Hip replacement and Physiotherapy treatment

Your Doctor may advice hip replacement surgery for your affected hip joint if The conservative management fails to control your symptoms Severe pain in the hip which interferes with daily activities Walking going up and down the stairs, getting in and out of the chair is difficult. Severe joint degeneration has caused stiffness which affects your daily activities and cause limping.

Consult your Physiotherapist if you have been advice for a joint replacement surgery. Physiotherapist will assess and can come up with a treatment plan to help you to maintain the flexibility in the muscles and joint and gentle strengthening exercises to improve the muscle strength. These exercises will help you to recover faster in your post operative rehabilitation phase.

Post operative Physiotherapy

Your Physiotherapy treatment usually starts on the day of surgery while you are in the hospital and ideally has to continue even after your discharge from the hospital till you attain your functional goals and full strength in your legs. Your hospital Physiotherapist will make sure that you do some early bed exercises and will get you back on your feet.

Following your discharge form the hospital your rehabilitation period can be from 3 to 6 months depending on the progress. Your exercise has to be monitored by a Physiotherapist and progressed appropriately to achieve functional recovery after your hip replacement surgery.

What to expect from out patient Physiotherapy treatment?

Your Physiotherapist in the out-patient clinic will be able to help you with:

• Necessary advice regarding precautions and contraindications of your surgery.
• Managing pain
• Specific exercises to strengthen your hip and maintain the range of movement depending on the phase of healing.
• Exercises to improve your balance and posture.
• Progress your walking, ability to do stairs and help you to return to normal activities or work.
• Gait training and exercise to avoid limping and dropping of your hip while on stairs.
• Improving your exercise tolerance and endurance with appropriate aerobic activities.
• Helps you to create a weekly activity to improve your strength, balance, endurance and flexibility

Hip precautions

You have to follow your surgeon’s instructions regarding any specific precautions or weight bearing instructions following the surgery. These precautions depend on the type of prosthesis used and surgery for e.g. a revised hip replacement surgery.

Some general precautions following hip replacement surgery are:

1. Do not bend at the hip more than 90 degrees-some examples are do not reach past your knees in sitting, do not raise your knees higher than hips, do not sit in low chairs and toilet seats or do not lean far forwards while trying to get up from the chair.
2. Do not cross your operated leg across the middle of your body –   Do not cross your legs in sitting, standing or lying.
3. Do not twist your operated leg, step around with small steps on the spot.
   
4. If you are using a walking stick, always use the stick in the hand opposite to your operated leg.
5. Take care to avoid accidental falls which could damage your new hip especially in the bathroom and kitchen.

Once you complete your 6-8 weeks review with the surgeon, you may be allowed more movement in the hip. It is always important not to force the movement beyond 90 degrees or into any extreme position. Avoid any movement where you have to plant your foot and pivot or twist.

What to expect from your new hip replacement?

Majority of patients achieve a pain free walking and return to low impact sports. Activities requiring extreme range of motion has to be avoided to prevent dislocation of hip. Use the walking aid till you stop limping.

Normally you will be able to walk unaided within four to six weeks and may be able to resume normal activities after 3 months. You will be able to drive after about 6 weeks, and return to work is in about 12 weeks after the surgery, but subject to advice from the surgeon. Return to work will also depend on the nature of work and may need graduated return and activity modification in case of physically demanding jobs.   

Full recovery can take up to one year and it is important to build up your strength based on your activity level and goals. Balance and coordination exercise help to avoid the risk of falls.

Weight management and diet is important as excessive body weight can increase the wear and tear of the new hip.

How to book an appointment with a Physiotherapist after your hip replacement surgery ?

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. You can call in any of these clinics to book for a same day appointment with a Physiotherapist. Most of the time we can arrange your initial visit on the same day in a location which is near to you.

Your initial appointment will be a one to one 40 minutes session with a Physiotherapist which includes initial assessment, education and treatment. Physiotherapist will come up with a treatment plan based on the post operative precautions and your goals. You will have 30 to 40 minutes of follow up, which will be usually 2 to 3 sessions a week depending on the factors identified on initial assessment, treatment plan, stage of healing and goals. You will be given home exercise programme with specific exercise to promote recovery. You need to take care when you start any new Physical activity. It is always wise to start at the lowest level and progress slowly and your Physiotherapist can guide to progress your activity.    

Contact your physiotherapist if even if you had the surgery long time ago and still you are struggling with your normal activities or leisure activities. Your Physiotherapist will be able to help you with specific activities or exercise which is best for you at the time and can always monitor the progress to work towards the goal.