Recovering from hip replacement surgery

A hip replacement can be daunting and involves some serious recovery. How can you be sure to get back to what you love doing relatively quickly, and avoid some of the common mistakes people make?

My physiotherapist team and I have seen the good, bad and ugly in how people approach the surgery and recovery. The differences are huge — sometimes it’s an attitude thing, sometimes people don’t listen to their doctors or take advice, but sometimes people make mistakes because they don’t know any better.

In hip surgery recovery, the small things mean a lot. How can you ensure you are on the good side of the equation, and recover better?

1. Always follow surgeon’s orders: Very important! Most times people think that they are okay because surgery went so well and they become lax about the surgeons/physios orders.

2. Keep the joints moving: Always within tolerable levels of pain.

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3. Get physio four to six weeks before the hip replacement: Our stats have shown that pre-operation physiotherapy improves post-op recovery time by 25-75 per cent. Make sure the physio has given you an exercise program, a plan to maintain the range, mobility and control you already have, and a post-op plan of attack.

4. Walking is vital: Get to this as quickly as possible. Walking will seem stiff and robotic in nature at first — think Frankenstein’s monster! Try standing in front of a mirror and marching on the spot — bending at the hips and knees to accentuate the movement will eventually reduce this robotic nature of walking (but avoid lifting your knee above 90 degrees). Eventually, no more Frankenstein’s walk!

5. Avoid the following movements: Some movements may put the hip in danger of dislocation — in particular: don’t bend your hip up too far or lift your knee too high — nothing above 90 degrees (take care in putting on shoes and socks); don’t cross your operated leg over your non-operative leg, even when lying down (many people use a special wedge to help keep their legs separated while sleeping); avoid walking pigeon-toed (internal rotation of the hip), your toes should be kept straight ahead or slightly rotated outwards when sitting, standing, or lying.

6. Always manage pain: Use pain medication where necessary. Fighting through the pain only slows your healing process. If pain levels are down the healing process is faster. But it can sometimes take six to 24 weeks to reduce pain levels. 

7. Look for improvement: Your walking, balance, ability to climb stairs and other movement should improve every three to four weeks — if there’s no improvement in this time see your specialist, physio or medical practitioner. 

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8. Do not be disheartened: Some weeks are faster than others. Some weeks seem slow because you progressed so well during periods after your operation. Always compare your progress to the very beginning. There will be the ups and the downs but on average you should be better than when you had the hip surgery.

9. Always get physio: Always. No matter how well you are doing. This area of surgery is deep and the hip is a complex area. It’s important your hip is assessed and checked to plan the optimum recovery. Good therapists will give you pain management strategies, an exercise program, address your biomechanics, range, strength and core. It’s a whole body assessment and treatment plan that will allow the hip area to heal. Just working on the hip will not give you the best results — the hip is central, with many areas ‘connecting’ to it. All other areas must also be addressed.

10. Hydrotherapy is great for improving healing: Being in chest-level water takes 70 per cent of the weight off. This allows for the biomechanics to work better. Muscles work under less load, joints move with less stress, core control improves and sets you up for strength and conditioning once you reach full functional levels. It does take time though – about 6 to 24 weeks.

11. Keep positive: only worry if you’re professionals are worrying. Till that time keep taking the steps to recovery and doing the little things — they add up to a lot!

Have you or a loved one undergone hip replacement surgery? What tips do you have for someone who might be undergoing such an operation?