Total Hip Replacement Exercise Guide-OrthoInfo - AAOS - Patrick J

Patrick J McGahan, MD
http://orthodoc.aaos.org/patrickmcgahan
Sacramento Orthopedic Center
2801 K St, Suite 330
Sacramento, CA 95816 USA
Phone: 916-733-5049 | Fax: 916-733-8914
Total Hip Replacement Exercise Guide
Regular exercises to restore your normal hip motion and strength and a gradual return to everyday activities are
important for your full recovery. Your orthopaedic surgeon and physical therapist may recommend that you exercise
20 to 30 minutes 2 or 3 times a day during your early recovery. They may suggest some of the following exercises.
Early Postoperative Exercises
These exercises are important for increasing circulation to your legs and feet to prevent blood clots. They also are
important to strengthen muscles and to improve your hip movement. You may begin these exercises in the recovery
room shortly after surgery. It may feel uncomfortable at first, but these exercises will speed your recovery and reduce
your postoperative pain. These exercises should be done as you lie on your back with your legs spread slightly apart.
Ankle Pumps
Slowly push your foot up and down. Do this exercise several times as often as every 5 or 10 minutes. This exercise
can begin immediately after surgery and continue until you are fully recovered.
Ankle Rotations
Move your ankle inward toward your other foot and then outward away from your other foot.
Repeat 5 times in each direction 3 or 4 times a day.
Bed-Supported Knee Bends
Slide your heel toward your buttocks, bending your knee and keeping your heel on the bed. Do not let your knee roll inward.
Repeat 10 times 3 or 4 times a day
Buttock Contractions
Tighten buttock muscles and hold to a count of 5.
Repeat 10 times 3 or 4 times a day
Abduction Exercise
Slide your leg out to the side as far as you can and then back.
Repeat 10 times 3 or 4 times a day
Quadriceps Set
Tighten your thigh muscle. Try to straighten your knee. Hold for 5 to 10 seconds.
Repeat this exercise 10 times during a 10-minute period.
Continue until your thigh feels fatigued.
Straight Leg Raises
Tighten your thigh muscle with your knee fully straightened on the bed. As your thigh muscle
tightens, lift your leg several inches off the bed. Hold for 5 to 10 seconds. Slowly lower.
Repeat until your thigh feels fatigued.
Standing Exercises
Soon after your surgery, you will be out of bed and able to stand. You will require help since you may become dizzy
the first several times you stand. As you regain your strength, you will be able to stand independently. While doing
these standing exercises, make sure you are holding on to a firm surface such as a bar attached to your bed or a
wall.
Standing Knee Raises
Lift your operated leg toward your chest. Do not lift your knee higher than your waist. Hold for 2
or 3 counts and put your leg down.
Repeat 10 times 3 or 4 times a day
Standing Hip Abduction
Be sure your hip, knee and foot are pointing straight forward. Keep your body straight. With your
knee straight, lift your leg out to the side. Slowly lower your leg so your foot is back on the floor.
Repeat 10 times 3 or 4 times a day
Standing Hip Extensions
Lift your operated leg backward slowly. Try to keep your back straight. Hold for 2 or 3 counts.
Return your foot to the floor.
Repeat 10 times 3 or 4 times a day
Walking and Early Activity
Soon after surgery, you will begin to walk short distances in your hospital room and perform light everyday activities.
This early activity helps your recovery by helping your hip muscles regain strength and movement.
Walking with Walker, Full Weightbearing
Stand comfortably and erect with your weight evenly balanced on your walker or crutches. Move your walker or
crutches forward a short distance. Then move forward, lifting your operated leg so that the heel of your foot will touch
the floor first. As you move, your knee and ankle will bend and your entire foot will rest evenly on the floor. As you
complete the step allow your toe to lift off the floor. Move the walker again and your knee and hip will again reach
forward for your next step. Remember, touch your heel first, then flatten your foot, then lift your toes off the floor. Try
to walk as smoothly as you can. Don't hurry. As your muscle strength and endurance improve, you may spend more
time walking. Gradually, you will put more and more weight on your leg.
Walking with Cane or Crutch
A walker is often used for the first several weeks to help your balance and to avoid falls. A cane or a crutch is then
used for several more weeks until your full strength and balance skills have returned. Use the cane or crutch in the
hand opposite the operated hip. You are ready to use a cane or single crutch when you can stand and balance
without your walker, when your weight is placed fully on both feet, and when you are no longer leaning on your
hands while using your walker.
Stair Climbing and Descending
The ability to go up and down stairs requires both flexibility and strength. At first, you will need
a handrail for support and you will only be able to go one step at a time. Always lead up the
stairs with your good leg and down the stairs with your operated leg. Remember "up with the
good" and "down with the bad." You may want to have someone help you until you have
regained most of your strength and mobility. Stair climbing is an excellent strengthening and
endurance activity. Do not try to climb steps higher than those of the standard height of seven
inches and always use the handrail for balance.
Advanced Exercises and Activities
A full recovery will take many months. The pain from your problem hip before your surgery and the pain and swelling
after surgery have weakened your hip muscles. The following exercises and activities will help your hip muscles
recover fully.
These exercises should be done in 10 repetitions four times a day with one end of the tubing around the ankle of
your operated leg and the opposite end of the tubing attached to a stationary object such as a locked door or heavy
furniture. Hold on to a chair or bar for balance.
Elastic Tube Exercises
Resistive Hip Flexion
Stand with your feet slightly apart. Bring your operated leg forward keeping the knee straight. Allow your leg to return
to its previous position.
Resistive Hip Abduction
Stand sideways from the door and extend your operated leg out to the side. Allow your leg
to return to its previous position.
Resistive Hip Extensions
Face the door or heavy object to which the tubing is attached and pull your leg straight back.
Allow your leg to return to its previous position.
Exercycling
Exercycling is an excellent activity to help you regain muscle strength and hip mobility. Adjust the seat height so that
the bottom of your foot just touches the pedal with your knee almost straight. Pedal backwards at first. Pedal forward
only after comfortable cycling motion is possible backwards. As you become stronger (at about 4 to 6 weeks) slowly
increase the tension on the exercycle. Exercycle forward 10 to 15 minutes twice a day, gradually building up to 20 to
30 minutes 3 to 4 times a week