Total Hip Post Op Exercises

Post-Operative Exercises after Total Hip Replacement

After a total hip replacement, patients should gradually return to normal, everyday activities using pain and fatigue as a guide for progression. The initial focus should be on walking normally. An observed limp after surgery is common as is feeling of a leg length abnormality. Focusing on a normal walk, even if slowed and awkward at the outset, is key to achieving a normal gait pattern. Do not push the pace or distance; focus on a smooth and normal gait pattern.

The following is a home guide for postoperative total hip exercises. Many patients do not require formal physical therapy and recover well with these simple guidelines. Your surgeon might suggest formal physical therapy to assist in your recovery if your desired activity level or current limitations require further assistance. Regular exercises are important to restore your normal hip motion, increase circulation and to help restore strength.

Early Postoperative Weeks 1-2: These exercises should begin immediately after surgery and continue until you have returned to normal activity.

Lying:

The following exercises can be completed in bed:

Ankle Pumps (gas pedals): Slowly push your foot up and down. Perform 10 repetitions every 5-10 minutes. As your activity level increased, perform these exercises during periods of prolonged sitting.
Heel Slides: While lying on your back, slide your heel toward your buttocks, bending your knee and keeping your heel on the bed. Do not let your knee/hip roll in our out. Repeat 10 repetitions 3-4 times per day.
Glute Sets: While lying on your back or seated, tighten your buttocks muscles and hold for a count of 5. Repeat 10 repetitions 3-4 times per day.
Quad Sets: While lying on your back or seated with your leg out straight and heel on the floor, tighten your thigh muscles and hold for a count of 5. Repeat 10 repetitions 3-4 times per day.
Abduction Slides: While lying on your back with legs outstretched, hip width apart, slide your leg out to the side as far as you can and then return. Repeat 10 repetitions 3-4 times per day.

Standing:

Soon after your surgery, you will be out of bed and able to stand. When moving from lying to sitting and sit to stand, it is common to feel a bit dizzy the first several times. While doing the standing exercises, use a counter or something firm to steady your balance until a few weeks have passed and you have regained the strength to remain confident and steady during the standing exercises.

Marching:

While standing at your kitchen counter or table for balance assistance, alternate lifting your knee to waist height in a marching fashion. Alternate legs for a total of 20 repetitions, repeating 3-4 times per day.

Walking:

As you are comfortable, you should begin taking regular walks throughout the day. Focus on a normal gait pattern and do not push to fatigue in the first several weeks. Attempt short 2-3 minute walks regularly throughout the day.

Early Postoperative Weeks 3-6:

Do not progress into next phase of exercises until the first phase of exercises are easy. Do not add an exercise if you experience pain performing it. Continue performing the exercises from early postoperative weeks 1-2 until week 6

Lying:

The following exercises can be completed in bed:

Bridging (butt lifts) – Week 3: While on your back, bend your knees up so that they are bent approximately 90 degrees with your feet flat on the surface, push through your feet, and lift your buttocks off the surface. Repeat 10-20 repetitions 2 times per day.
Froggers – Week 3: While on your back, bend your knees up so that they are bend approximately 90 degrees with your feet flat on the surface. Gently allow your knees to roll apart as far as they are able comfortably. Rest in this position for 5-10 seconds. Repeat 5 repetitions 3 times per day.
Straight Leg Raises: While on your back, bend the non-surgical knee to 90 degrees. Lift the surgical leg, while straight, off the surface 6-12 inches. You might require assistance to do this without pain for the first few weeks. Repeat 10-20 repetitions 2 times per day.

Standing:

Step-Ups: Using a standard step, step up with the surgical leg first, step down (backward) with the nonsurgical leg first. Repeat 20 repetitions, 2 times per day. If you are walking up stairs normally at this stage, you do not need to perform this exercise. As this exercise becomes easy, perform the exercise more slowly.
Mini-Squats: Holding over the edge of your kitchen or bathroom sink for balance, perform a short sitting motion as if you are sitting into a chair. Only go as far as you comfortably can, not exceeding 90 degrees. Repeat 10-20 repetitions, 2 times per day. As this exercise becomes easy, you may pause a few seconds in the mini squat position.