Exercises and Activities to Avoid After Hip Replacement

If you have had a total hip replacement surgery, there are certain precautions you need to take while you are recovering. This is especially true if your surgery was done via a posterior approach (at the back of the hip, near the buttocks).

These precautions are important in order to avoid a hip replacement dislocation. When this happens, the artificial ball of the upper leg (femur) slips out of the artificial hip socket.

This article will explain the three precautions you need to take after your surgery and for how long.

Precautions After Hip Replacement

For at least the six weeks after surgery, and sometimes up to six months, you'll need to take extra precautions as your mobility returns. For example:

• Avoid bending your hip past 90 degrees
• Don't cross your leg on the side with the new hip over your other leg
• Keep your toes straight when you walk

Recommendations

After a total hip replacement with a posterior incision, three movements should be avoided to prevent the dislocation of your artificial hip. Until you are fully recovered and your mobility and range of motion have been fully evaluated by your orthopedic surgeon, you should avoid:

• Hip flexion past 90 degrees: This means that you should not bend your hip up too far or lift your knee too high. When you are sitting in a chair, for example, your thigh should be parallel to the floor. Sitting in a low chair or bending your knee and hip up to put on a sock may break this 90-degree rule and put you at risk for hip dislocation.
• Crossing your operated leg over the other one: You should not cross your leg with the new hip over the other one. You may be required to use a special wedge called an abduction pillow when sleeping to help keep your legs separated.
• Walking pigeon-toed (internal rotation of the hip): After a posterior approach total hip replacement, you should not rotate your hip inward. This means that your toes should be kept straight ahead or slightly rotated outwards when walking, sitting, standing, or lying down.

Sometimes the very exercises you may do as part of a physical therapy program after hip surgery can be risky. Your physical therapist can show you how to do them so they don't result in a dislocation.

Duration of Precautions

Most people need to follow the precautions for approximately 90 days after surgery. Some healthcare providers may want you to follow the precautions for about six months. Others may only have you follow them for 60 days. It all depends on your health and mobility level before the surgery and how complex the surgery was. It will also depend on the intensity of your post-operative rehabilitation and recovery.

Your healthcare provider will tell you when you no longer need to follow your total hip precautions.

A 2011 study in the Journal of Orthopaedic & Sports Physical Therapy reported that most people experience rapid recovery in the first three to four months following a total hip replacement. After that, improvements continue at a slower rate for up to a year.

Lifetime Precautions

Depending on your age and physical condition, you may also need to adopt some lifetime precautions after hip surgery, including:

• Avoid bending the hip too far: Older adults in particular should continue to avoid flexing the hip past 90 degrees or lifting the knee above hip level. Don't sit in deep or low chairs if they will result in a high knee position.
• Avoid twisting motions: Certain movements can increase the risk of dislocation. Examples include crossing your legs, pivoting, or walking with your toes turned in.
• Sleep with a pillow between your legs: If you are a side sleeper, it's a good idea to keep a pillow between your legs to help your hip and leg stay aligned.
• Avoid high-impact, repetitive activities: Running, jumping, and high-impact sports that involve a lot of twisting like basketball and racquetball may cause wear and increase the risk of dislocation.

Talk to your healthcare provider about whether these precautions are necessary in your situation.

Summary

After a total hip replacement surgery, you will do rehab with a physical therapist. You will also need to avoid certain movements in your everyday life to avoid the possibility of dislocating your new hip ball and socket.

Remember that each person heals differently after total hip replacement surgery. Working with your physical therapist is the best way to ensure a safe and rapid recovery.