Physical Therapy after a Hip Replacementby Liz Hoobchaak | 20 Comments
Hip replacements are one of the most commonly performed orthopedic surgeries. Having been performed since 1960, the surgical technique and prosthesis used have been perfected to allow the patient optimal recovery of functioning with less pain. Having the surgery is only half the battle when it comes to the new joint. Physical therapy is the other important aspect in a full and successful recovery.
Following a hip replacement, physical therapy will help to restore the joint motion and strength. Initially therapy begins in the hospital the day after your surgery. The therapist will teach you how to properly move around in bed, get out of bed, get into the shower and car, go up and down a step, and walk with crutches or a walker. There may be some simple exercises you can perform in the bed to help prevent blood clots such as tightening your thighs, buttocks, and moving your ankle.
Following a hip replacement, some patients may do a short stay in a rehab facility for additional therapy before they go home. This usually depends on the age of the patient, functioning when they leave the hospital, additional care from family members at home, and what their home life environment is like (for example, lots of stairs). Some patients may go home after the hospital and have a therapist come to their home. Once the patient is comfortable and strong enough to leave the house, they can begin outpatient therapy.
Outpatient physical therapy will continue to progress the exercises that you began in home therapy. Outpatient facilities offer more options for the patient, such as exercise equipment, and allows them to rehabilitate in a real life setting alongside others that may be recovering from a similar surgery. The focus will be on increasing the range of motion in the new joint as well as strengthening the muscles surrounding the hip. Balance exercises will also be performed to help decrease the risk of falling. Ice or heat may be used in therapy. Heat may be used to warm up a tight muscle and ice may be used after the exercises to reduce swelling and soreness. Your physical therapist will keep in mind any personal goals that you may have, such as returning to golf, to ensure that you perform specific exercises to help you reach that goal.
Following a hip replacement, there are some important considerations that your physical therapist will help you to follow to decrease your risk for dislocating your new hip. If you have the traditional hip replacement from a posterior approach, meaning the incision is along the back of the hip, there are certain motions to avoid. These include not bending the hip past a 90 degree angle, not crossing your leg over the midline of your body (such as crossing your legs), and not allowing the hip to be rotated inward. Some things you can do to follow these precautions are: put a pillow between your knees, use a raised toilet seat, avoid sitting in too low a seat, avoid bending down to tie your shoe, and always make sure your knee caps are pointed forward or slightly out, never inward. Make sure to speak to your doctor or therapist to know what your precautions are since they may be different with certain surgical techniques.
Even though hip replacements are very successful surgeries, the dedication of the patient and the physical therapist will be the key to gaining your most optimal functioning so that you can start enjoying life pain free again.