Hip Rehabilitation after Surgery
Active participation in physical rehabilitation and strict adherence to precautions can help patients of total hip replacement surgery return to an active life.
Hip replacement surgery is a major procedure. However, the outcomes of total hip replacement surgery are usually very successful. One of the important critical factors for a successful outcome is following the physical rehabilitation process.
In order to help achieve the goals for a successful total hip replacement, you must actively participate in the rehab process and work diligently on your own, as well as with the physical therapists, on hip physical therapy exercises to achieve optimal results.
Early rehabilitation
Your recovery program usually begins the day of surgery. The rehabilitation team will work to provide you with the care and encouragement needed during the first few days after surgery.
You may be given a device called an incentive spirometer that you inhale from and exhale into. It measures your lung capacity and assists you in taking deep breaths. These exercises reduce the collection of fluid in the lungs after hip replacement surgery, preventing the risk of pneumonia. Coughing is an effective tool for loosening any congestion that may build in the lungs following surgery.
The physical therapist will begin working with you on the day of or day after surgery. They will teach you some simple hip physical therapy exercises to be done in bed that will strengthen the muscles in the hip and lower extremities. These exercises may include:
- Gluteal sets: Tighten and relax the buttock muscles.
- Quadricep sets: Tighten and relax the thigh muscles.
- Ankle pumps: Flex and extend the ankles.
Your physical therapist will also teach you proper techniques to perform such simple tasks as:
- Moving up and down in bed.
- Going from lying to sitting.
- Going from sitting to standing.
- Going from standing to sitting.
- Going from sitting to lying.
Although these are simple activities, you must learn to do them safely so that the hip does not dislocate or suffer other injuries.
Another important goal for early physical therapy is for you to learn to walk safely with an appropriate assistive device (usually a walker or crutches). Your surgeon will determine how much weight you can bear on your new hip, and your therapist will teach you the proper techniques for walking on level surfaces and stairs with the assistive device. Improper use of the assistive device raises the chance for accident or injury.
The occupational therapist will also visit with you to teach you how to perform activities of daily living safely. They will provide you with a list of hip precautions, which are designed to protect your new hip during the first 8-12 weeks following surgery.
Precautions
Taking certain precautions will be necessary after total hip replacement surgery. Your physical therapist will tailor these to your individual surgery and needs and explain them in detail. You must follow these precautions strictly to prevent dislocation of the hip implant and the possibility of a second operation.
Use of aids
The occupational therapist will instruct you in the proper use of various long-handled devices for activities of daily living. These devices may include the following:
- A reacher to dress and pick things up from the floor.
- A sock aid that will assist in putting on socks.
- A long-handled sponge to wash your legs and feet.
- A leg-lifting device to move the operated leg in and out of the car or bed.
- An elevated toilet seat.
- An elevated bathtub chair to fit in the shower or tub.
At home
Following surgery, a physical therapist may help you with your rehabilitation protocol. In addition to the hip physical therapy exercises performed with the therapist, you should continue to work on hip exercises in your free time. It is also important to continue to walk on a regular basis to further strengthen your hip muscles. An exercise and walking program helps to enhance your recovery from surgery and make activities of daily living easier to manage.
Here is a list of potential exercises that you may be asked to perform:
- Ankle pumps
- Quadricep sets
- Gluteal sets
- Heel slides
- Leg lifts
- Knee extension
- Hip abduction
If an exercise is causing significant pain, reduce the number of repetitions. If the pain continues, contact your physical therapist or physician.
While at home, you will continue to walk with the assistive device unless directed by your surgeon to discontinue use. You must also remember to strictly follow the hip precautions and weight-bearing instructions during the first few months following surgery. It is recommended that you not drive unless your doctor approves it.
Long-term rehabilitation goals
Once you have completed your rehabilitation program, you can expect to be able to perform activities of daily living with little to no pain or assistance. Patients following total hip replacement routinely are able to walk, dress, bathe, drive, garden, cook, and return to work. Although final outcomes may vary from patient to patient, total hip replacement surgery is one of the most successful procedures in modern medicine. Most patients return to a full and active life.
