A hip replacement – also referred to as “hip arthroplasty” – is a surgical procedure that is designed to replace a hip joint with a joint or implant that has been synthetically created. It most instances, it needs to be performed due to an injury or the onset of disease within the join. Other reasons include fractures to the area, as well as an immense degree of wear and tear to the joint. While this procedure does aid in regaining mobility and provides relief from pain, there are risks associated with it. Additionally, it takes several months for a full recovery. In this comprehensive guide, you will learn about the procedure as well as exercises and other strategies that will help in boosting recovery.
The Procedure
When a surgeon performs a hip replacement, they remove sections of the hip joint and replace them with created constructed parts. These are typically composed of ceramic, very hard plastic, or metal. The artificial joint placed in the hip is referred to as a “prosthesis”.
When you undergo this procedure, you are placed on a general anesthesia. This places you into a deep sleep and relaxes the muscles in the body. In some instances, you may also be provided with an anesthetic that is placed in the spine. Both general and spinal anesthesia also prevents the development of pain.
A cut is made along the hip and adjustments are made so that the hip joint is exposed. The ball joint is then carefully removed and the artificial joint is placed. If necessary, a drain is placed to help eliminate any fluid that may be present.
The area is then put back into place and the incision is closed. In some instances, the procedure may require that you receive a transfusion. This is simply due to the fact that you will lose blood during the procedure. It is ideal that you donate blood prior to the procedure in case this step is necessary.
Immediately Following the Procedure
Once the hip replacement surgery is completed, you will stay in the hospital for anywhere from just a few days to up to a week. The surgeon may order a wedge cushion that must be placed between the legs so that the joint remains stable and stationary.
Approximately one day following the surgery, you will likely start physical therapy. Within just a matter of days, you will likely be able to walk with a mobility aid. The physical therapy may continue for weeks or even months following your surgery.
Hip Replacement Exercises
In order to completely recover from your hip replacement surgery, you will need to perform regular exercises. These are important in restoring your strength, the strength of your hip, and your overall mobility. The goal is to ensure that you are able to – eventually – perform day-to-day activities.
Your surgeon and your physical therapy team will work in collaboration with you and provide you with exercise recommendations ranging from the types of exercises that you should perform and how much time you should dedicate to the tasks on a daily basis.
Below are some examples of the hip replacement exercises you may have to perform. Remember, always follow the guidelines issued by your surgeon and physical therapy and obtain approval before completing any of the following activities.
The goal associated with the initial exercises that you will perform following your hip replacement surgery is to increase the circulation within the legs and feet.
Additional goals include preventing blood clots, strengthening the muscles, and optimizing the movement and mobility of the hip. While it is true that exercising may prove to be uncomfortable, the activities that you perform will help in boosting the recovery and will even help in offsetting the postoperative pain that may be experienced.
Many of the exercises may be started immediately following the surgery, while in recovery. Just remember, never perform any of these activities unless you have prior approval from your surgeon and/or physical therapist team:
- Abduction Exercise – While laying on your back and with your arms laying by your side, slide one leg out to the side of your body as far as you comfortably can and then move it back. You should do 10 reps per leg and up to 4 sessions each day.
- Ankle Pumps – Immediately after surgery and while lying in the bed, push your foot up and down. You should do one foot at a time. Then, after 10 reps, move to the opposite foot. You should continue – as much as you are able to – for up to 10 minutes at a time. This should be repeated as regularly as you are able to tolerate until you are completely recovered from the surgery.
- Ankle Rotations – While lying down, move the ankle inward toward the opposite foot and outward, moving away from the opposite foot. You should rotate each ankle 5 times in each direction, up to 4 times daily.
- Bed-Supported Knee Bends – While lying in bed, pull your foot back – towards the buttocks region – and make sure that the knee is bent. Ensure that the heel is situated on the bed. Hold the knee for about 10 second and then straighten out the leg. Do this at least 10 times for each leg. You may perform this hip replacement exercise 3 or 4 times daily.
- Buttock Contractions – While lying on the bed, simply tighten the muscles in your buttocks and hold the position up to the count of 5. You should repeat this up to 10 times. You may perform this exercise up to 4 sessions each day following your hip replacement surgery.
- Quadriceps – Here, you will tighten up the muscle in your thigh and attempt to straighten out the knee. You should try to hold the position for up to 10 seconds. You should do this at least 10 times within 10 minutes and continue on until the thigh region feels very tired.
- Standing Hip Abduction – Hold on to a chair while standing. Point your body forward. Lift one leg out to the side and lower it back to the floor. You should repeat this up to 10 times for each leg and may perform this exercise up to 4 times each day following your hip replacement surgery.
- Standing Hip Extension – Hold on to a chair in the standing position. Slowly lift your leg in a backward motion. While it may prove to be challenging, try to keep the back as straight as possible. You should hold this position for about 10 seconds and then return the leg back to its normal position. You should do this up to 10 times for each leg. You may perform this exercise 3 to 4 times each day.
- Standing Knee Raises – Standing with a chair, lift your leg towards your chest, but do not place it higher than your chest. Hold the position for a few seconds and then return your foot to the floor. You should do this with each leg 10 times. Perform this exercise 3 to 4 times each day.
- Walking – As you advance in your recovery, you will proceed to the point where you will use a walker or a pair of crutches in order to walk. You will be instructed on the appropriate amount of weight to put on the leg that was operated on. You must work closely with your surgeon and your physical therapy team to ensure that you are walking properly. You must always walk slowly and thoughtfully as to avoid injury to the leg. As you become stronger and start to advance in the healing process, you will not require mobility aids.
Hip Replacement Exercises to Avoid
Once you have completed the hip replacement surgery, it is imperative that you understand that you will need to take several precautions. Ultimately, the main concern following surgery is dislocation of the newly placed artificial joint.
According to statistics, up to 2% of all people will suffer from a dislocation within a year’s time. You want to avoid becoming a statistic. While there are several exercises and physical activities that you should avoid, there are three main movements that should be avoided. These include the following:
- Crossing the Operated Leg Over the Other – When lying down in bed, you should avoid the urge to cross the leg that was operated on over the leg that was not operated on. It is best to utilize a wedge pillow so that you may avoid this temptation. This special type of pillow is often called an “abduction pillow”. It is designed to assist in stabilizing the hip while encouraging you to keep the legs completely separated.
- 90- Degree Flexion of the Hip – In short, you should avoid bending the hip in an excessive manner and/or lifting the knee too far up. Examples of activities that fall into a dangerous area include bending to put on a sock or tie a shoe, or sitting in a chair that is considered to be quite low. If you engage in this type of movement, you may find that you experience a dislocation of the hip.
- Internally Rotating the Hip – It is important that you avoid rotating the hip in an inwards fashion following your hip replacement surgery. When you are sitting, lying down, standing, and walking, you should make a conscious effort to ensure that your toes are always pointing forward. You may even point them a bit out; however, you should avoid any rotation that results in an internal rotation to the hip.
In order to get information on all of the exercises and activities that you should avoid after having a hip replacement surgery, you should consult with your surgeon, your primary care provider, and your physical therapy team. While hip replacement surgery is – more or less – the same for all patients, there are many that have unique cases. Yours may be such a case and unique conditions may apply to you.
Signs That Indicate a Problem
There are several signs that indicate that you may have an issue and that you need to contact your doctor. These include – but are not limited to – the following:
- Hearing a popping sound that occurs when you are in movement
- Experiencing highly intense pain within the hip or in the groin area
- Problems with walking or the complete inability to walk
- Discovering that the newly placed joint starts to catch when you move
- Finding the inability to move the artificial joint that has been placed in your hip
- Experiencing issues where the leg that was operated on seems to be shorter than the other
Physical Therapy Aids in Recovery
If you are reading this, chances are, you have not yet found a physical therapist to help you through the recovery process because you are searching for information on what types of exercises you may do. It is always best to have a physical therapy team as part of your care team immediately following surgery.
Not only do these specialists help in providing you with exercises that may be done during recovery, they are trained to help speed up the recovery process.
They can assist in strengthening the new joint, building up the muscles, and helping you reach the point of your “new normal”.
In addition to all of this, physical therapists have many skills, tools, and resources at their disposal. In addition to standard exercises, you may have the capability of healing through the use of specially-designed, highly technological equipment as well as special classes.
We here at Back to Motion Physical Therapy are experts in assisting patients successfully recovery from hip replacement surgery. Our team of experts will work closely with you and your surgeon to customize a rehabilitation and recovery program specifically for your individual needs. Give us a call today to discover all of the services and specialties that we have to offer: 303-832-5577