Hip Resurfacing with Precautions Therapy Resources xpe045 (4/2015) AHC
Hip Resurfacing Home Exercise Program - Phase I 1. Breathing Exercises Exercise can be done while sitting or lying down. Action: Place your hands directly below the V formation of your ribs. Take a slow deep breath in through your nose. Keep your neck and relaxed. You should feel your stomach push out against your hand. Exhale slowly through your mouth with pursed lips, you should feel your belly move inward as you exhale. 2. Ankle Pumps Exercise can be done while sitting or lying down. Action: Pull foot up and then point foot down as far as possible. 3. Quad Sets Action: While lying down, tighten the muscles on the top of the thigh and hold for 5 seconds. Relax and repeat. 4. Gluteal Sets Exercise can be done while lying down on back or stomach, sitting or standing. Action: Squeeze buttocks together and hold for 5 seconds. Relax and repeat. 5. Heel Slides Action: While lying down, slowly bend knee, sliding heel up towards buttock. Do not lift heel from surface. Slowly return to the starting position. (May need assist from another person or a towel to preform this exercise.) 6. Knee to Chest Stretch Action: While lying down and with hand behind knee, pull knee up towards chest until comfortable stretch is felt in the back of the hip. Continued X34245 (9/2014) AHC Hip Surgery
Hip Resurfacing Home Exercise Program - Phase I, Page 2 7. Terminal Knee Extension Action: Lie down. Place rolled towel under knee. Slowly lift foot up by straightening the knee as far as possible. Hold for 5 seconds, then return to starting position. 8. Supine Hip Abduction Action: Lie down. Keep knees straight and toes pointed up to the ceiling. Slide involved leg out as far as possible and return to the starting position. (May need the assist of another person for this exercise.) If your physician has prescribed hip precautions, place a pillow between your knees as shown. 9. Bent Knee Fall Out Action: Lie down. Keep the non-surgical leg straight and position the surgical leg with foot on floor and knee bent. Put hands on pelvis to monitor motion. Gently let the bent knee fall out to the side. Do not force additional movement. The back and pelvis should not move. Return to starting position. 10. Knee Extension Action: While sitting, slowly lift foot as you straighten knee. Hold knee straight for 5 seconds, then slowly return to starting position. 11. Modified Straight Leg Raise Action: While lying on your back, rest on your forearms. Tighten the muscle on the front of your thigh, then lift your leg 8 to 10 inches from the surface, keeping your knee locked. Slowly return to the starting position. 12. Sitting Push-Ups Sit near the front of a chair that has armrests. Place hands on the armrests and bend forward from the hips. Push with your arms and lift the weight of your body halfway to a standing position. Your feet should stay on the floor. Don t let your spine round forward. Keep chest lifted up to prevent breaking hip precautions. Hold for a count of 3. Slowly lower body back to the starting position using the arms. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X34245 (9/2014) AHC Hip Surgery
Hip Resurfacing Precautions Follow these precautions at all times. Consult your surgeon for when you no longer have to follow these restrictions. Sitting Choose a tall chair with firm seat and arm rests. Avoid soft, low chairs. DO Correct Sitting: Keep your back straight and your knees level with or below your hips. Knees should not be higher than your hips. Do sit on tall toilet seat. A toilet riser may be needed. Do sit with both feet on the floor, keeping your knees 6 inches apart DO NOT Do not bend forward at waist when sitting down or standing up. Do not bring your knee to your chest. Do not sit on low toilet or chair.. Do not cross your legs or ankles. Do not sit with your knees turned in Continued X34250 (09/2014) AHC Hip Surgery
Hip Resurfacing Precautions, page 2 Standing DO Do stand with toes pointed forward. Do use a device, such as a longhandled reacher, to reach down to pick up items off the floor. Do move your feet first to turn your body. DO NOT Do not stand with toes turned in. Do not cross legs while standing. Do not bend over from the waist.. Do not twist your upper body with feet planted Continued ' X34250 (09/2014) AHC Hip X42028 (12/10) AHC Osteoporosis Program Surgery
Hip Resurfacing Precautions, page 3 Lying Down DO When lying on your back, keep legs apart with 1-2 pillows between knees and toes pointing up. How to roll: 1. Lie on your back. 2. Bend both knees. 3. Put two pillows between your knees. 4. Roll like a log onto operated side. 5. To roll back, reverse process. DO NOT Do not lie with legs turned in. Do not lie with legs crossed. Do not pull blankets up like this. Do not lie without a pillow between legs. Do not lie on side without pillow between legs. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. Continued X34250 (09/2014) AHC Hip Surgery ' X42028 (12/10) AHC Osteoporosis Program
Bed Transfer with Hip Precautions Lying down 1. Sit at edge of bed. Extend surgical leg out in front of you. 2. Support your upper body with your arms. Slightly lean back and lift your surgical leg onto the bed without bending forward past 90 degrees. 3. Lift your non-surgical leg onto the bed. 4. Using your elbows and forearms, lean back and slowly lower upper body down onto the bed. X32639 (3/2014) AHC Continued Transfers/Total Hip Replacement
Bed Transfer with Hip Precautions, Page 2 Sitting up 1. Prop yourself up on your forearms and move upper body forward without bending past 90 degrees. 2. Swing your non-surgical leg off of the bed. 3. Swing your surgical leg off of the bed. Allow your knee to relax. Do not hold it out stiff. Remember your hip precautions: Do not bring your surgical leg across the midline of your body, and keep your surgical leg in line with your hip. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X32639 (3/2014) AHC Transfers/Total Hip Replacement
Adaptive Equipment Dressing: Hip Precautions You may find everyday tasks, such as dressing,may be difficult and will require some thought and preparation following your surgery. By planning ahead and being prepared, you may find these tasks more manageable. The following suggestions and tips may be helpful. Dressing Gather all necessary articles of clothing and equipment and place next to where you will be dressing. Sit on the edge of the bed or in a chair. Start by dressing your feet using a sockaide. Do not bend to reach your feet or cross your legs. For pants and undergarments, dress the surgical leg first. Use a long reacher or dressing stick to hold garments down by your feet. Pull the clothes up with the stick until you can reach the waistband with your hand. Do not lean forward if you have hip precautions. Dress the other leg, using the same technique. Stand with walker for support and pull over hips. To undress, use the reacher or dressing stick to push garments down and over your feet. Undress the non-surgical leg first, followed by the surgical leg. Do not lean forward. Put on shoes using a long-handled shoehorn. Elastic laces are available to make slip on shoes out of tie shoes. To take off shoes, use a dressing stick, reacher or long-handled shoehorn to push off. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24518 (3/2014) AHC Adaptive Equipment/ADL
Recommended Adaptive Equipment Equipment Purpose Reacher Dressing Stick Sock aide To assist with lower body dressing For picking up items beyond your reach A long rod with attached hook to assist with lower body dressing To assist with applying socks when unable to reach Long handled shoe horn Long handled sponge Leg lifter To assist with applying shoes when unable to reach To assist with following precautions that limit bending Longer sponge that is beneficial after back or hip surgery, in order to reach lower legs during bathing To assist with getting legs into and out of bed Extended tub bench Oversized chair that extends over the tub Used when unable to safely step over the tub Shower chair with or without back Used during showering when unable to safely stand for a length of time Toilet riser with handles Toilet riser without handles Commode Other Elevated toilet seat that rests on toilet Grab bars added for additional support during transfers Elevated toilet seat Beneficial after back or hip surgery Adjustable toilet seat with grab bars Portable can be used throughout the home Can also be placed over bathroom toilet Items can be purchased at most pharmacies or medical equipment stores. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X44248 (3/2014) AHC Adaptive Equipment
Toilet Transfer Following Hip Surgery After your surgery, you may find it difficult to complete daily tasks such as toileting. The following suggestions and tips may be helpful to you. Toileting 1. Use the equipment recommended by your therapist(s). 2. Back up to the toilet with your walker until you feel the toilet on the back of your legs. 3. Extend your surgical leg out in front of you. 4. Reach back for the grab bar, toilet seat, and/or armrests and lower yourself to the toilet. 5. Bend your hip and knee on your non-operated leg as your are sitting down. 6. When getting off the toilet, extend your surgical leg out in front of you. 7. Push up from the toilet seat or armrests. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24520 (Rev. 4/2014) AHC Transfers/Total Hip Replacement/Total Knee Replacement
Tub Transfer with Hip Precautions You may find everyday tasks, such as using the bathtub,may be difficult and will require some thought and preparation following your surgery. By planning ahead and being prepared, you may find these tasks more manageable. The following suggestions and tips may be helpful. Using the tub transfer bench Place rubber bath mat outside the tub and non-slip mat inside the tub to prevent falls. Attach grab bars to the side of the tub to help with balance. DO NOT use towel bars. Back up toward the tub until you feel the bench with the back of your legs. Extend surgical leg out in front of you. Reach for the back of the shower bench. Carefully sit down on the bath seat. Lift legs one at a time over the side of the tub and turn to face the faucets. (DO NOT bend your hips past 90 degrees if one was replaced.) Stand to turn on faucets to avoid reaching forward and bending at the waist. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24521 (3/2014) AHC Transfers / Total Hip Replacement
Standing Tub Transfer After Hip Surgery 1. Align walker next to tub and use wall, sink or grab bar to support yourself. 2. Step into tub with non-surgical leg first. 3. Slightly lean forward and swing surgical leg behind you over the side of the tub. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X32652 (4/2014) AHC Transfers/Total Hip Replacement
Car Transfer You may find everyday tasks, such as getting in and out of a car, to be a little harder after your surgery. By planning ahead and being prepared, you may be able to manage these tasks better. The following may be helpful. Preparation tips for caregivers Place firm pillow on seat to make it higher. Use a slick pillow cover or a garbage bag to make sliding easier. Park away from curb. Move seat back and recline. Stand by to assist. Getting into car Back up to car Tuck head down and place hand on back of car seat for support while sitting down. Use only unaffected leg to push up and back onto seat. Caregiver assists as needed. Slowly swivel around. TIP: Wear smooth clothing to make this easier. Once sitting place a pillow between knees. Fasten seat belt and keep back reclined. Special precautions Keep legs apart. Avoid twisting affected leg. Follow hip precautions if needed. The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24522 (3/2014) AHC Transfers