Hip replacement surgery relieves pain for hundreds of thousands of people each year. However, some are disappointed because of persistent weakness and trouble walking. Early after surgery we hear “be patient” or just “take it easy”. Or, “all you need to do is walk more”. This approach to hip replacement recovery is just not good enough if you want your quality of life back.
By working closely with your physical therapist, you can do better. An individually tailored exercise program will speed up your recovery. Perform the exercises at home or in the clinic with your physical therapist. Both methods are effective. The key is that you are performing the right exercises based on your deficits and goals.
Exercise is Proven to Speed Up Your Hip Replacement Recovery
A 2013 review of clinical studies prove exercise leads to better outcomes after hip replacement. Stationary cycling improves your quality of life during the first 3 months after surgery and 2 years later. Early strength training during the first 2 months results in the greatest functional improvements. After 8 weeks, weight-bearing exercises (examples included below) are best to improve your function.
A more recent review of the research suggests both at-home and supervised exercise improves outcomes after surgery. Patients who attended supervised physical therapy did slightly better. However, both approaches improve strength, walking, and reduce pain after your surgery.
The decision to exercise at home or under the direction of your physical therapist is not universal. Both approaches work. It is best to discuss this with your physical therapist, surgeon, and family. Develop a plan that fits your needs and adjust as you go.
A Sample of Easy Exercises for Hip Replacement Recovery
Whether you exercise at home or with your physical therapist, the key is that you are performing the right exercises. Your physical therapist determines this after your initial evaluation. Everyone who has a hip replacement doesn’t do the same exact exercises.
In general, start with low-intensity exercises lying down. After a week or 2, your pain and stiffness will improve. Then you will transition to more challenging exercises. This includes weight-bearing exercises done standing.
Below are 5 examples of some of the common exercises we prescribe. They emphasize muscle activation and strengthening of your glutes and quads. They are safe to perform whether you had your surgery through the front (anterior approach) or back of your hip (posterior approach). Perform them once per day. We recommend you do 2 to 3 sets of 8 to 12 repetitions for each of them.
1. Prone Glute Squeeze
Isometrics are done by contracting the muscle without joint movement. This makes the isometric glute squeeze an exercise you can do early and often. Start with gentle contractions. Increase the intensity as your pain decreases. If you have trouble lying flat on your stomach put a pillow under your abdomen.
The bridge strengthens your glutes and core. It also helps restore hip extension mobility. Be sure not to arch your back too much. Concentrate on squeezing your buttocks.
3. Clam Shell
The clamshell strengthens your gluteus medius. This muscle is important because it stabilizes your hip and pelvis when you walk. Weakness will cause you to walk with a side-to-side lean.
If you are struggling with this exercise you can modify it. Lie on your back, instead of your side, and place a band around your thighs. Pull apart with both legs. When you get stronger, go back to doing it on your side.
4. Sit to Stand
Start by doing this exercise with a few pillows stacked on a firm chair. The higher you make the chair, the easier it will be at first.
As you get stronger, remove the pillows or find a slightly lower chair. Don’t overdo it at first. You want to make sure the exercise is challenging but not painful. Also, be sure not to lean away from your involved side. Your body is really good at compensating.
5. Single Leg Balance
Ok, this exercise is going to be tough for you. Modifications will probably be needed at first. Stand close to a chair or counter. Use 1 hand to assist with your balance.
Over time, slowly decrease your dependence on the chair or counter. The better you get at this exercise, the more your walking will improve.
Start Early for Your Best Hip Replacement Recovery
Don’t delay getting started. If you are stiff and sore, do the glute squeezes and modify the clam shell. Work the other exercises in as you feel better. Also, don’t underestimate the power of getting outside and doing a short purposeful walk every day. Keep moving but don’t overdo it.
Delaying your rehabilitation will lead to poor habits. Your body is great at figuring out how to compensate. So if you develop a poor walking pattern it will be very difficult to correct this later on.
Working with your physical therapist early will save you time and aggravation down the road. If you need help getting started call our office and schedule an initial evaluation with your physical therapist.