Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.
Total hip replacements are increasing in popularity in both the United States and worldwide. It’s estimated that over 300,000 surgeries are performed here in the US and that could increase to over 500,000 within the next 5 years. Even though the surgeries and the recovery period after is getting faster and easier with modern medicine, it is still a long road to recovery. The first 6 weeks after a total hip replacement are still very painful and challenging physically, mentally, and emotionally. The brand new hip is stiff and swollen for quite a while after surgery. Here are some of the best tips for a faster and easier recovery after surgery. In addition to our list to help you progress, checkout our exercises to avoid after a total hip replacement to help you progress faster.
Ask for Physical Therapy
Despite this being a major surgery, it’s still not a given that you will be given a script for physical therapy. So you may need to ASK TO GO TO PHYSICAL THERAPY. This seems crazy right?! You just had this expensive life altering surgery and you may not get to see the experts in recovery afterwards? Some surgeons think that their skill levels are so grand that no other care is needed or some insurances can be a pain, but it’s highly recommended you go to physical therapy. A physical therapist will help guide you through the unknown and keep you on track. You only want to do this surgery once, so why wouldn’t you do it right to make sure everything comes out as good as it can.
Use a Recumbent Elliptical
Motion is lotion and is one of the best ways to control pain. This is one of the best and easiest ways to improve range of motion, decrease pain, and improve strength. The recumbent elliptical is great after a total hip replacement because it allows you to exercises in a non-weight bearing position while maintaining hip precautions and you can control the resistance. We like this model because it is easy to get on and off without hurting your hip. Start slow and easy at 10 minutes at mild to moderate resistance and work your way up as your hip pain decreases. We like the HCI Fitness Physiostep because it’s one of the most affordable options and keeps your hips at or below 90 degrees of flexion, keeping you within your precautions.
Get off the Pain Meds… But Not Too Early Either
Getting off the pain meds should be a high priority for everyone as they can be addictive, cause constipation, and make you feel just plain nasty. There are other ways to help pain control including an ice and compression pack, analgesic pain relieg cream, and personal muscle massagers to help manage the pain. However, the best pain reliever of all is activity including walking, bicycling, or as mentioned about the elliptical. Combine these with lighter over the counter pain meds like Tylenol or Ibuprofen and you will be on your way off the drugs faster. However, the drugs are prescribed for a reason so it’s always best to take them as prescribed to stay ahead of the pain instead of playing catch up.
Use a Set of Steps
A set of steps, especially if you don’t have access to a good set of stairs with a railing, is extremely helpful. The steps help with concentric, isometric, and eccentric strengthening of the hip. They are low cost, easy to move and hit all major muscle groups associated with the hip muscles, most importantly the ones that stabilize the hip. You’ll notice right after surgery that stairs are really difficult and is something that everyone has to work on. After some practice you will be able to go up the stairs but not down. Finally, going down the stairs at the 3-6 month mark will be much easier if you build up the strength. To practic we love the set of stairs on Amazon.
Emphasize Hip Abduction Strengthening
The outside of the hip is where our hip abductors reside. They are extremely important muscles that help us stay upright when standing or walking, and help us control the position of our leg and pelvis. They suffer major trauma during the surgery that causes them to be weak and inhibited after surgery. The lateral hip muscles should be an emphasis in any rehab program following a hip replacement. You can strengthen them in many different ways such as lying on your side (tough to do initially after surgery) or standing with a resistance band around the ankles. This is a standard exercise across the country for hip strengthening and rehab programs as well as we use it in strengthening and performance of our athletes. Simply put, it’s just a great exercise to do for overall health.
3-Way Hip Strengthening
Work on Single-Leg Balance
Working on a single-leg stance does more than improving balance, it is one of the most important functional activities you can work on. By working on a single leg stance, you are strengthening and improving the endurance int the muscles of the hip and pelvis. The very same muscles that you just had cut during your surgery. The other benefit is that it makes the muscles all work together. The muscles on the front, back, and side all have to work as one to keep you upright, a skill that gets altered after surgery. Finally, this helps the nervous system. The longer you can hold the single-leg balance the more signal you have to recruit through the nervous system. This results in better communication between the nerve and the muscles and decreases pain signals to the brain. To make a single-leg balance harder try using a foam pad or a balance disc to increase the challenge.
Make Walking a Habit After Surgery
This is the first and last recommendation that the surgeon will tell you when they see you, you must create a walking program. This is beneficial because it loads the hip joint, stretches out the muscles that were just cut, and improves strength as you increase distance. Try to start at 10 minutes that first week and then progress as pain tolerate. One of the best rehab exercises for a total hip is to WALK BACKWARDS. This stretches out the front of the hip, promotes glute activation and helps decrease the habit of limping which has likely been there since way before surgery.
A total hip replacement is a life changing event. On one hand you are excited and ready to get back to the things that you used to love doing and on the other hand it is a long and painful recovery process. By seeing our tips you now have the information and the confidence to progress to your goals. It is also a good idea to see our exercises to avoid during total hip replacement to further help you feel better.
- Rapid Rehabilitation and Recovery with Minimally Invasive Total Hip Arthroplasty. – https://journals.lww.com/corr/Abstract/2004/12000/Rapid_Rehabilitation_and_Recovery_with_Minimally.37.aspx
- Enhanced recovery program for hip and knee replacement reduces death rate – A study of 4,500 consecutive primary hip and knee replacements – https://www.tandfonline.com/doi/full/10.3109/17453674.2011.618911?scroll=top&needAccess=true
- Enhanced recovery in total hip replacement: A clinical review – https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620x.95b12.31303
Pain Management and Accelerated Rehabilitation for Total Hip and Total Knee Arthroplasty – https://www.sciencedirect.com/science/article/pii/S0883540307003208