Hip replacement therapy often begins within 24 hours after surgery. Therapy begins with simple exercises while sitting on a chair. The patients moves up to walking with crutches or a walker. As the patient gains strength, he/she starts to step, walk, and climb. Later on, they are encouraged to walk under their own power. Moreover, physical therapy is important to prevent contractures, improve patient education, and strengthen muscles around the hip joint through controlled exercises.
Hip Replacement Therapy: Rehab Techniques
Patients are instructed not to strain the hip joint with heavy lifting or other unusual activities at home. Specific techniques of body posturing, sitting, and using an elevated toilet seat can be extremely helpful. For example, patients are instructed not to cross the operated lower extremity across the midline of the body (not crossing the leg over the other leg) because of the risk of dislocating the replaced joint. They are also discouraged from bending at the waist. In addition, they use a pillow between the legs when lying on the non-operated side in order to prevent the operated lower extremity from crossing over the midline. Most patients move to a skilled nursing facility for their hip replacement rehab.
Occupational therapists are an important part in the rehabilitation process. These therapists review precautions with the patients related to everyday activities. They also educate the patients about the adaptive equipment that is available and the proper ways to do their “ADLs” or activities of daily living.
Hip Replacement Therapy: Medications
As patients gain strength and motion flexibility, they continue to use supportive devices under supervision by the occupational therapist and doctor. Patients also take medications to prevent blood clots in the legs. These include warfarin (Coumadin) or aspirin. Occasionally, heparin (enoxaparin [Lovenox]) is also used. Additional medications are given for pain, sleep, and muscle relaxation.
Gradually, patients become more confident and less dependent on supportive devices. Patients are instructed to look for signs of infection, including swelling, warmth, redness, or increased pain in or around the surgical site. The wound site is inspected regularly by the attending physician.
Watch this video on the exercises that are recommended for hip replacement patients.