Total Hip Replacement
Post-operative Instructions and Exercises
The following is a list of instructions to help you recover from your hip surgery. These are general instructions to be used as guidelines. Post-operative visit • Make an appointment for a post-operative visit with your surgeon. This is usually 10-14 days after surgery • Your surgeon may take and x-ray of your new hip • Each individual situation is different. Feel free to ask questions during your office visits. • Write down your questions before you come into the office so you don’t forget anything Medications You have been given a prescription for pain medication. Please remember to: • Take only what is ordered by your surgeon • Take your pain medicine 45 minutes before you exercise • Try to take the medicine before the pain becomes very bad • Call your surgeon if the medication does not reduce your pain • Avoid alcohol and illegal drugs when taking pain medication Blood Thinning Medication You started on a blood thinner while in the hospital • Your surgeon may have called them anticoagulants • Blood thinners help prevent phlebitis, pulmonary embolism and blood clots • Be sure you understand the type of blood thinner you must take • Your doctor will give you a list of blood thinning medications you should take when you leave the hospital Hip Precautions After hip surgery, you must follow a set of instructions called Total Hip Precautions. This means you must be careful how you position your leg • DO NOT bend your hip more than 90 degrees • DO NOT cross your legs or ankles • DO NOT turn your toes inward Activity • Your activity will be limited until you have recovered from your surgery • Avoid activities such as tennis, running, and jogging • DO NOT jump or put sudden stress on your leg • DO NOT pivot on your operated leg. Take small steps and make a U turn • Low impact activities are best as you recover (walking, biking, or swimming) • Make sure you rest between periods of exercise. Raise your knee, ankle and leg for one hour twice a day. This will help reduce the swelling which may occur after walking.
You can put ice on your hip if it swells. Apply for 20 minutes, 3 times each day. Swelling in the leg is very common after hip replacement surgery. Walk and perform your exercises every day.
Helpful Tips The following tips will help you adjust to your new knee when you are home. • Use a “reacher” to pick objects up off the floor • Remove wires and area rugs from the floor so you don’t trip and fall • Sit on a high stool when working in the kitchen • Put frequently used items in kitchen, bedroom and bathroom at waist level so you can reach them easily • Slide objects along the counter top so you don’t have to carry them • Limit the time you spend sitting, since this tends to make the stiffness and swelling worse.
Please call the office if you have any questions
Call 911: if you have a new onset of shortness of breath, chest pain or difficulty breathing Call the office immediately if you have: • Drainage from the wound • Increasing redness around your stiches • Fever higher than 101 degrees • Increased tenderness of the thigh or calf or increasing pain • Swelling of the knee, calf or ankle that does not respond to being raised for one hour. The leg must be raised above the level of the heart
Total Hip Precautions Until your hip is completely healed, you must follow your hip precautions. Carefully positioning your leg will help prevent the hip from slipping out of the socket. The following pictures will show you how to maintain these precautions.
Always keep your back upright and your knees level with or below your hips when sitting in a chair
DO NOT cross legs or ankles
DO NOT stand with your toes turned in
DO NOT bend way over
DO NOT pull blankets up like this
DO pull blankets up like this
DO pick up from floor DO NOT lie on your side without a pillow between your legs
DO NOT get up like this
DO NOT sit on a low toilet or chair
Activities of Daily Living/Mobility Getting up from a seated position: • Move to the edge of the chair/bed • Place your operated leg straight out in front of you to decrease the pressure on your new hip • Place one hand on the chair/bed and the other on the walker • Leading with your hips, stand up • Move your operated leg back so you are standing up straight *remember do not bend your hip more than 90 degrees
Use your sock-aide and long handled shoe horn to put on pants, socks and shoes:
Walking Walking is your most important exercise. • Take 4 or 5 small walks each day • Slowly try to walk a little further each day • Unless your surgeon or Physical Therapist has told you something else, you can put as much weight on your leg as you are comfortable with
Using your walker: Stand in the walker with your hips and toes pointing forward • • •
Move the walker forward (keep all four legs flat on the ground) Next move your operated leg Move your non-operated leg last
Using your crutches: Stand between your crutches with your hips and toes pointed forward Do not lean on the crutches with your armpits • • •
Move your crutches forward With both crutches on the ground move your operated leg forward Move your non-operated leg last
Using your cane: Hold the cane on the side of your non operated leg. • • •
First move the cane forward and slightly to the side Step forward with your operated leg Step forward with your non-operated leg last
Using the Stairs You will not be able to use your walker on the stairs. Your therapist will teach you how to use crutch(es) or a cane Walking Upstairs • Step up with your non-operated leg first • Next bring your operated leg up • Your cane/crutch(es) goes last
Walking Downstairs • Your cane/crutch(es) goes first • Next step down with your operated leg • Your non-operated leg goes last
Your Exercise Program The following is a list of exercises you should continue to do at home. Your Physical Therapist instruct you in which exercises you should perform and will modify your exercise program as needed • You should perform the series of exercises three each day. • You should do 10 repetitions of each exercise with the goal of building up to three sets of ten repetitions. Rest in between each set. • If you find one particular exercise difficult or painful, stop that one exercise and let your Physical Therapist know. • All movements should be slow and controlled. You should not hold your breath while performing the exercises • Do not perform the exercise if it causes pain. Pain is your body’s way of telling you to rest. • It is normal to feel a little muscle soreness after exercising. It is often helpful to apply ice to your hip for 10 minutes after you. If the soreness lasts more than 48 hours let your surgeon or Physical Therapist know.
Exercises to do lying down Ankle pumps Bend your ankle up towards your body as far as possible then point your toes away from your body. *can be done sitting in a chair or lying down in bed
Gluteal Sets Lying on your back with the operated leg as straight as possible, sqeeze your buttocks together firmly. Hold for 5 seconds.
Quad Sets Lying on your back with your operated leg as straight as possible, tighten the muscle on the front of the thigh. You should feel the kneecap pull up and the back of the knee press down. Hold for 5 seconds. *you can bend the non-operated leg up to prevent your back from getting sore
Short Arc Quad Sets Lying on your back with a small pillow rolled under your thigh, raise your foot until your leg is completely straight Hold for 5 seconds *you can bend the non-operated leg to prevent your back from getting sore
Hip Flexion Lying on your back, keep your foot on the bed and slide your foot towards your buttocks. Slowly slide your leg out to the starting position. *you can bend the non-operated leg to prevent your back from getting sore Hip Abduction Lying on your backwith your operated leg straight, slide slide it out to the side. Slide your leg back to the starting position, do not let your legs cross. keep your toes pointed to the ceiling and your leg on the bed (do not lift it). *you can bend the non-operated leg to prevent your back from getting sore
Exercises to do standing Heel Raises Hold onto a table for balance. Raise up on your toes, lifting your Heels up.
Knee Flexion Hold onto a table for balance. Bring your foot upwards towards your buttocks, bending your knee.
Hip Flexion Hold onto a table for balance. March in place.
Knee Extension Hold onto a table for balance. Keeping your heels flat on the floor, bend your knees halfway into a squatting position.
Hip Abduction Hold onto a table for balance. Raise your operated leg out to the side. Keep your toes pointed straight ahead and your leg straight. Don’t lean from side to side.