What exercises help recovery & strength after hip replacement?

Posted by Helen, Volunteer Mentor @naturegirl5, Mar 3, 2020

I'm looking for feedback, suggestions, and support for re-building strength after left total hip replacement.

My surgery (anterior incision) was at Mayo in November, 2019. For the first 3 months after surgery, I followed the physical therapist's recommendations for exercises (range of motion, walking, stationary bike) and added no leg bands or weights to my lower body. I even went snowshoeing and that was great! Let me note that I've been lifting weights for almost 30 years and was physically active until the hip pain became worse over the past few years. Thus, the decision to do the recommended total hip replacement. At the 3 month follow-up on February 20, 2020, the surgeon said there are no restrictions on my physical activity but to take it slow. I've still trying to figure out what "taking it slow" means. I'm lifting light weights (10-15 pounds) on machines (hamstring curls, leg extensions, leg press). I've added these just since returning from that February 20 appointment at Mayo and go to the gym twice a week. I have osteoporosis so weight lifting is important. But here's the thing - I have more pain and discomfort in my surgical leg and lower back than before February 20.

What is everyone else doing for their rehab post surgery at the 3 month mark? How are you have pain? How are you managing?

Blessings to you all.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

Make an appointment with your hip doctor and let him know this and get specifics on what taking it slow means exactly.

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I am finally seeing some progress after my original post back in March (I started this thread). I started PT a month ago (it took that long to get in) and I'm doing the recommended exercises. I'm using a Theraband for external hip rotation strengthening while standing and then also doing internal hip rotation strengthening with a band that requires that I lie on my side, bend my knees at a 90 degree angle and move my legs apart. The PT also added a coordination/gait exercise that requires that I braid my steps laterally through 18inch squares (like a hopscotch that I will draw on our driveway with sidewalk chalk). I'm using a Bosu to do squats. Now that is challenging! So, lots of exercises to work on balance, coordination and strength. Thanks to all who posted here with support and suggestions. I'll say to all, push for physical therapy. It makes a difference and you are doing something for your own progress. My surgeon said back in February that I'd be hiking this summer. I'm not quite there yet but I hope to be hiking on trails this Fall.

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@naturegirl5

I am finally seeing some progress after my original post back in March (I started this thread). I started PT a month ago (it took that long to get in) and I'm doing the recommended exercises. I'm using a Theraband for external hip rotation strengthening while standing and then also doing internal hip rotation strengthening with a band that requires that I lie on my side, bend my knees at a 90 degree angle and move my legs apart. The PT also added a coordination/gait exercise that requires that I braid my steps laterally through 18inch squares (like a hopscotch that I will draw on our driveway with sidewalk chalk). I'm using a Bosu to do squats. Now that is challenging! So, lots of exercises to work on balance, coordination and strength. Thanks to all who posted here with support and suggestions. I'll say to all, push for physical therapy. It makes a difference and you are doing something for your own progress. My surgeon said back in February that I'd be hiking this summer. I'm not quite there yet but I hope to be hiking on trails this Fall.

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@naturegirl5 Thanks for the update on your progress. I second the motion that people insist on comprehensive PT after hip replacement - especially joint rotation & gait training. These are two very important things that we lose when joints deteriorate and we wait things to get "bad enough" to replace. I'm sure your determination will get you back on the trails.
Sue

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@johnbishop

Hi @naturegirl5, I haven't had a hip replacement yet... 🙂 but I'm close to a year out from a total knee replacement and am trying to keep exercising as much as I can because I also think it's important. Sounds like you are doing great with exercising but just trying to figure out how much might be too much. I do all of my exercises at home using an elliptical and a recumbent exercise bike. I also have 10 pound hand weights that I use but not quite as often but then I'm an old guy. I did find a PDF file from Vancouver Health - Exercise Guide for Hip Replacement Surgery that has a section for exercise guidelines 3 months to a year starting on page 33 of the PDF. One thing on the page that I thought might be helpful for you is a chart for hip joint loads during exercise. Page 38 lists a lot of Internet resources that may also be helpful for you.

Exercise Program for Total Hip Replacement - Vancouver Coastal Health
-- https://vch.eduhealth.ca/PDFs/FB/FB.863.Ex37.pdf

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Thanks John for THR program, l was like naturegirl5. Went back to ward nursing @ 6mths heavy work with manual handling Pt's. Now post op 4wksTKR, it's best my hip has felt with rest it going slow with recovering. Do you have a program for TKR John?

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@naturegirl5

I am finally seeing some progress after my original post back in March (I started this thread). I started PT a month ago (it took that long to get in) and I'm doing the recommended exercises. I'm using a Theraband for external hip rotation strengthening while standing and then also doing internal hip rotation strengthening with a band that requires that I lie on my side, bend my knees at a 90 degree angle and move my legs apart. The PT also added a coordination/gait exercise that requires that I braid my steps laterally through 18inch squares (like a hopscotch that I will draw on our driveway with sidewalk chalk). I'm using a Bosu to do squats. Now that is challenging! So, lots of exercises to work on balance, coordination and strength. Thanks to all who posted here with support and suggestions. I'll say to all, push for physical therapy. It makes a difference and you are doing something for your own progress. My surgeon said back in February that I'd be hiking this summer. I'm not quite there yet but I hope to be hiking on trails this Fall.

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Good progress there naturegirl5, l was very much like you found recovery not on par as information given with recovering. With my mucsle being so ac tyive l gained a Seroma & with pushing my exercises & activaties a Bursitis in hip joint. & I did start to go back road cycling & trails @ 8mths & also have a very physically Nursing job. My hip started burning/Pain. Now post opp 5wks TKR which rest has been the best for my hip. Your doing fantastic with your healing specially reading squaring & balancing. I wished someone said to me "it takes time & listen to your body" all best Naturegirl5

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@klarnold

Thanks John for THR program, l was like naturegirl5. Went back to ward nursing @ 6mths heavy work with manual handling Pt's. Now post op 4wksTKR, it's best my hip has felt with rest it going slow with recovering. Do you have a program for TKR John?

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Hi @klarnold - Here are a few different ones I've come across for post TKR that may be helpful.

5 Quad Exercises to Do After Knee Replacement: https://www.arthritis-health.com/blog/5-quad-exercises-do-after-knee-replacement

Home exercise program: Knee exercises after knee replacement:
https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/after-surgery/knee-exercises

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@klarnold

Good progress there naturegirl5, l was very much like you found recovery not on par as information given with recovering. With my mucsle being so ac tyive l gained a Seroma & with pushing my exercises & activaties a Bursitis in hip joint. & I did start to go back road cycling & trails @ 8mths & also have a very physically Nursing job. My hip started burning/Pain. Now post opp 5wks TKR which rest has been the best for my hip. Your doing fantastic with your healing specially reading squaring & balancing. I wished someone said to me "it takes time & listen to your body" all best Naturegirl5

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Thank you, klarnold. I am cycling although it's recreational. Still, it's good exercise that does not aggravate my hip. Like you, I wish someone, anyone, would have said that it will take more than a few months to get back to where I was a few years ago when I could be more active. And yes, listen to your body. I wish you all the best, klarnold, at work in your nursing job and at play.

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@sueinmn

@naturegirl5 Thanks for the update on your progress. I second the motion that people insist on comprehensive PT after hip replacement - especially joint rotation & gait training. These are two very important things that we lose when joints deteriorate and we wait things to get "bad enough" to replace. I'm sure your determination will get you back on the trails.
Sue

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Thanks, Sue.

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@naturegirl5

I am finally seeing some progress after my original post back in March (I started this thread). I started PT a month ago (it took that long to get in) and I'm doing the recommended exercises. I'm using a Theraband for external hip rotation strengthening while standing and then also doing internal hip rotation strengthening with a band that requires that I lie on my side, bend my knees at a 90 degree angle and move my legs apart. The PT also added a coordination/gait exercise that requires that I braid my steps laterally through 18inch squares (like a hopscotch that I will draw on our driveway with sidewalk chalk). I'm using a Bosu to do squats. Now that is challenging! So, lots of exercises to work on balance, coordination and strength. Thanks to all who posted here with support and suggestions. I'll say to all, push for physical therapy. It makes a difference and you are doing something for your own progress. My surgeon said back in February that I'd be hiking this summer. I'm not quite there yet but I hope to be hiking on trails this Fall.

Jump to this post

It sounds like you're making great progress! I am getting frustrated with mine (or lack of?).It was 4 months post-surgery before I got ANY exercise program and that was only after I finally got a PT referral. On discharge after surgery, I was given NO exercises to do except that my surgeon said to "just walk" (my P. Therapist says I "fell through the cracks" on early exercise). I have been doing progressive balance (not a problem) and strengthening exercises but to this day, 5 months after surgery and after nearly 2 months of PT, I still cannot bear full weight on the operated side and am having to use a cane. Due to severe arthritis in the hand/wrist using the cane, I am not able to walk for more than about 1/8 mile before my hand and wrist get too painful ( I do wear a wrist brace). The same pains prevent using the treadmill for more than about 1/8 (SOMETIMES almost 1/4) mile. As for the THR itself, x-rays show it has healed just fine and my surgeon has "signed off" unless the joint itself has any trouble.
I have only seen my PT for video visits and she cut those back from weekly to semi-weekly due to lack of weight-bearing progress (which she can't understand the cause of). My range of motion is nearly back to normal and I think the sit-stand exercise, the stand abduction with resistance band and side-stepping along 15' of counter while in semi-squat MUST be adding strength to my glutes but I still cannot get the last 20 lbs of my weight shifted onto that leg. The muscles just can't support it. There is no pain just continued weakness. I have been using a pedal exerciser and a gravity rider and my endurance is improving but I can't see any improvement in weight-bearing although friends say I'm walking more evenly with the cane now.
I don't know if it has an effect, but the operated leg was always about 1/4" longer than the other and I think that has increased as it looks it on the standing x-ray with height scale. At any rate, I am going to request an in-person visit with the PT to see if that will give her a better idea of what else I should be doing to get weight onto that leg. I'm now 5 months post-op and the PT doesn't know why I can't stand on that leg yet. It's hard to stay positive.
I appreciate all the tips and encouraging posts on this thread!

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@oregonjan

It sounds like you're making great progress! I am getting frustrated with mine (or lack of?).It was 4 months post-surgery before I got ANY exercise program and that was only after I finally got a PT referral. On discharge after surgery, I was given NO exercises to do except that my surgeon said to "just walk" (my P. Therapist says I "fell through the cracks" on early exercise). I have been doing progressive balance (not a problem) and strengthening exercises but to this day, 5 months after surgery and after nearly 2 months of PT, I still cannot bear full weight on the operated side and am having to use a cane. Due to severe arthritis in the hand/wrist using the cane, I am not able to walk for more than about 1/8 mile before my hand and wrist get too painful ( I do wear a wrist brace). The same pains prevent using the treadmill for more than about 1/8 (SOMETIMES almost 1/4) mile. As for the THR itself, x-rays show it has healed just fine and my surgeon has "signed off" unless the joint itself has any trouble.
I have only seen my PT for video visits and she cut those back from weekly to semi-weekly due to lack of weight-bearing progress (which she can't understand the cause of). My range of motion is nearly back to normal and I think the sit-stand exercise, the stand abduction with resistance band and side-stepping along 15' of counter while in semi-squat MUST be adding strength to my glutes but I still cannot get the last 20 lbs of my weight shifted onto that leg. The muscles just can't support it. There is no pain just continued weakness. I have been using a pedal exerciser and a gravity rider and my endurance is improving but I can't see any improvement in weight-bearing although friends say I'm walking more evenly with the cane now.
I don't know if it has an effect, but the operated leg was always about 1/4" longer than the other and I think that has increased as it looks it on the standing x-ray with height scale. At any rate, I am going to request an in-person visit with the PT to see if that will give her a better idea of what else I should be doing to get weight onto that leg. I'm now 5 months post-op and the PT doesn't know why I can't stand on that leg yet. It's hard to stay positive.
I appreciate all the tips and encouraging posts on this thread!

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@oregonjan Reading your description makes me think something else is going on. An in person PT or chiro consult might pick up something else like a nerve impingement or a spine issue. Water PT might help too. If the cane is an issue (I cannot use one due to arthritis) a forearm crutch or an upright walker are options. Please pursue this as the longer it lingers, the harder recovery gets.
Sue

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