Exercises to strengthen your hip post surgery

Hello my name is Alex Barnes and this is my colleague Claire Kelly we are part of the physiotherapy team here at Horder Healthcare, This video has been created for you to help and guide you through the rehabilitation process following your total hip replacement surgery done here at the hoarder centre. If you have had your hip surgery with another provider you may still find this video useful however if you have any queries we recommend that you contact the therapy staff that you saw whilst in hospital. Hopefully this video should answer some of the questions you might have and help you to identify your progress although don't compare yourself to others as people will heal at different rates. If you have any problems or concerns after this video please refer back to our website for our contact details. This video has been designed for patients who have been discharged from hospital with no special instructions and are walking with or without the use of walking sticks or elbow crutches. It is normal to experience pain after your surgery Don't be surprised if you have pain at night for the first six weeks. This is particularly because you'll be in a static position for a prolonged period of time and your hip will get stiff. Stiffness will also occur if you've been sitting for a long period of time as well so we advise you to be getting up every half an hour or so or changing your position to reduce this. You should find the amount of stiffness reduces over the first couple of months as the tissue heals and the swelling reduces. To manage your pain and stiffness it is important to continue to take your medication as it was prescribed. This will enable you to continue with your exercises to help with your recovery. If you have any queries or concerns please speak to either your GP or call us here at Porter Healthcare. You'll be seeing a nurse approximately two weeks after your surgery to check your wound. They will be looking for signs of infection which is unlikely but things to look out for would be the area around your wound becoming red and warm. If you have any concerns please speak to your GP or call us here at Horder Healthcare. If everything is okay then you can start massaging the area around your wound until the scar is completely healed and then you can massage the wound itself as well. Using the heel of your hands or your fingers with some E45 or vitamin E cream just massage gently. It is important to continue following your precautions for the first six weeks after surgery. This means to not allow your bottom to be lower than your knees when you're sitting in a chair and also don't lean past your knees in standing. The other precaution to remember is not allowing your legs to cross over that middle line. So imagine a line down your middle don't let your operated leg cross over at your ankles, at your knees and you also need to avoid lying on your good side in bed for the first six weeks. The third precaution to remember is not twisting in sitting and in standing in either direction. All of the exercises in this section should be done on the operated and non operated leg. Doing these exercises on the non operated leg helps to improve the strength and stability and balance around the operated leg. At this point I would like to introduce Joe. Joe is going to help us demonstrate some of the exercises we would like you to do following your total hip replacement surgery. Hip flexion standing using a table or chair for support for this exercise we're using a treatment couch slowly lift the operated leg up making sure not to go beyond the level of the hip. Feel the muscles working in the front of the thigh. Slowly lower the leg and rest. Do this exercise little and often throughout the day. Some of these exercises will cause some discomfort however they should not be too painful. Hip abduction. This exercise is designed to work the muscles on the side of the leg. Using support in front of you lift the operated leg out to the side. Make sure you lead with the heel and take the leg slightly back and behind of straight. Lift the leg as far as comfortable. Make sure not to swing the leg and keep the body still and upright. Do this exercise little and often increasing the number of reps as you progress through your recovery. Hip extension. Standing in front of a support take the operated leg back behind you Squeeze the bottom muscle as you do this. When doing this exercise make sure not to arch the back and also not to bend forward when doing this exercise. You may feel a stretch down the front of the thigh as you do this this is quite normal. Repeat this exercise little and often. Hip abduction strengthening. To improve the strengthening on the side of your leg walk along with your kitchen work surface exaggerating this leg lift to the side and then step together. Make sure you keep your body nice and upright when you're doing this exercise. It is a good idea to do this exercise in both directions to help both strength and stability of your operated hip. Sit to stand. Using a chair which ideally has armrests and is of a suitable height I. E. When sitting in the chair the hips should be above the level of the knees. Slowly stand from sitting. As you do this make sure not to bend too much at the waist use your arms for support and squeeze the buttock muscles as you stand up. During the early stages you may wish to put the operated leg slightly further forward this should make it more comfortable for you to stand from this position. As this gets easier try to put more weight through the operated leg as you stand up. If you can stand for me Joe. Also to make this exercise more challenging use less support from the arms. Once standing place the hands back onto the armrest and slowly lower yourself back into the chair. Doing this slowly makes the muscles work harder. Try to do this little and often. We recommend that you do this until the muscles in the thighs and the buttocks become tired. You may experience a little bit of discomfort when doing this. This is quite normal. Try to do this at intervals throughout the day. Ideally we would like you to get to the point whereby you can move from sitting to standing without using the support of your arms. The stairs are another way to develop the muscles around the hip replacement. Now while in hospital they would have taught you to do the stairs leading with the unoperated leg and to come down the stairs with the operated leg leading. This is to make it more comfortable for you to get around. However, we would like to strengthen up the muscles around the buttock and thigh of that operated leg. So, when you feel ready step up with the operated leg. Use the rail and stick to assist you with this. As you step up feel the bottom muscle and thigh muscle working as you step up with the operated leg. Again when you feel ready try coming down the stairs leading with the unoperated leg first. Use the rail and the stick to assist you in lowering yourself down. In time when you feel safe enough you should attempt to do the stairs normally I. E. Alternating the legs as you climb the stairs. During the early stages you can use the support of the rail to assist you. As you progress and get better try to challenge yourself by putting less weight through the rail. Ideally you should reach the stage whereby you don't need to use the rails. When you are discharged from hospital you would have been walking with either two sticks or two crutches. We are going to be using two sticks today for the demonstration. When you left us from hospital you were probably walking with a pattern of both sticks forward first then the operated leg and then the good leg as demonstrated here. Excellent. Would you like to come back to the beginning Jo? Some of you may find that you lapse automatically into a more of a marching pattern. This is absolutely fine if you do this but do ensure that it's opposite arm to leg that is moving together. Good. When you are ready you'll be able to progress down to one stick. Make sure you keep the one stick in the opposite hand to your operated leg. Then you can walk with the stick then the operated leg and the good one. When you are walking just make sure you're looking straight ahead and always thinking of your posture. The advice and exercises given to you up until this point should enable you to carry out your daily activities reasonably well however some of you may wish to aspire to higher levels of physical activity such as returning to sport or other demanding activities. In which case it may be appropriate for you to see a physiotherapist for a more tailored and comprehensive program. Otherwise a good alternative is to join one of the classes available at Horder Healthcare. These classes aim to condition the body but have the added benefit of working towards similar goals with people in the same situation as yourself. For more information on these classes please refer back to our website.