After a hip replacement, every exercise you do in your PT sessions will target one or more of the following objectives:
- Regaining your balance on your new hip
- Strengthening your glutes
- Reaching the full range of motion in your new hip
Regaining balance
You might be unsteady after surgery. Balance is critical to getting you back home and resuming your life. So balance will be the first order of business with your physical therapist.
When you’re ready, your therapist might have you stand on one leg (usually starting with 20 to 30 seconds to a minute and progressing to longer periods) near a counter so that you can grab it if you need support.
You may also try what’s called a three-way stance: You hold onto a counter or your walker, then extend the leg behind you, to the side, and then to the front. With your therapist’s supervision, you might march in place or do mini-squats.
“It’s important to do the squats with your therapist to make sure you aren’t bending too deeply at the hips,” Dr. Hankenson says. “You’ll have restrictions around range of motion at first.”
Strengthening your glutes
Your glutes—the group of muscles that form your buttocks—are the main muscles that support your hips and the movements that come from them. You’ll need to strengthen them in order to be stable on your new hip and use it to its fullest potential.
“Strengthening the glutes may help with pain reduction and potentially reduce future injury as they redistribute forces across the joint,” Dr. Hankenson says.
Your physical therapist will provide specific glute-strengthening exercises that are safe and appropriate for you. One option may be to lie on the floor and squeeze, hold, and release your glutes several times.
Increasing range of motion
Range of motion refers to the full movement potential of a joint; it’s the distance and direction a joint can move between flexed and extended positions. After a hip replacement, the range of motion you use will increase gradually over the first few weeks. It’s important to do only the prescribed range-of-motion exercises while your hip is still healing to reduce the risk of dislocation.
“Your doctor’s range-of-motion precautions may include not over-flexing at the hip, not crossing your legs, and using a pillow between your legs when sleeping on your side,” Dr. Hankenson says.
Make sure you understand what you should and should not do as part of your at-home exercises and day-to-day activities. Also check with your physical therapist to make sure you have the proper form when you do your exercises.
“You will have to take extra care, following your therapist’s or surgeon’s instructions, to reduce the risk of hip dislocation,” says Dr. Hankenson. “This can happen when doing high-impact activities [before you’re cleared to do so] or not following range-of-motion precautions given by your doctor.”
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