Exercises Following a Hip Replacement Surgery
Exercises are important to improve blood circulation, enhance muscle strength and regain normal joint mobility. Physiotherapist will assist the patient with -
- getting in and out of bed post surgery,
- walking with a frame,
- sitting on a chair, and
- transferring to the toilet seat.
Prior to discharge, the patient's relatives are instructed about the necessary temporary or permanent changes that need to be done at home to support the basic functions of the patient.
Once the patient is fit enough to be started off with isotonic exercises involving active movement of hip joint, the physiotherapist would indicate few or all of the following exercises:
- Place a rolled towel underneath patient's knee. Now ask the patient to push the knee flat into the towel. While doing this, patient's heel would be lifted off the bed to straighten knee. Ask the patient to hold in this position for five seconds and then slowly relax.
- Lay the patient flat on the bed with face towards the ceiling, and try to bring his knee towards his chest (only up to a 90 degree angular bent), without him experiencing any pain. This provides a moderate stretch to the muscle. Repeat.
- Lay the patient flat on the bed with face towards the ceiling and knee straight, take the patient's leg to the outer side up to the limit of pain or uneasiness and then return to the starting position. Initially, the patient's attendant should assist the patient in doing this exercise and gradually motivate the patient to perform the exercise on his own.
Lay the patient on his back and instruct him to bend his knee to 90 degree with foot flat on the bed. Ask him to slowly lift the back, pushing the feet. Hold the position for 2 seconds. Slowly return to the starting position.
- With the patient sitting on a chair, instruct him to pull his toes up, tighten his thigh muscles and straighten his knee. The patient needs to hold this position for at least 5 seconds and then slowly lower it down.
- Guide the patient to go up the stairs using a handrail, with the good leg first and then bring the operated leg up to the same step. The opposite applies while climbing down the stairs.
There are certain precautions that the patient needs to take note of -
- Driving is not permitted minimum up to six weeks. After this, the physiotherapist may advise driving with a cushion to support the back and the hip.
- Patient needs to take his showers in standing position or while sitting on a chair for 6 months post-op.
- Patient needs to sleep on his back for at least six weeks with legs slightly apart separated by a pillow and a knee immobilizer at night.
- The patient is advised not to sit on low chairs, low stools, or reclining chairs. The patient should only sit on chairs with arms for at least 3 months.
- The patient should not cross his legs at the knees. Taking support of the arms of the chair to sit down or get up from a chair is essential, so that the weight of the body is transferred to the chair causing minimum pressure on the operated leg.
- For 4-6 weeks, patient should be walking in weight bearing position with major support and then with minimal support till the 8th week. Post 12 weeks, patient should be able to walk in a weight bearing position without support.
