usually painful, so many parents do not realise their baby has it. It is often found during the routine newborn physical examination (NHS, 2026). If it is not found early, you may notice:
- a clicking or popping sound when your baby moves their hips
- one leg moving differently from the other, for example during play or nappy changes
- legs of different lengths
- your baby dragging one leg when crawling, or limping when they start walking
See your family doctor or nurse practitioner if you think your child may have DDH (NHS, 2026). In babies, DDH is diagnosed with an ultrasound scan of the hip (NHS, 2026).
Sources
References
- American Academy of Orthopaedic Surgeons (n.d.) Developmental dysplasia of the hip (DDH). OrthoInfo. Available at: https://www.orthoinfo.org/diseases--conditions/developmental-dislocation-dysplasia-of-the-hip-ddh/ (Accessed: 7 October 2026).
- NHS (2026) Developmental dysplasia of the hip. Available at: https://www.nhs.uk/conditions/developmental-dysplasia-of-the-hip/ (Accessed: 7 October 2026).