Rehabilitation after Hip Surgery

One of the most critical factors in achieving successful total hip replacement depends upon your diligence in physical rehabilitation. You must actively participate in the rehab process, working diligently on your own, as well as with the physical therapists, to achieve optimal results.

Early Hip Rehabilitation

Your recovery program usually begins the day after surgery. The rehabilitation team will work together to provide the care and encouragement you need during the first few days after surgery.

You may be given a device called an incentive spirometer that you inhale and exhale into. It measures your lung capacity and assists you in taking deep breaths. These exercises reduce the collection of fluid in the lungs after surgery, preventing the risk of pneumonia. Coughing is an effective tool for loosening any congestion that may build in the lungs following surgery.

The physical therapists will begin as early as 1-2 days after surgery. They will teach you simple exercises that can be performed in bed to strengthen the muscles in the hip and lower extremity. These exercises may include:

Gluteal sets: Tighten and relax the buttock muscles
Quadricep sets: Tighten and relax the thigh muscles
Ankle pumps: Flex and extend the ankles

Your physical therapist will also teach you proper techniques to perform such simple tasks as:

Moving up and down in bed
Going from lying to sitting
Going from sitting to standing
Going from standing to sitting
Going from sitting to lying

Although these are simple activities, you must learn to do them safely so that the hip does not dislocate or suffer other injury.

Another important goal for early physical therapy is for you to learn to walk safely with an appropriate assistive device (usually a walker or crutches). Your surgeon will determine how much weight you can bear on your new hip, and the therapist will teach you the proper techniques for walking on level surfaces and stairs with the assistive device. Improper use of the assistive device raises the chance for accident or injury.

The occupational therapist will teach you how to safely perform activities of daily living, and will provide you with a list of hip precautions which are designed to protect your new hip during the first 8-12 weeks following hip surgery. The occupational therapist will also instruct you in the proper use of various long-handled devices for activities of daily living. These devices may include the following:

A reacher to dress and pick things up from the floor
A sock-aid to assist in putting on socks
A long-handled sponge to wash your legs and feet
A leg-lifting device to move the operated leg in and out of the car or bed
An elevated toilet seat so that you don't violate your hip precautions when using the bathroom
An elevated bathtub chair to fit in the shower or tub

The precautions following hip replacement surgery must be strictly adhered to in order to prevent dislocation of the hip implant and the possibility of another operation.

At Home

Following surgery, a physical therapist may help you with your rehabilitation protocol. In addition to the exercises done with the therapist, you should continue to work on the hip exercises in your free time. It is also important to continue to walk on a regularly basis to further strengthen your hip muscles. An exercise and walking program helps to enhance your recovery from surgery and helps make activities of daily living easier to manage.

You may be asked to perform a variety of exercises, including leg lefts, ankle pumps, quadricep sets, gluteal sets, hip abduction, and knee extensions. If an exercise causes lasting pain, reduce the number of repetitions. If the pain continues, contact your physical therapist or physician.

While at home, continue to walk with an assistive device unless directed by your surgeon to discontinue use. You must also remember to strictly follow the hip precautions and weight-bearing instructions during the first few months following surgery. It is recommended that you not drive unless you have been approved by your doctor.

Long-term Rehabilitation Goals

Once you have completed your rehabilitation program, you can expect to be able to perform most activities of daily living with little to no hip pain or assistance. Following total hip replacement, patients routinely are able to walk, dress, bathe, drive, garden, cook, and return to work. Although final outcomes may vary from patient to patient, hip replacement surgery is one of the most successful procedures in modern medicine and most patients return to a full and active life.