GETTING READY FOR TOTAL HIP REPLACEMENT

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1 GETTING READY FOR TOTAL HIP REPLACEMENT Pre-Op Exercises for a Better Recovery

2 Your Recovery Begins Now Even if your hip replacement surgery is weeks or months away, start getting ready now. People who are well-prepared tend to have a smoother recovery. Exercising before surgery (often called prehab) gives you the strength and skills you ll need after surgery. How to Prepare Your healthcare team will help, but getting ready for surgery is up to you. Use this booklet as a guide. You need to: Exercise your leg muscles. Strengthening these muscles will help you use your new hip during and after healing. (See pages 4 through 6.) Strengthen your arms. Stronger arm muscles make using a walker, crutches, or a cane easier. (See page 5.) Set up your home. If you prepare your living area now, getting around will be easier and safer when you return from the hospital. (See page 7.) Your Team These people will help with your preparation, surgery, and recovery: A physical therapist (PT) teaches you exercises to build up your strength and help you recover. The PT also helps you learn to use the cane, crutches, or walker that will help you get around during your recovery. An occupational therapist (OT) teaches you new ways to do daily activities while you heal. An orthopedic surgeon performs the surgery and oversees your treatment. A nurse or case manager coordinates your care. 2

3 Your New Hip Understanding the hip joint can help you see how exercising ahead of time aids your recovery. During surgery, your damaged hip joint will be replaced with an artificial joint (prosthesis). This can reduce pain and stiffness. In time, you should be able to return to activities that have become painful. By starting now, you might reach that goal sooner. Damaged Hip Damaged cartilage Inflamed joint Pelvis Socket Ball The round head of the thighbone (ball) fits into a socket in the pelvis to form your hip joint. Normally these bones are lined with smooth, stress-absorbing cartilage. Problems such as osteoarthritis or inflammatory arthritis can make the cartilage wear down. Then the ball and socket rub together, resulting in pain and stiffness. Damage can also be due to bone problems, such as a fracture that didn t heal properly or necrosis (bone decay). Artificial Hip Ball Socket The artificial hip has a ball and socket made of plastic, metal, or other strong materials. These replace the damaged parts so the joint can move without painful rubbing. Until fully healed, your new hip may have limited movement. To protect it, your surgeon may tell you to avoid certain movements. 3

4 Leg and Arm Exercises Leg and arm exercises help build strength you ll need after surgery. Talk to your PT or surgeon if you re not sure how to do an exercise safely. Be sure to follow any special instructions you re given. Unless you re told otherwise, do each exercise at least 5 to 10 times, twice a day. Leg Exercises These strengthen the muscles that support your hip. Doing them now will help you move more easily after surgery. Lie down on a bed to do these exercises. Exercise both legs equally unless you re given other instructions. Quadriceps Sets Tighten the muscle above your kneecap to press the back of your knee into the bed. Hold for 5 seconds, then release. Straight Leg Raises Bend one leg with your foot flat on the bed. Keeping the other leg as straight as possible, lift it about 1 foot off the bed. Hold for 3 seconds, then slowly lower the leg to the bed. Abduction/Adduction Start with your feet together. Slide one leg out to the side as far as you comfortably can. Keep your toes pointed toward the ceiling. Move your leg back to its starting position. Heel Slides Slide your heel up the bed toward your buttocks as far as you comfortably can. Hold for 3 seconds. Then slide your heel back to its starting position. 4

5 As you exercise, be sure not to hold your breath. Gluteal Sets Squeeze your buttocks together tightly. Hold for 5 seconds, then release. Arm Exercises These build upper body strength. This will help you use your cane, crutches, or walker. It will also help you when getting up from a chair or bed. Exercise both arms. Use small weights only if directed by your PT or surgeon. Biceps Curls Sit up straight. Keep your elbow close to your body and your wrist straight. Bend your arm, moving your hand up to your shoulder. Then slowly lower your arm. Triceps Curls Sit and lean forward from the waist. Bend your elbow so your forearm is parallel to the floor. Straighten your elbow as you extend your arm behind you. To Help with Circulation After Surgery Ankle Pumps After surgery, these help reduce swelling and prevent blood clots. Start practicing now. To do ankle pumps, slowly point and then flex both feet. Seated Press-Ups Sit in a sturdy chair with arms. With your palms flat, press down on the armrests to lift yourself up from the chair. Hold for 5 seconds. Slowly bend your elbows to ease back down. 5

6 Improving Fitness Improving fitness with daily exercise will strengthen muscles that support your hip. It also helps you maintain a healthy weight, which can reduce stress on the hip. Before starting any exercise program, talk to your surgeon or primary healthcare provider. Low-Impact Exercise To improve fitness without putting too much strain on your hip, make lowimpact exercise part of your daily routine. Safe examples include swimming, water aerobics, walking, using an elliptical machine, or riding a stationary bike. It s normal to have some hip discomfort during exercise. But stop if you have increasing pain or swelling. If arthritis is an issue, ask your healthcare team how you can manage pain during exercise. Try Pool Walking In the water, your body feels weightless. This gives you a gentle way to exercise that may be more comfortable than other activities. Water exercise also helps improve coordination and balance. In a pool therapy program, a PT works with you in the water. Or, you can try pool walking on your own: In a level area of the pool, stand in waist-deep to chest-deep water. Walk at a comfortable pace. To work different muscles, walk forward, sideways, or backward. Ask your PT how long you should spend for each pool-walking session. He or she can also give you pool safety tips. 6

7 Preparing Your Home Preparing your home before surgery will make it a safer and more comfortable place to recover. Do as much as you can now, with help from friends and family as needed. An OT may visit your home before or after surgery to help you set up. Setting Up Your Home Stock up on items you ll need, such as toiletries, medications, and foods that are easy to prepare. Plan not to use the stairs more than once a day. You may want to set up a sleeping area downstairs. Have a railing installed on the staircase, if needed. Clear the floor of tripping hazards, such as throw rugs or pet toys. Move electrical cords out of the way or tape them down. Add pillows to low chairs so you don t have to bend too much to sit. Store food and supplies so you can reach them easily. Keep items you use often, such as the TV remote, computer, and phone, within easy reach. Setting Up the Bathroom Get a commode chair or elevated toilet seat. A bath bench or shower chair may also be recommended. Have a handheld showerhead and grab bars installed in the tub or shower. Get a rubber-backed bath mat to prevent slipping on a wet floor. Buy a long-handled sponge and liquid soap. These help keep you from needing to bend while showering. 7

8 Your Prehab Exercise Program Your healthcare team will help you get ready for surgery, but doing the work is up to you. Get help filling out the chart below. Then make time each day to do the exercises as instructed. If any exercise causes sharp or increasing pain, dizziness, shortness of breath, or chest pain, stop doing it and check with your healthcare team. (Repetitions/Sessions per day) Week 1 Week 2 Week 3 Week 4 Quadriceps sets / / / / Straight leg raises / / / / Abduction/adduction / / / / Heel slides / / / / Gluteal sets / / / / Biceps curls / / / / Triceps curls / / / / Seated press-ups / / / / Ankle pumps / / / / Also available in Spanish TAKE OUR PATIENT SURVEY. Help us help other patients. Please visit to provide your feedback on this booklet. This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. 2014, 2016 The StayWell Company, LLC All rights reserved. Made in the USA

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