Getting fit for Total Hip Replacement surgery

If you have agreed with your consultant to have a total hip replacement, there are several things that you can start doing and organising before your operation that will improve your post-operative experience and help you to progress faster.

Pre-operative exercises

Strengthening the muscles around your hip, thigh and lower back prior to your hip operation will help your leg to recover much more quickly after the surgery and will make walking more comfortable and easier to do. It will also assist in improving the circulation to your hip and leg, enabling faster wound healing. Some of these exercises may be difficult or painful to do initially if your muscles are very weak, so start off gently, and gradually build up by increasing the range of movement and/or number of repetitions. If you are struggling with the exercises, find them painful or have other medical conditions making it difficult to perform them, you should seek the advice of a Chartered Physiotherapist.

Exercises Lying on a bed

Static Quadriceps - Tighten your thigh muscle pushing the back of your knee flat down on to the bed whilst keeping your foot at a right angle to your leg. Repeat 10 times each leg.

Straight Leg Raise - Tighten your thigh muscle to straighten your knee then lift the leg up several inches off the bed whilst maintaining the straight knee. Hold for 5 seconds then lower. Repeat 10 times each leg.

Inner Range Quadriceps - Place a thick rolled-up towel under your knees. Lift your heel up off the bed to straighten your knee fully, keeping the back of the knee on the roll. Repeat 10 times each leg.

Hip Abduction - Keeping your leg straight with your toes pointing up to the ceiling, slide your leg sideways as far as you can and back. Repeat 10 times each leg.

Hip Flexion - Slide your heel up the bed towards your bottom and slide back down again. Repeat 10 times each leg.

Gluteal Squeeze - Squeeze your buttocks tightly together, hold for 5 seconds then relax. Repeat 10 times.

Bridging - Lying with your knees bent up and feet flat on the bed, tighten your buttocks, thighs and lower abdomen and lift your buttocks well clear of the bed, hold for 5 seconds. Repeat 10 times.

Sitting Exercises

Knee Extension - Keeping your thigh still, lift your foot off the floor to straighten your knee, then bend it down again. Repeat 10 times each leg.

Hip Flexion - Lift your thigh off the chair to waist level keeping your knee bent, then lower back down. Repeat 10 times each leg.

Standing Exercises holding on to the back of a chair

Marching on the spot - Lift alternate knees to waist level. Repeat 10 times each leg.

Hamstring Curls - Lift alternate feet towards your buttocks feeling a stretch down the front of your thigh. Repeat 10 times each leg.

Hip Abduction - Keeping your knee straight and your foot and knee pointing forwards, lift your leg out sideways and back down to the floor. Repeat 10 times each leg.

Hip Flexion and Extension - Keeping your knee and back straight, gently and slowly swing your leg forwards and backwards. Repeat 10 times each leg.

Swimming is also an excellent exercise as it is non weight bearing and therefore reduces stress on the joints. You may be more comfortable using a straight leg crawl kick rather than breaststroke leg action.

A Chartered Physiotherapist can help guide you through these exercises. Many of these exercises are also routine post-operative exercises so familiarising yourself before your surgery will just make those first few times post operatively that much easier.

Trevayne Cox, Senior Physiotherapist, Central Health Physiotherapy, Springdene Clinic, Barnet

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