Hip Replacement: Rehabilitation after Surgery

Right after surgery the range of motion that is safe for your new hip is limited. Your hip will need special care until you have completely healed. Your health care provider and therapists will work with you to develop a plan for healing and rehabilitation. This plan will help you get stronger and improve your range of motion. You will use a walking aid, such as a walker or crutches, after surgery. Your provider will probably prescribe pain medicine. Medicines or therapy may also be prescribed to prevent blood clots.

As you recover from the surgery, you will be able to move your hip more easily and fully, and less painfully.

What treatments will help my hip heal?

Rest

Rest is an important part of treatment after surgery. Try to avoid movements and activities that increase your pain. If you are having pain with an activity or movement, stop. Be sure to use your crutches or walker as instructed by your health care provider. Put only the amount of weight on your leg that is approved by your provider.

Heat

Use heat only if your health care provider tells you to do so. Use heat on the sore area for 15 to 20 minutes up to 4 times each day. A moist hot pack, a heating pad, warm shower, or bath help to relieve pain. Heat makes blood vessels get larger, increasing the blood flow. The increased blood flow helps flush away chemicals that cause pain. It also helps bring in healing nutrients and oxygen. It's not a good idea to sleep with an electric heating pad at night.

Ice

Use cold packs or ice bags on the sore area for 10 to 15 minutes up to 4 times each day. Ice makes blood vessels get smaller, decreasing the blood flow. This helps control inflammation and the pain it causes. You can use cold packs, ice bags, or ice massage. Put a damp towel between the cold pack and your skin.

Exercise

Improving your balance, range of motion, and strength can help you control pain and symptoms. It can also help you avoid future problems. Your physical therapist will carefully instruct you on the proper way to do your exercises so that you strengthen your hip without damaging it. Some of the exercises you learn may include modified knee raises, slowly moving your leg to the side, slowly moving your leg to the back, and thigh stretches. Do your exercises as prescribed. Follow the weight-bearing restrictions that your health care provider gives you.

Occupational Therapy

An occupational therapist will help you learn how to modify your daily activities so that they are safe and comfortable for you. Your therapist can show you how to:

• get in and out of bed without straining your hip
• use a shower bench or chair to bathe
• use a long-handled shoehorn to put on and take off shoes
• get in and out of a car without twisting your hip
• use a walker.

What can I do to help my hip heal?

• Follow the treatment plan prescribed by your health care provider and physical therapist.
• When sitting, keep your feet about 6 inches apart. Don't try to cross your legs.
• When getting up from a chair, slide toward the edge of the chair and then use your walker or crutches for support.
• When lying in bed, place a pillow between your legs to keep the joint in proper alignment.
• Use a special abductor pillow or splint to keep your hip in correct alignment.
• Use an elevated toilet seat to keep your knees lower than your hips when you sit on the toilet.
• Wear well-fitting flat shoes.
• Don't leave electric cords around on the floor because you might trip over them. Arrange furniture so you don't bump into or fall over it.
• Have nonslip floors. Avoid wet floors. Don't use area rugs, which you could trip over.
• Install grab bars in your bathroom. Put nonskid tape in your bathtub and shower.
• Make sure that stair treads and handrails are firmly in place.
• Use a cane or walker for as long as your health care provider advises.
• Try to exercise daily, according to the advice of your health care provider or therapist. Once you have healed, walk a mile a day if you can.
• Maintain a healthy weight for your height.
• Ask your health care provider when you can resume sexual activity and if you should avoid certain positions to protect your new hip.

What positions or activities should I avoid?

Your new hip joint has a limited range of movement. You will need to take special precautions to avoid displacing the joint, including:

• Avoid crossing your legs or ankles whether you are sitting, standing, or lying.
• Don't bend your hip more than 90°.
• Avoid chairs that are too low. When sitting, keep your knees below the level of your hips. You may sit on a pillow to keep your hips higher than your knees. Do not sit in chairs that lean back too far, since getting up from these chairs can cause problems in the hips.
• Avoid climbing, heavy lifting, and unusual vigorous physical activity. Do not use step stools or ladders to reach high places. Get help when you need it.
• Avoid bending over at the waist. Use a long-handled shoehorn or a sock aid to help you put on and take off your shoes and socks without bending over. Special devices may be helpful for reaching or grabbing objects that are too high or too low for you to reach easily.
• Avoid wearing high heels and sandals with light straps. Avoid shoes with soles that are too slippery or too sticky, such as some crepe or rubber soles.
• Do not turn the leg that is attached to your new hip inward (pigeon-toed).

Avoid activities that put a strain on the surgical area. If you feel pain, stop or change what you are doing. During your activities, let pain guide your decisions about what you do.

When should I call my health care provider?

Call your health care provider if:

• You have a lot of pain.
• You notice your calf, thigh, or hip is unusually swollen, warm, or red.