For a total hip replacement, it’s very important to know, and abide by, your precautions after surgery. Listen to your surgeon and physical therapist and do what they tell you to do because they are the most familiar with your particular situation and know the things you should do to recover as quickly as possible. Always check with them first before doing any rehab or recovery exercises.
There are three big precautions for a total hip replacement with a posterior approach. These three precautions are don’t bend past 90 degrees of hip flexion. So that means no bending down to tie your shoes or pulling your knee up towards your chest to put on socks. The next one is no hip adduction. This is crossing your leg across your body, like crossing your leg over your knee. The last one is no hip internal rotation, which is turning your foot inward. All of these put a lot of pressure on where the surgery site is and where the muscles are very weak, so they are important to follow.
Now I will show you some isometric exercises you can do very soon after your surgery. The first exercises are quad sets. Sit in long sitting with your legs straight out in front of you. If you want, put a rolled towel underneath your knee to give yourself a target. Then squeeze your knee down into the roll towards the ground. Hold it for 3 seconds, and do ten of them.
Now is a hamstring set. Bend up your knees in a hooklying position. Push your heel down into the ground and hold it for 3 seconds, do this 10 times.
Then you will do glut or butt squeezes. You are basically trying to tighten your buttocks muscles, almost like if you have to go to the bathroom, and you are trying to hold it. Start off with 10 of these with a 2-3 second hold.
The next two are hip adductor and abductor isometric exercises. First take a ball or pillow folded in half, and put it between your knees. Squeeze into the ball and hold for 3 seconds, repeat 10 times. Then take a belt and wrap it around your thighs just above your knees. Push outwards toward the belt like your legs are opening up like a clamshell. Hold for 3 seconds, and repeat 10 times.
Then you will do an ankle pump. You can prop your ankle up on something if you want, but keep your heel free to move around. I am using a roll, but you can just hang your foot off of the bed or stool. You are going to pull your toes up at your ankle, and then push down like you are pushing on a pedal. This is dorsiflexion and plantarflexion. It works as a natural pump to get the fluid and inflammation out of the leg, so you can do this several times a day. It can also help prevent DVTs, so this is very important.
Finally, you want to focus on the way you walk. Getting back to a normal gait pattern is very important. When we walk normally, our heel hits first, we roll through our foot, and then we push off with our toes. If we don’t get the heel strike in the beginning of the step, we tend to limp. If you are still limping, then you still need an assistive device like a walker or cane. If you walk with a limp, then your muscles will get in the habit of doing it, even when your muscles are strong again.