Monday, March 27, 2023

Exercises For Total Hip Replacement

Standing Abduction Against Wall

Total Hip Replacement – Exercises 0-4 Weeks After Surgery
  • Stand on operated leg
  • Bend non-operated leg and push your knee against the wall and return to standing on both legs
  • Your hip should not be touching the counter
  • Make sure to keep your hips level and thighs in line

Progression: Try to take your hand off the counter so that your lower leg is the only part of your body touching the wall.

Why Is Physical Therapy After A Total Hip Replacement Surgery Important

Regaining your range of motion and strength after total hip replacement surgery is critical to regaining your ability to do the things that are important to you. You will start the following exercise program very soon after your surgery. Your physical therapist will help you with the exercises initially and you will be expected to continue the exercises as instructed. As you recover, some exercises will be discontinued and others may be added. Please let your therapist or surgeon know if you are having difficulty with your exercises.

What Causes Early Loosening Of A Hip Replacement

Nearly all hip replacements rely on whats called a press fit. The metal implants are wedged tightly into the bone and held there by the compression and friction of that bone and metal interface. But this is just a short-term solution.

For long term durability, the bone has to actually grow into the metal parts of the hip. These metal pieces have a porous coating on the outside with microscopic ridges and valleys. Over time, bone cells to creep in and grow attached to it just like a tree growing around a nearby fence post. And that is what keeps the prosthesis locked in place in the long-term.

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Will Anterior Hip Replacements Cause An Epidemic Of Early Loosening

In the first few weeks after a joint replacement, all the tissue that was dissected to get to the joint has to heal back together. And with traditional hip replacements, there is a moderate amount of pain with activity that prevents you from doing too much.

The popular anterior approach for a hip replacement can greatly reduce the immediate pain of surgery, which is great! The only downside is people feel so good they dont follow their post-operative precautions. But that could prevent your bone from truly healing into the new hip. And that can lead to early failure.

Exercises To Avoid After A Hip Replacement

34 best Total Hip Replacement images on Pinterest

You want to limit high-impact exercises, like running and HIIT moves that involve jumping, in order to protect the longevity of your implants and reduce the stress on them.

“Personally, I think it is still important to keep in mind that these are artificial implants and there may be some concerns with their long-term durability with certain activities,” Dr. Ast says.

“We tend to ask patients not to use running as their primary form of exercise, meaning if patients want to run from time to time that is probably fine, but to run multiple miles, multiple times a week may not be the best idea for the longevity of these implants.”

Very high-impact activities, like skydiving, are not recommended because they can increase the risk of the bone breaking around the implant.

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Upper Extremity Exercises: Strengthen Your Arms Before Using Crutches Or A Walker

After your hip replacement surgery, you will probably spend some time on crutches or using a walker while you recover. Both of these mobility aids require some upper arm strength. Get your arms in shape before surgery with these exercises!

Bicep Curls


  • Stand with your feet hip-width apart on the TheraBand CLX band and hold one end loop in each hand
  • Lower your arm to a starting position and then bring your hands up to your shoulders by bending your elbows, keeping your upper arms by your sides
  • Hold, return to starting position, and repeat for 10 repetitions
  • Sitting

  • Sit in a sturdy chair with the CLX band under your feet and one end loop in each hand
  • Lower your arm to a starting position and then bring your hands up to your shoulders by bending your elbows, keeping your upper arms by your sides
  • Hold, return to starting position, and repeat for 10 repetitions
  • To make this exercise more challenging, move both hands down a loop to create more resistance.

    Elbow Extensions

  • Sit in a stable chair
  • Stabilize your resistance band by holding one end in your hand with the arm extended
  • Grasp the other end of the band in your other hand with your elbow bent
  • Straighten your arm, pulling the band back while holding steadily with the other hand
  • Hold, return to starting position and repeat
  • After 10 repetitions, repeat on the other arm
  • Seated Chair Press Ups

  • Sit down in a sturdy chair with sturdy armrests and no wheels, sitting towards the front of the chair
  • Repeat for 10 repetitions
  • Exercises After Hip Replacement Surgery: 6 Weeks

    At six weeks post-op, you’re going to build upon the glute and hip flexibility exercises you were doing at four weeks and start incorporating balance exercises, which are essential for preventing injury. You can also reduce the number of times you do these exercises to just once a day instead of three, Eannucci says.

    “After six weeks, I generally tell patients to start increasing their exercise routines and also to start adding hip stretching exercises, but this depends on the individual,” Dr. Ast says.

    Specifically, he recommends doing hip rotational stretches and exercises because people with severe hip arthritis tend to lose their rotational flexibility, which is necessary for doing daily tasks, like putting on your socks and shoes.

    “One of the most important stretches is to try to regain the ability to sit cross-legged with your ankle of the operated leg on the knee of the other leg. This is a useful position for putting on shoes and socks and caring for feet, but this flexibility is often lost as the hip becomes stiff from arthritis,” Dr. Ast says.

    Make sure you keep up with your walking routine and aim to clock in two to three miles a day. This is also a good time to incorporate some core exercises into your routine, he adds.

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    Why Is Exercise Important After Hip Replacement Surgery

    Regaining your range of motion and strength after total hip replacement surgery is critical to regaining your ability to do the things that are important to you. Exercising your new hip has multiple benefits including: reducing stiffness, increasing flexibility, improving muscle strength, and preventing blood clots.

    To help reduce swelling and improve circulation:

    • Lie down with your legs at the level of your heart for at least 20 minutes. You can place a foam wedge lengthwise beneath your surgical leg if you have an increase in swelling
    • Use a cold pack. Cold therapy works by reducing blood flow to the hip, which can significantly reduce inflammation and swelling that causes pain
    • Actively exercise the muscles of the hip with ankle pumps. Pump your feet up and down by pulling your feet up toward you, then pushing your feet down away from you. Complete this exercise 10 to 30 times each hour to help prevent blood clots in the legs
    • Walk often throughout the day. Walk around your home using a front-wheel walker, crutches or a cane. Gradually increase the distance you walk as you begin to develop a greater range of motion.

    Beginner Exercises After A Total Hip Replacement

    Total Hip Replacement – Exercises 9-12 Weeks After Surgery

    After your total hip replacement, you will start gentle exercises right away to facilitate proper healing and recovery. Early movement is so important in meeting your strength and range of motion goals. Below you will find some common exercises your surgeon and physical therapist will recommend you begin performing initially after your surgery.â

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    Exercises After Hip Replacement Surgery: 4 Weeks

    In addition to walking regularly, most hip replacement post-op exercises strengthen your glutes to help stabilize your hips and restore joint mobility.

    During the first four weeks post-surgery, Erica Fritz Eannucci, PT, DPT, physical therapist and HSS physical therapy manager, recommends these exercises for strengthening your glutes and improving hip flexibility. Do 3 sets of 10 reps per exercise three times a day for the first four weeks post-op.

    According to a small July 2016 study in âPhysical Therapy Researchâ, preoperative gluteus medius muscle atrophy is a predictor of walking with a limp six months after surgery.

    So by strengthening your glutes â particularly your gluteus medius, which is responsible for moving your leg away from your midline â you’ll be able to walk and do other activities more comfortably.


    You want to avoid exercises that target your hip flexors, the group of muscles near the front of your hips, which can irritate the muscles. “For most patients, it’s not necessary to do a large amount of hip flexor strengthening after a hip replacement however, if patients desire to strengthen their hip flexors, I recommend they wait at least six weeks and preferably even longer,” Dr. Ast says.

    Should You Exercise Before Surgery

    Despite the speed of minimally invasive surgery, the hip replacement process happens weeks in advance. The surgeon would recommend a pre-habilitation program with hip exercises. Exercises stretch and strengthen the surrounding muscles while speeding up recovery. Other benefits include improved circulation and reduced muscle fatigue. Studies also show that preoperative exercise reduces pain and the chances of complications. The following exercises are particularly helpful for hip replacements.

    Recommended Reading: Torn Labrum Hip Surgery Recovery

    Ankle Pumps And Rotations

    You can start ankle exercises right after surgery. Lying on your back, flex and point your feet hinging at the ankle. Pump them like this several times. You can do ankle pumps every 10 minutes or so. For ankle rotations, make a circle with your foot by moving it at the ankle. Turn your foot inward toward the other foot, sweep outward away from the other foot, and then back inward. Go several times in each direction 3 to 4 times a day.

    Supine Short Arc Quad :

    Total Hip Replacement Exercise

    Equipment needed: floor mat, pillow or rolled towel1. Place a pillow or rolled towel under your thigh. Lie on your back with your legs stretched out, toes pointing upward, heels on the floor, and your knee slightly bent over the pillow or bolster. 2. Straighten your knee, lifting the heel off the floor. Hold for a moment once your leg is fully extended, then slowly lower your heel back to the starting position. 3. Repeat about 10 times, or until muscle fatigue. You can perform this exercise on both legs.Note: Make sure your toes point upward throughout the entire movement and that you engage your core and buttocks. To protect your low back, you can bend the opposite leg for added support during this exercise.â

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    Total Hip Replacement: When To Return To The Gym

    While the muscles, ligaments, and capsule of the hip heal in just a few weeks the bone healing takes longer. We generally believe that this occurs at the same rate as a broken bone. And we know that it takes between 6 weeks and three months for adults to heal most fractures.

    With more detailed studies, like a Bone Scan, we can see the actual activity of the bone cells as they heal. And this tells us that the early healing is just the tip of the iceberg. Studies show that it can take between one and two YEARS for the bone to completely finish remodeling after a hip replacement.

    This does NOT mean you need to stay off the hip for two years. In fact, weight-bearing exercise is what tells your bone to keep remodeling and getting stronger. But you do need to take it easy for at least 3 months. You should always check with your own surgeon on the specifics though, each surgery is different.

    And you certainly can exercise and should do rehab immediately after a hip replacement. The important thing is not to overdo it. So now that Ive thoroughly scared you, let me tell you what you actually CAN do immediately after a hip replacement.

    What Exercises Are Safe After Hip Replacement

    First of all, moving the leg while laying down is a safe motion. Walking, stairs, light jogging, and air squats are all safe to do, as well. What these have in common is there is plenty of motion without pausing.

    Unsafe exercises including standing on the surgical leg while exercising the other leg. This requires the operative hip to exert a lot of force. Likewise, single-leg balancing on the operative hip and running both show forces that exceed the acceptable limits routinely.

    Similarly, swimming with a freestyle stroke is safe because of the limited motion the hip goes through. A breast-stroke, however, puts too much force and motion on the hip. It regularly exceeds acceptable limits.

    This study didnt specifically look at heavy lifts such as deadlifts or weighted squats. But it did show that air squats just sneak right up to the edge of the acceptable limits. So we know that adding a barbell would push it over the edge.

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    ‘from Me To You’ A Patient Testimonial

    Dear resident in Ward D8,You have a beautiful view out to the Gog-Magog Hills. Be nice to your physiotherapists. They are not being cruel to you, although it will definitely feel like it. My physios have excellent patter that take your mind off the exercise pain, which is necessary. The worst day is the second day after your operation and the second night is awful too. The second night you will be awake at dawn. Open the window curtain before dawn and, in the hour before dawn, you will see the planet Venus shining brightly in the predawn sky . The Moon will appear, looking beautiful, and then the Sun. Day 3 starts out bad, but improves suddenly and rapidly. By the end of your brief stay, you will feel much better about your operation. Hospitals are positive places they exist to make you better. There aren’t many institutions with so noble an aim.I hope you get better soon, well, I know you will here.Best wishes,Alex

    Ankle Pumping For Circulation

    Total Hip Replacement – Exercises 4-6 Weeks After Surgery

    Do these exercises to strengthen your muscles.How often: 2 to 3 times a day

    Do 10 repetitions of each exercise. If you are comfortable with the exercises, gradually increase the number of repetitions until you reach 20 repetitions.

    Do your exercises lying down for the most comfort. Your bed is an excellent place to do your exercises.

    Do your exercises lying down for the most comfort. Your bed is an excellent place to do your exercises.

    Ankle pumps

    Pump your feet up and down by pulling your feet up toward you, then pushing your feet down away from you.

    Thigh squeezes

    Tighten the muscles on the top of your thigh by pushing the back of your knee down into the bed. Hold for 5 seconds and relax.

    Buttock squeezes

    Tighten your buttocks muscles by squeezing the muscles together. Hold for 5 seconds and relax.

    Heel slides

    Bend your surgical hip and knee by sliding your heel up toward your buttocks while keeping your heel on the bed. Slide your heel back down to the starting position and relax. Keep your kneecap pointed up toward the ceiling during the exercise. You may want to use a plastic bag under your heel to help it slide easier.

    Leg slides

    Slide your surgical leg out to the side, keeping your kneecap pointed up toward the ceiling. Slide your leg back to the starting position. You may want to use a plastic bag under your heel to help it slide easier.

    Lying kicks

    Straight leg raises

    Sitting kicks

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    Total Hip Replacement: 3 Exercises For An Earlier Return Of Functional Gait

    Categories: Acute Care, Athletic Training, Lower Quarter, Occupational Therapy, Orthopedics, Physical Therapy, Return to Sport

    The hip is the second most common joint replaced in the body after the knee. Many approaches to hip replacement exist, but they all have the same long-term outcome.1 Additionally, surgeons do not routinely refer patients to outpatient rehab following hip replacement as they usually do for knee and shoulder replacement. This is becoming even more the norm in todays bundled payment structures.2

    Why Should You Exercise Before Hip Replacement Surgery

    Have you heard the term prehab? Pre means before and hab refers to rehabilitation. Prehab includes things like nutrition and workouts. Prehab exercises are done before surgery to help improve your outcome after surgery by strengthening the muscles youll be using and working during recovery.

    In fact, studies have shown that hip and knee replacement patients who participated in prehab reduced their need for inpatient care after surgery by up to 73%.5 The increased strength makes it easier to start walking and getting in and out of bed soon after surgery. Physical therapist Steve Sylvester says that Patients who are more fit prior to surgery may have shorter hospital stays and fewer outpatient rehab sessions. 5

    So start your hip replacement prehab now!

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    What You Should Know & Buy Before Hip Replacement Surgery

    Getting ready for your hip replacement? Learn about how a hip replacement is performed, including two ways the replacement can be attached to the bone. And find out our top suggestions for helpful tools as you recover, including a reacher, a raised toilet seat, and more. Plus, find out what happens after surgery. Get the answers by reading this article, What You Need to Know Before a Hip Replacement!

    Lower Extremity Exercises: Strengthen Your Hip Before Surgery

    Total Hip Replacement Hip Precautions

    Try these simple exercises to get your hips and legs in shape before your hip replacement surgery. Follow the steps below or watch the video to get started!

    Aim for 10 repetitions for each exercise below.

    Ankle Pumps

  • Lay down on your back on your bed
  • Bring your toes up towards the ceiling, flexing your foot
  • Bring your toes down towards the floor, like youre pressing on a gas pedal
  • Repeat at a nice, quick pace
  • Quad Sets

  • Lay down on your back on your bed
  • Place a rolled towel under your knee
  • Push down into the towel roll, tightening up your quads
  • Hold for five seconds
  • Heel Slides

  • Lay down on your back on your bed
  • Slide your heel up towards your glutes as far as you feel comfortable, bending your knee
  • Hold for 5 seconds
  • Slide your heel back down to your starting position
  • Switch to the opposite leg and repeat
  • If there is too much resistance, place a sheet of plastic, a piece of cardboard, or a cookie sheet down to lower the resistance.

    Long Arc Quads

  • Sit in a chair with your knees back towards the edge of the chair as much as possible
  • Sit with good posture, sitting up straight with your chest out and shoulders back
  • Extend one leg straight out towards the ceiling, keeping your foot relaxed
  • Hold for five seconds and then return to your starting position
  • Switch to the opposite leg and repeat
  • Bridge

  • Lay down on your back on your bed
  • Bring both feet up towards your glutes, so your knees are bent at about 90 degrees
  • Keep your feet shoulder-width apart
  • Hold for 5 seconds
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