Q:I am scheduled for hip replacement very soon. What, if any, exercises should I do beforehand? What will I be required to do afterward?
A: Hip replacement is a modern marvel. Just a decade ago, a hip with severe osteoarthritis or one broken because of a fall was often a death sentence. Now patients can get out of pain, move away from severe disability, and continue living productive lives. But, as with our bodies in general, strong muscles before and after surgery will make the difference in the quality of your recovery.
“By working on range of motion and strength before the operation, less is lost afterwards,” says Denver physical therapist Stuart Wilson. He suggests getting your post-operative exercises from your physician ahead of time so that you can become used to both the exercises and the way they are supposed to feel.
Exercisers definitely had an easier time of it than non-exercisers in a 2006 study. Nearly three-fourths of participants who exercised three times a week in a six-week program went straight home after surgery instead of going into a rehabilitation facility. The exercisers were also able to better handle routine activities after surgery than non-exercisers, according to a report in Arthritis Care & Research.
Their workout routine was designed to be easy on the joints with the first three weeks spent working out in a pool and the last three weeks performing general strength training, stretching and cardiovascular work. All of the cardiovascular exercising was performed on non- impact recumbent bikes and elliptical walking machines.
After hip replacement, the exercises will focus on getting the muscles of the ankle, buttocks and legs moving and flexing, to prevent blood clots and to start the muscle-strengthening process. Most of the initial exercises are performed while lying in bed. (Find examples on the American Academy of Orthopaedic Surgeons website, , in the section titled “Total Hip Replacement Exercise Guide.”)
Very soon after surgery, you will be assisted in your efforts to stand, working toward standing independently as soon as possible. You will need to hold onto a firm surface to perform standing knee raises, standing hip abduction (lifting leg away from the body), and standing hip extensions (lifting the leg backward slowly).
Walking will be performed with a walker in order to keep as much weight as possible off the operated leg. You may need to do this for several weeks before graduating to a cane or crutch.
Your physical therapist will eventually start you on gentle strength-training exercises using plastic tubing and low-resistance cycling on a stationery recumbent bicycle. Walking in water — using a walker at first — is also recommended. Be patient: A full recovery can take months.
Wilson, who owns Champion Sports Medicine and Physical Therapy, recommends a healthy balance between rest and movement. “You get really good at what you do — if you sit a lot you get very good at sitting, so good that you become bad at moving.” He stresses that patients must become good at both resting and moving in order to promote healing.
The old adage “use it or lose it” is never more crucial than after surgery. Not only does exercise get the blood flowing to promote healing but it also improves the mental attitude and mood.
Linda J. Buch is a certified fitness trainer in Denver; linda@ljbalance.com.
