Many patients have requested
guidelines for rehabilitation following hip resurfacing
surgery. The following information has been compiled by
Frances Ihenacho, a qualified sports therapist, personal
trainer and post-op rehabilitation specialist -
www.jumpstarttrainingsystems.org
Rehabilitation after joint replacement
surgery will vary depending on the type of procedure, the
implant used, and the surgical approach used by the surgeon.
These factors can influence, for example, how quickly you
can put weight on your operated leg. Your surgeon will let
you and your rehabilitation team know exactly what regime
you should follow and what limitations you will have.
In general, most people get out of bed
with help on the day after surgery. Your physiotherapist and
sometimes an occupational therapist will teach you how to
exercise, walk, and carry out routine activities such as
dressing and cooking while you allow your joint to heal.
The following rehabilitation plan is
intended simply as a general guideline for hip resurfacing
patients which we hope will be helpful, but you must get
specific instructions from your surgeon as to the
appropriate rehabilitation regime he advises you to follow
after your operation.
Exercises for Post Hip-Resurfacing Operation
-
A Patient’s Guide
The most important thing to remember before
doing any exercises is that everyone’s recovery and
rehabilitation is different, so try not to compare your
progress with that of another. Those who were more
physically active, more flexible and had more strength
pre-op often appear to make more progress post-op, but this
is not important. What is important is that each individual
patient regains the confidence to get to a level of activity
and fitness that is compatible with his or her lifestyle and
desired physical ambitions. Not everyone will want to ride a
bike or go jogging, but for those who do, you can
realistically achieve those goals. Once you have the
stamina, stability, and muscular strength, the possibility
of leading a normal active life becomes a reality.
Here are six basic exercises I have put together which will
hopefully give you the confidence to regain good mobility
and strength after your hip resurfacing operation.
The Hips and the Muscles
Strengthening and re-training the muscles
around the hips is essential to normalising your gait and
stabilising your core-stability. Many patients report
‘strange feelings’ around the operation site, sometimes
numbness, soreness and/or a tingling sensation. This can be
a bit disconcerting and often stops patients from attempting
certain movements. In order to strengthen the muscles in the
hips, it’s important to engage the muscles mentally as well
as physically!
Some of the exercises listed can be done seated, some
standing and some lying down. Some are better done with the
aid of a Swiss-ball. All are ways of improving your
core-stability and in time will give you confidence to be
more active. Sometimes trying out the exercise on the
un-operated hip first is a good way to compare strength and
sensation and gives you an excellent gauge of your ability.
The Buttocks
Exercise 1
Work the buttock muscle by standing on your
un-operated leg. Move your operated leg backwards from the
hip, and, keeping it straight, squeeze the buttock as hard
as you can. Make sure the movement is controlled, (not
swinging the leg) keeping the rest of the body still. At the
same time as you are pushing backwards, think about
squeezing that buttock cheek as hard as you can. Repeat the
exercise initially 5-10 times per day, building up to 15-20.
Alternatively, you can do this one on
the floor as in Figure 2 or on the Swiss ball as in
Figure 3.
Figure 1
Figure 2
Figure 3
The Abductors
The outer thigh muscles are often weakened
by lack of movement when a hip-resurface is needed. Patients
often experience knee discomfort in the operated leg, and
performing the following exercise can strengthen the muscle
down the outside of the leg.
Exercise 2
Standing on un-operated leg, lift leg
sideways out from the hip, squeezing the outer thigh muscle.
Again, make it a slow, controlled movement, not swinging the
leg, nor moving any other part of the body. Repeat 5-10
times, again build up to 15-20.
Like the buttock exercises, these can be performed lying
(Figure 5) or leaning over the Swiss-ball (Figure 6).
Figure 4
Figure 5
Figure 6
The Adductors
The inner thigh must be exercised gently
immediately post-op. With all rehab exercises, it’s not a
wild, sweaty workout, just a gentle reawakening of muscles
and a feeling of progressive strength.
Exercise 3
Initially, this exercise is best performed
seated in a chair, using a ball or a rolled up towel between
the knees. Sit on a chair or on the Swiss-ball, with the
feet flat on the floor, knees at a 90 degree angle and the
back of the calves clear of the chair. Keep the back upright
and the stomach muscles pulled in tight. Squeeze the ball or
towel using the inner thigh muscles (Figure 7). Hold
for a count of 5 and then release.
Repeat 10-15 times, build up to 20.
Figure 7
The Abdominals
It’s important to strengthen the stomach
muscles, particularly the lower abs, as these are very
important to your core area. Sit-ups on the floor or on the
Swiss –ball are an excellent way to tone these muscles. When
working the stomach muscles, it’s important to think of them
shortening and trying not to let the natural arch in the
lower back disappear.
Exercise 4
Lying on your back, feet flat, knees bent.
With hands behind head with the elbows out wide, lift the
head and shoulders up at the same time, looking up at the
ceiling all the way through the exercise. Breathe out on the
way up and breathe in on the way down, trying not to let the
head touch the floor. Repeat 10-15 times and try and work up
to 25-30 per day.
Figure 9 shows the exercise on the
ball.
Figure 8
Figure 9
The Lower Back
Like the abdominals, the lower back muscles
provide another important support to your pelvic girdle.
This exercise should be done with care and attention,
thinking about tensing up the muscles at the base of the
back. Be careful not to fling the body upward or make any
sharp, jerking movements.
Exercise 5
Lower back extensions are good to per form
on the mat, but a better range of movement is found on the
Swiss-ball. As a beginner, lie flat on the floor face-down
and put the arms down by your side on the mat, or have the
one palm on top of the other, resting in the lower back.
Tuck the chin under by the chest and keep it there
throughout the exercise. Slowly raise the torso off the mat,
trying to get the chest off the mat and squeezing the lower
back muscles. Try to relax the buttocks and don’t forget to
breathe! Repeat 10-15 times, working up to 20.
When using the Swiss ball (Figure 11),
have your feet wide apart and flat against a wall surface
with the toes touching the floor. Legs should be straight
and the chest should be clear of the ball.
Figure 10
Figure 11
The Thighs
The fronts of the thighs often lose
strength after surgery and as these muscles need to be
strong to help you get walking again, strengthening them is
a good idea. This beginner’s exercise is good to do whilst
rehabilitating and can be done on a chair (Figure 12) or on
the Swiss-ball (Figure 13).
Exercise 6
Sitting with the body straight, turn one
toe up to the ceiling and try to extend the leg up as high
as you can from the knee joint. You should feel the tension
on the top of the thigh. Hold for a count of 3 and then
lower it, without touching the floor. Repeat 10 on each leg,
working up to 20-25 per day. To challenge the balance using
the ball, try not to let the back of the other calf touch
the ball whilst working the leg.
