Total Hip Replacement Exercise Guide
Importance of Total Hip Replacement Exercises
Exercising the muscles that surround and support the hip help restore range of motion and joint strength after hip replacement surgery. To ensure a positive surgical outcome, you are recommended to perform physical therapy exercises 2-3 times a day and walk for 30 minutes every day. You will be provided with a specific hip exercise routine by your doctor. The following exercises are generally recommended:
Hip Strengthening Exercises for the Early Post-Surgical Recovery Phase
These exercises can be performed while in the recovery room soon after the surgery. You are encouraged to do them as soon as possible as they improve blood circulation in your feet and legs and prevent formation of blood clots in addition to strengthening your muscles.
- Ankle Pump Exercise: Lie on your back with your leg extended and rhythmically contract your calf and shin muscles to perform a back and forth pumping movement with your feet. Do this exercise as often as possible every 10 minutes while in the recovery room.
- Ankle Rotation Exercise: Rotate your ankle joint by making 5-10 circles with your toes in the clockwise and anticlockwise direction 3-4 times a day.
- Isometric Buttock Contractions: While lying on your bed, tighten your buttock muscles and hold the contraction for 10 seconds. Do this 3-4 times a day.
- Quadriceps Set Exercise: Lie on your back on your bed with your leg fully extended. Contract the thigh muscle (quadriceps) and hold the contraction for about 10 seconds and then relax. Do about 3-4 sets of 10 repetitions 2-3 times a day.
- Lying Hip Abduction: Lie on your back with your leg fully extended. Extend the operated leg out to the side and then bring it back to the midline. Do about 10 repetitions 2-3 times a day.
- Straight Leg Lift Exercise: Lie on your back on your bed with your leg fully extended. Raise you heel a few inches off the bed while keeping your leg as straight as possible. Hold this position for about 10 seconds and then slowly lower your heel. Do about 2-3 sets of 10 repetitions 2-3 times a day.
- Heel Slides: Lie on your back on your bed with legs extended. Slowly slide your heel towards your buttocks while bending your knee and then slide your heel back to extend your leg. Do about 3-4 sets of 10 repetitions 2-3 times a day.
- Standing Hip Flexion: Place your hands on the back of a chair for support and slowly lift your knee up toward your chest till your thigh is nearly parallel to the floor. Hold this position for 1-2 seconds and then lower your leg. Do about 3-4 sets of 10 repetitions 2-3 times a day.
- Standing Hip Abduction: Place your hands on the back of a chair for support and slowly lift your operated leg out to the side making about a 45-degree angle with the other leg. Hold this position for 1-2 seconds and then lower your leg. Do about 3-4 sets of 10 repetitions 2-3 times a day.
- Standing Hip Extension: Place your hands on the back of a chair for support and slowly lift your operated leg behind you making about a 45-degree angle with the other leg. Hold this position for 1-2 seconds and then lower your leg. Do about 3-4 sets of 10 repetitions 2-3 times a day.
Resumption of Activities after Total Hip Replacement
You will be encouraged to start walking while in the recovery room. Early resumption of weightbearing and walking helps you speed up your recovery and return to routine activities of daily living.
- Walking: Initially, you may have to use a walker or a pair of crutches to walk so you can control the amount of weight placed on the operated hip. From a standing position, with your weight evenly balanced, advance the walker or crutches a small distance and move the operated leg forward by lifting the toes off the ground first and bending the knee and hip joint to lift the foot. When placing the operated leg on the ground, touch your heel first, then flatten the foot. As your muscles become stronger, you can use a walking cane in your opposite hand to assist with walking, and finally walk without using any aids.
- Stair climbing: Initially, use the handrail for balance and support when going up and down stairs. Lead with the unoperated leg when going up the stairs and with a cane and the operated hip when going down the stairs. The stairs should be no higher than 7 inches (standard height) when you start stair climbing after total hip replacement. This is an excellent activity to improve endurance and strength.
Advanced Total Hip Replacement Exercises
Full recovery after total hip replacement may take a few months. The following exercises help maximize hip function and mobility:
- Resistance Exercises: About 4-6 weeks after the surgery, you may be strong enough to use resistance bands or 1 to 2-pound ankle weights when performing standing hip flexion, abduction and extension exercises. You can gradually increase the weight as you make strength and endurance gains.
- Stationary Bike: This is an excellent low-impact activity to improve hip mobility. Adjust the seat height so that your foot just touches the pedal with the leg fully straightened. Pedal backwards initially, and once you have achieved a comfortable backward cycling motion, start pedalling forwards. Build up your endurance to 20 minutes 3 times a week.
You may have temporary discomfort and swelling after exercise, but this should improve with foot elevation and application of ice wrapped in a towel to the hip. Contact your doctor or physical therapist for persistent or worsening symptoms.