Total Hip Replacement Exercise Guide

Total Hip Replacement Exercise Guide
This exercise booklet contains the approved exercise program for your hip joint
replacement. This booklet is only a guide and does NOT replace any advice or
instructions you may be given by your physiotherapist or surgeon.
Precautions After Surgery
The majority of the soft tissue heals in the first 12 weeks after surgery. During this time do NOT attempt
any exercise that has not been prescribed to you by a physiotherapist. Doing so may cause injury and
increases the risk of dislocation.
In order to return to an active lifestyle your hip will need to recover fully. It is important to take certain
precautions and exercise regularly to promote correct healing.
Safety Precautions (12 week MINIMUM)
•
Always avoid extremes of range of motion
•
When seated your knees should always be lower than your hips
•
Do NOT bend your hip past 90°
•
Use a raised toilet seat
•
Use a cushion when sitting in a vehicle
•
Always sit on a high, firm chair at the level of your knees or higher.
•
Do NOT lean forward from a sitting position to reach for items or put on shoes (if necessary, use a
long-handled shoe horn or reacher instead).
•
Do NOT twist your leg or turn your hip or knee
•
Move your feet to turn when you are standing. Do NOT twist your trunk
•
Do NOT sit cross-legged
•
When lying on your side in bed or turning over to do your exercises use a large pillow between
your legs
•
When lying on your back do NOT cross your ankles.
Note: ONLY do the exercises prescribed to you by your physiotherapist.
Doing these exercises daily will help Improve range of motion, increase muscle strength and increase
mobility. Make sure to write down the number in the exercise log at the back of the booklet. Unless
otherwise instructed, practice these exercises daily.
Pain Control
If swelling or pain increases for more than two hours after the exercise talk to your therapist and reduce
your activity. Continue to do most exercises. Medications, as prescribed by your doctor or pharmacist,
can be taken if pain becomes a problem.
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Walking
At first, avoid walking on uneven surfaces and slopes. Slowly increase your walking distance every
day, but do not increase by more than 20% in one day. Continue to use your walking aid until your are
advised to stop by your therapist and make sure to wear good, supportive footwear.
Back Stability
This exercise strengthens the muscles that
stabilize your back so that it is protected when
exercising your leg.
Transversus Abdominis (Lying Down)
Lie on your back with your knees bent and feet flat.
Tighten your stomach muscles by pulling your belly
button into your spine. Do not flatten your back.
Breathe normally.
Holdseconds
Repeattimes
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Range of Motion
These exercises help increase movement in the
hip joint.
Hip Flexion Heel Slides
Lying on your back, bring one knee up towards your
chest. Do NOT bend past 90°. You may use a towel
behind your thigh to help you.
90º
Repeattimes
Hip Abduction
Lying on your back with your stomach tucked in and
your legs straight, slide your operated leg out to the
side. Keep your kneecap and toes pointing to the
ceiling. Return to starting position.
Repeattimes
Hip Extension
Lying on your back with both knees bent and feet
flat, hold your unoperated leg up towards your
chest. At the same time slowly push your operated
leg into the bed.
Repeattimes
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Strength Exercises
These exercises will help improve your muscle
strength and protect your new hip joint.
Hip Flexion (Lying Down)
Lying on your back, slide one heel up and lift the
foot slightly off the bed (to~60˚ of hip flexion).
Holdseconds
Repeattimes
Hip Extension (Lying Down)
Lie on your back with a towel between your knees,
keeping both knees bent and feet slightly apart.
Tuck in your stomach, squeeze your buttocks and
lift your hips off the bed.
Holdseconds
Repeattimes
Knee Extension Over a Rolled Towel
Place a rolled towel or large can under the back of
your operated leg as shown. Straighten your knee
by tightening the muscles on the front of your thigh.
Push the back of your knee into the roll.
Holdseconds
Repeattimes
Add
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Strength Exercises
Hip Abduction (Standing)
Standing on the unoperated leg, keep your body
upright and your stomach tucked in. Hold on to
a counter top or other stable object for support.
Keeping your pelvis level, and your knee caps and
toes pointed forward move your operated leg
sideways. Do not lean sideways while lifting your
leg. Return your leg to the center.
Holdseconds
Repeattimes
Add
lbs of weight to ankle
Knee Flexion (Standing)
Standing on your unoperated leg, hold onto a
counter for support. Keeping your thigh in line with
your other leg, bend your operated leg up towards
your buttock.
Holdseconds
Repeattimes
Add
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Progression of Strengthening Exercises
Hip and Knee Flexion (Standing)
Stand on your unoperated leg, keep your body
upright and tummy tucked in. Hold on to a stable
object for support (e.g. counter top). Bend the hip of
the operated leg
Holdseconds
Repeattimes
Add
lbs of weight to ankle
Hip Extension (Standing)
Standing on your unoperated leg, lean your upper
body forward. Hold onto a stable object for support
and lift your operated leg behind you, keeping
your knee straight and squeezing your buttock.
Keep your knee cap and toes facing forward during
movement.
Holdseconds
Repeattimes
Add
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Progression of Strengthening Exercises
Hip Extension with Knee Bent (Lying Down)
Lying on your stomach over pillow, Bend your
operated leg at the knee. Tighten your stomach
muscles and buttock and lift your thigh off the bed.
Make sure your pelvis remains flat on the bed.
Holdseconds
Repeattimes
Hip Extension (Long Lever)
Lying on your stomach over a pillow, tighten your
stomach muscles and buttock. Lift your entire leg
up off the bed, making sure your pelvis remains flat
on the bed.
Holdseconds
Repeattimes
Add
lbs of weight to ankle
Lying on Side Hip Abduction
Lie on your unoperated side with a large pillow
between your thighs to prevent your top leg from
crossing over the midline. Bend the knee of your
operated leg making sure that your leg does not
rotate in or out and tighten your stomach muscles.
Slowly lift the leg up and off the pillow. Do not let
your hip roll back.
Holdseconds
Repeattimes
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Stretching Exercises
These exercises help flexibility in the muscles
around your hips. Make sure to always stretch,
slowly, after strengthening exercises.
Hamstring Stretch
Keeping a straight back, slowly straighten one knee
until you feel a stretch at the back of your thigh.
Holdseconds
Repeattimes
Calf Stretch
Stand and place the front of one foot on a 2-3” book.
Keeping the heel in contact with the floor, slowly
lean forward until you feel a stretch in your calf.
Holdseconds
Repeattimes
Quadricep Stretch
Lie on your stomach over a pillow. Put a folded
towel under your forehead and tighten your
stomach and buttocks. Using a towel around your
ankle, bend one knee to pull foot up behind you
until you feel a stretch in the front of the thigh.
Holdseconds
Repeattimes
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Balance and Advanced Exercises
These exercises challenge your body with
functional activities and improve your balance.
Stationary Bicycle
Make sure to adjust seat height so that the
operated hip does not bend more than 90°. Start
slowly and gradually increase the speed. Slowly add
resistance as you improve.
minutes
Balance (Early)
Standing with your legs apart and feet parallel and
holding onto a counter, if needed, transfer your
weight from one leg to the other. Progress until you
can stand on one leg for 10 seconds.
Repeattimes
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Balance and Advanced Exercises
Balance with Wobble Board/Pillow (Late)
Holding onto a wall or counter for safety, stand on
wobble board or a pillow. Try to keep your balance.
Holdseconds
Hip Abduction with Theraband (Sideways
Walking)
Secure the band firmly above both knees. Keeping
your hips straight and level and your toes pointed
forwards, tighten your stomach muscles and walk
sideways.
Repeattimes
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Balance and Advanced Exercises
Step up/ Step down (Sideways)
Start with both feet on the floor, holding onto a
counter or railing for support. Step sideways onto a
step with one leg, then follow with the other. Return
to the starting position. Make sure to do this slowly.
Repeattimes
Step Ups (Forward)
Stand facing a low step and hold onto the rail on
your unoperated side. Put the foot of the operated
leg onto the step and slowly step up. Slowly return
to the starting position. Progress to not holding the
rail.
Repeattimes
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Balance and Advanced Exercises
Wall Slides
Stand with your back against the wall, placing your
feet shoulder width apart and 6 inches away from
the wall. Slide down the wall, slowly bending your
knees (30-45° maximum), and slide back up the
wall.
Holdseconds
Repeattimes
Sitting to Standing from a High Chair
Sitting on the edge of a high chair lean forward and
slowly stand up without using your hands. Slowly sit
back down. Do not bend past 90°.
Repeattimes
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Other Exercises Recommended by your Therapist
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Sitting to Standing from a High
Chair
Wall Slides
Step Ups (Forward)
Step up/ Step down (Sideways)
Hip Abduction with Theraband
(Sideways Walking)
Balance with Wobble Board/
Pillow (Late)
Balance (Early)
Stationary Bicycle
Quadricep Stretch
Calf Stretch
Hamstring Stretch
Lying on Side Hip Abduction
Hip Extension (Long Lever)
Hip Extension with Knee Bent
(Lying Down)
Hip Extension (Standing)
Hip and Knee Flexion (Standing)
Knee Flexion (Standing)
Hip Abduction (Standing)
Knee Extension Over a Rolled
Towel
Hip Extension (Lying Down)
Hip Flexion (Lying Down)
Hip Extension
Hip Abduction
Hip Flexion Heel Slides
Back Stability
Exercises
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Exercise Log
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• 104-3551 Blanshard St. Victoria, BC V8Z 0B9 • tel: (250) 940-4444 • fax: (250) 385-9600