Post-Operative Exercises

Activity Guidelines
Exercise is important to help you obtain the best possible results from your hip surgery. You will begin doing exercises with the therapist on the first day after your operation. You will perform many of these exercises in between your therapy sessions as well as during each session. Prior to discharge, you will receive thorough instructions as to the exercises you are to continue. This instruction will come from the Academy therapist, the home health therapist, or from the therapist that will follow you as an outpatient if deemed necessary.

The next few pages contain some guidelines for your post-operative activity and exercise program. Your therapist will personalize these for you if necessary.

Total Hip Replacement Post-Op Exercise Plan: Weeks 1-2 

Three or four days after your surgery you will be ready for discharge from the hospital.  Most joint patients go directly home.  A few are referred for outpatient therapy, home health therapy or maybe to an Acute Rehab Unit. Regardless, you will need to continue activity and exercise. 

During weeks one and two of your recovery your goals are to:

• Continue walking with a walker or two crutches unless otherwise instructed.
• Walk at least 200-400 feet with walker or crutches.
• Walk up and down curbs and ramps.
• Actively bend your hip to 60 degrees.
• Straighten your hip completely.
• Independently sponge bathe or shower (after staples are removed) and dress, maintaining hip precautions.
• Gradually resume light household tasks.
• Twice a day, do 20 minutes of home exercises from the program given you – with or without the therapist.

Total Hip Replacement Post-Op Exercise Plan: Weeks 2-4 

During weeks two through four you will find that your level of independence and general strength increases. It is still very important that you continue to work on your strength, endurance and range of motion. This ensures the best outcome for you and your new hip.

Your goals for this period are to:

• Achieve all of the goals listed for week 1-2 if not yet accomplished.
• Wean from the walker or two crutches to a cane or a single crutch as instructed.
• Walk at least a quarter of a mile.
• Bend your hip to 90 degrees (unless otherwise instructed).
• Independently shower and dress, maintaining hip precautions.
• Resume household tasks.
• You may begin driving if you had surgery on your left hip with your physician’s permission.
• Twice a day, do 20 minutes of home exercises form the program given you.

Total Hip Replacement Post-Op Exercise Plan: Weeks 4-6 

By this time you will be feeling very confident and comfortable with your new hip, but you are still recovering and maximum benefit is the goal. Continuing to be goal oriented and committed to your home exercise program is important.

Your goals for this time period are to:

• Achieve all prior goals if not yet accomplished.
• Walk with a single cane or crutch and no limp.
• Walk a quarter to half mile.
• Begin progressing on stairs from one foot at a time to regular stair climbing, but only for a few stairs at a time.
• Actively bend hip.
• Drive a car.
• Continue with home exercise program twice a day.

Total Hip Replacement Post-Op Exercise Plan: Weeks 6-12 

During weeks 6-12 you should be able to resume normal activity and perhaps even add some that you could not do prior to surgery.

Your goals for this time period are to:

• Achieve prior goals if you have not yet accomplished them.
• Walk with no cane or crutch and without a limp.
• Climb and descend stairs in a normal fashion (foot over foot).
• Walk a half to full mile.
• Resume all activities including dancing, bowling, and golf (closer to week 12).

Home Exercises for After Your Total Hip Replacement 

The exercises included in this group are for flexibility and strength. Both are important for your full recovery and return to normal activity. Many of these exercises you will recognize and being similar or the same as those you were instructed to do prior to your surgery. You will begin doing the exercises indicated immediately and others are not to be added until the instructions indicate. The program will be personalized for you by the therapist in the event that you have some additional limitations or special circumstances. Please pay close attention to the instructions and the recommended time for initiating them as this will lead to the best path to complete recovery. Your therapist may supplement the exercises provided with others if your recovery is moving along at a faster rate than anticipated. 

Ankle Pumps 

1. While lying in bed or sitting in a chair, bend your ankles (both feet) up and down 15-20 times.
2. Do not exercise several times a day. Not just when you are formally “exercising.”
3. Make sure your leg does not twist or turn while doing this exercise.

 

Quad Sets: Knee Extension 

1. Lie on your back in bed. Tighten the muscle on the top of your thigh and hold.
2. Slowly count to five (5) out loud.
3. Relax.
4. Repeat 10-20 times.

Gluteal Squeeze: Hip Extension 

1. Lie on your back in bed. Squeeze buttocks muscles 
    (your bottom) together.
2. Slowly count to five (5) out loud.
3. Relax.
4. Repeat 10-20 times.

Terminal Knee Extension: Short Arc Quads 

1. Lie on your back in bed. Place a large can or rolled towel under your operated knee.                      
2. Lift foot, straightening knee. Do not lift your entire leg off of the roll.
3. Slowly count to five (5) out loud.
4. Relax and return to the starting position.
5. Repeat 10 times.

 

Heel Slides: Hip and Knee Flexion

1. Lie on your back on bed. Bend your knee and slide your heel toward your bottom. CAUTION: Remember your hip precautions and do not bend your hip more than 90 degrees.
2. Slowly count to five (5) out loud.
3. Relax and return to the starting position.
4. Repeat 10 times.

Hip Abduction and Adduction: Lying on Back 

CAUTION: You must have help with this exercise for the first six weeks. After six weeks you can do this exercise alone.                           

1. Lie on your back on bed. Slide your leg out to the side. Keep toes pointed up and knee straight.
2. Bring leg back to the starting point. For weeks 1-6 you must have someone help you slide your leg to the side and return it to the starting position.
3. Repeat 10 times.

 

Knee Extension: Long Arc Quads

Sit in a chair remembering to maintain the proper bend in your hip (Hip Precautions).  Straighten your knee as much as you can. Slowly count to five (5) out loud. Relax and return to the starting position. Repeat 10 times.

Hip Flexion 

1. Stand upright and hold onto counter top or back of
    chair, march in place.
2. Remember Hip Precautions when bending your hip.
3. Repeat 10 times.

Strengthening Arms 

1. Sit in armchair, remembering HIP PRECAUTIONS. 
2. Place both hands on the arm rests.
3. Place the foot of the operated leg out slightly in front of the other foot on the floor.
4. Straighten your arms raising your bottom up as much as possible.
5. Return to the seated position.
6. Repeat 10 times.

Side-lying Hip Abduction and Adduction 

CAUTION: This exercise is not to be done until week seven post operatively.

Lie on your non-operated side on the bed with two pillows between your knees.  Slightly bend the un-operated leg (the one on the bottom). Tighten the muscle on the front of your thigh on the operated leg. Lift your leg 6-8 inches away from the other leg (off of the pillow). Return to the starting position. Repeat 10 times.

Standing Hip Abduction and Adduction 

CAUTION: This exercise is not to be done until week seven post operatively.

1. Stand upright and hold onto a counter top or the back of a chair.
2. Tighten the muscle on the top of your thigh on the operated leg.
3. Lift the operated leg out to the side.
4. Relax bringing the leg back to the midline.
5. Repeat 10 times.