Physiotherapy Before and After Hip Replacement Surgery

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Physiotherapy Before and After Hip Replacement Surgery

The role of physiotherapy before and after hip replacement surgery is important to ensure the success of the surgery and enhance the patient’s quality of life. 

Hip replacement surgery, or hip arthroplasty, is a surgical procedure performed to relieve hip pain and restore function in the hip joint which could be severely affected by conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, or traumatic injuries. 

In this article, we will discuss the various aspects of physiotherapy associated with hip replacement surgery.

• Why is it recommended physiotherapy during hip replacement surgery?
• What are the common physiotherapy exercises recommended before hip replacement surgery?
• What are the benefits of physiotherapy before hip replacement surgery?
• Why is physiotherapy recommended after hip replacement surgery?
• What are the different types of physiotherapy exercises recommended after hip replacement surgery?
• What are the benefits of physiotherapy after hip replacement surgery?

Why is it recommended physiotherapy during hip replacement surgery?

Preoperative physiotherapy, also known as prehabilitation, that is it is recommended physiotherapy before as well as after hip replacement surgery as it can help the patient in the following ways:

• Helps improve the patient’s physical condition before surgery 
• Improves surgical outcomes
• Helps in rapid postoperative recovery process

What are the common physiotherapy exercises recommended pre- hip replacement surgery?

The following physiotherapy exercises are recommended before undergoing hip replacement surgery:

• Strength training exercises: Exercises that are focused on the lower body, such as leg presses, squats (within tolerance levels), hip abductions, and bridges are recommended to improve muscle strength.
• Flexibility exercises: Stretching exercises that target the hip flexors, hamstrings, quadriceps, and iliotibial band help in improving flexibility and range of motion.
• Aerobic Exercises: Low-impact activities like swimming, cycling, and walking are recommended to improve cardiovascular health without putting excessive stress on the hip joint.
• Patient education: In addition to the above physical therapy exercises, preoperative physiotherapy also includes educating the patients about the surgery, postoperative expectations, and the importance of adhering to rehabilitation protocols. Patient education includes the following:

• Understanding the Procedure: Detailed explanations about what to expect during and after the surgery are provided to the patient.
• Pain Management Strategies: The patient is given information on how to manage pain postoperatively using medications, ice packs, and specific pain-relief techniques.
• Use of Assistive Devices: The patient is given training on the proper use of crutches, walkers, or canes to ensure safe mobility after surgery.

( Know more about- What is Physiotherapy ? )

What are the benefits of physiotherapy pre- hip replacement surgery?

Undergoing physiotherapy before a hip replacement surgery has the following advantages:

• Strengthening of muscles: The primary goal of prehabilitation is to strengthen the muscles surrounding the hip joint, especially the gluteal, quadriceps, and hamstring muscles. Stronger muscles can help support the joint better, reducing the load on the hip and decreasing the postoperative pain.
• Improving the range of motion: Exercises that improve the flexibility and range of motion of the hip joint can make postoperative rehabilitation smoother and more effective. Improved flexibility can also help in performing daily activities with greater ease preoperatively.
• Increasing cardiovascular fitness: Maintaining or improving cardiovascular fitness through aerobic exercises is important as it helps in managing the physical stress of surgery, reduces the risk of complications, and supports overall recovery.
• Psychological preparation: Prehabilitation can help reduce anxiety and increase confidence by familiarizing the patients with the exercises they will perform after surgery. This familiarity can reduce fear and uncertainty about the postoperative rehabilitation process.

Why is physiotherapy recommended post hip replacement surgery?

Physiotherapy before and after hip replacement surgery refers to the various exercises recommended after the surgery to help in the following things:

• Quicker recovery
• Relief from post-surgical side effects like pain and swelling
• Restoration of the hip joint function and mobility 
• Improved healing

What are the different types of physiotherapy exercises recommended following hip surgery?

The different types of physiotherapy exercises recommended after hip replacement surgery are as follows:

Immediate postoperative phase: 

The first phase of postoperative physiotherapy usually begins within a few hours after the surgery. Early mobilization is important to prevent complications and start the recovery process.

The different exercises recommended during this period are:

• Ankle pumps and circles: These exercises help improve circulation in the lower extremities and prevent blood clots.
• Quadriceps sets: Isometric exercises refer to those exercises where the patient tightens the thigh muscles to maintain the muscle strength without moving the joint.
• Gluteal sets: It involves tightening the buttock muscles to enhance hip stability.
• Heel slides: This exercise involves sliding the heel up and down the bed to gently increase knee and hip range of motion.
• Hip abductions: It involves moving the leg out to the side while lying down to strengthen the muscles around the hip.

Intermediate postoperative phase: 

As the healing process continues, the intensity and complexity of the physiotherapy exercises increase. This phase focuses on restoring full function, strength, and mobility of the hip joint.

The different exercises recommended during this period are:

• Standing hip abductions: It involves strengthening the muscles on the side of the hip by lifting the leg out to the side while standing.
• Mini squats: It helps in strengthening the quadriceps and improving balance by performing partial squats.
• Step-ups: This exercise involves practicing stepping up and down on a low platform to enhance leg strength and coordination.
• Stationary cycling: Low-impact aerobic exercises like stationary cycling help in improving cardiovascular fitness and joint mobility.
• Balance exercises: Using balance boards, foam pads, or simply standing on one leg is suggested to improve stability and proprioception.

Long-term Rehabilitation:

Long-term rehabilitation can last for several months after surgery and aims to ensure that the patient can return to their normal activities and, if possible, to sports or other physical hobbies as well.

The different exercises recommended during this period are:

• Advanced strength training: This involves using resistance bands, weights, and gym equipment to enhance muscle strength and endurance. This might include leg presses, lunges, and more dynamic movements.
• Aerobic conditioning: Activities such as walking, cycling, swimming, or using an elliptical machine are suggested to maintain cardiovascular health and improve overall fitness.
• Sport-specific training: For athletes, tailored exercises that help them return to their specific sport are suggested, which may involve sport-specific drills and agility training.
• Functional mobility drills: Practicing complex movements that mimic daily activities, such as carrying groceries, gardening, or dancing are recommended, to ensure patients can return to their normal routines confidently. ( Know more about- What is Bone Fracture? )

What are the benefits of physiotherapy following hip replacement surgery?

Depending on the post-operative phase and the types of exercises the patient is recommended to perform during that phase, the following are the benefits of physiotherapy during hip replacement surgery :

Benefits of physiotherapy in immediate post-operative phase:

The benefits of physiotherapy during this phase are:

• Pain management: Physiotherapists use various techniques and exercises to manage the postoperative pain. This may include gentle movements, positioning strategies, and use of ice or heat application.
• Preventing complications: Early movement and specific exercises help in preventing complications such as deep vein thrombosis (DVT), pneumonia, and joint stiffness.
• Restoring movement: Gradually increasing the range of motion and promoting safe, controlled movement help restore the normal hip function.
• Strengthening muscles: Muscle strengthening exercises help in supporting the new hip joint and improve the overall mobility.

Benefits of physiotherapy in intermediate postoperative phase:

The benefits of physiotherapy during this phase are:

• Enhancing strength: More challenging exercises are introduced to build muscle strength and endurance, focusing on both the operated and non-operated limbs.
• Improving balance: Balance exercises are important for safe mobility and preventing falls. These exercises often involve standing on one leg, using balance boards, or practicing balance tasks.
• Functional training: This training focuses on daily activities such as walking, climbing stairs, and getting in and out of a car. This phase also includes practicing sit-to-stand transitions, which are important for independence.
• Reducing scar tissue: Techniques are used to mobilize the scar tissue and prevent adhesions that can limit movement.

Benefits of physiotherapy in long-term rehabilitation:

The benefits of physiotherapy during this phase are:

• Maximizing function: Physiotherapy during this phase ensures that the hip joint functions as normally as possible. This involves advanced exercises tailored to the patient’s lifestyle and functional goals.
• Improving quality of life: Physiotherapy helps the patients return to a pain-free, active lifestyle. This includes regaining the ability to perform hobbies, recreational activities, and daily tasks with ease.
• Preventing future issues: The patients are taught how to maintain hip health, including proper posture, body mechanics, and the importance of regular exercise to prevent future injuries or complications. ( Know more about- Cost of Total Hip Replacement in Bangalore )

We hope that we were able to answer all your questions about physiotherapy before as well as after hip replacement surgery through this article.

If you want more information about physiotherapy before and after hip replacement surgery, you can contact a good physiotherapist. Also get hip replacement surgery at the best hospitals in India like Manipal Hospital Whitefield.

We only aim to give you information through the article and do not recommend any medication or treatment in any way. Only a qualified doctor can give you good advice because no one else is better than them.