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.

@maryfrommi

Hi @oregonjan

I was an avid hiker before hip replacement surgery and it sounds like we face(d) similar challenges walking after THR surgery. I ended up seeing a PT who is a gait specialist. Here’s what helped me the most, beyond the strengthening exercises, I think. I had to intentionally walk slow for a week or two using the heel, roll, toe. This was for every step, no exceptions. I had the same walking sideways along the counter exercises too. One day I turned on some dance music. It didn’t happen overnight, but after that I played fun music when I did them. I guess a multimodal approach worked. Best wishes on your recovery! I know how difficult it is.

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Time for an update on use of a cane: It is a permanent condition. There is no "fix" for the fact that the muscles supporting the opposite hip were not correctly reattached to solid bone but partly to a "floating" fragment, other than very complicated, difficult procedures with questionable results. I went through all the PT and muscle strengthening possible. I will never be able to hold my left foot up off of the ground more than VERY briefly (long enough to move the foot a bit) without the support of a cane or leaning onto something solid. Without such support, I am only able to limp by moving my foot at the most about 6 inches at a time. Fortunately, my balance is very good.
HOWEVER -- I am still having NO hip pain, now 2 1/2 years post-surgery, so that part of the procedure was a complete success!
I will just have to always use a cane (or walker). It does cause hand, wrist, and some shoulder pains with long use (arthritis) but last spring my daughter and I spent a week at the coast and walked many places, including on the beach (there is a "sand foot" which fits on the cane and allows walking in soft surfaces) and also climbed 78 steps back up from the beach so my mobility had not suffered as much as I feared. 5-mile walks do tire my left (cane) hand badly but I use either a wrist brace or a thumb spica on that hand. I only use a walker when I need to carry a lot of things as it tends to cause pains in both shoulders with extended use.
But at 82 years old, I am just hoping my left hand can stay "in action" and I'll "keep on truckin' "
Thanks for all the advice. Best of luck to all the THA recipients! Look forward to being pain-free!

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@oregonjan

Time for an update on use of a cane: It is a permanent condition. There is no "fix" for the fact that the muscles supporting the opposite hip were not correctly reattached to solid bone but partly to a "floating" fragment, other than very complicated, difficult procedures with questionable results. I went through all the PT and muscle strengthening possible. I will never be able to hold my left foot up off of the ground more than VERY briefly (long enough to move the foot a bit) without the support of a cane or leaning onto something solid. Without such support, I am only able to limp by moving my foot at the most about 6 inches at a time. Fortunately, my balance is very good.
HOWEVER -- I am still having NO hip pain, now 2 1/2 years post-surgery, so that part of the procedure was a complete success!
I will just have to always use a cane (or walker). It does cause hand, wrist, and some shoulder pains with long use (arthritis) but last spring my daughter and I spent a week at the coast and walked many places, including on the beach (there is a "sand foot" which fits on the cane and allows walking in soft surfaces) and also climbed 78 steps back up from the beach so my mobility had not suffered as much as I feared. 5-mile walks do tire my left (cane) hand badly but I use either a wrist brace or a thumb spica on that hand. I only use a walker when I need to carry a lot of things as it tends to cause pains in both shoulders with extended use.
But at 82 years old, I am just hoping my left hand can stay "in action" and I'll "keep on truckin' "
Thanks for all the advice. Best of luck to all the THA recipients! Look forward to being pain-free!

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Congratulations on staying motivated and active after the challenges! I love success stories - even when "success" looks different than what we anticipated.

I have a friend who had similar misadventures with her hip replacement, and felt she was never going to get back to walking because of the hand/arm pain from using either a walker or cane. She persisted, found a rehab center near her home in Nebraska where they had a wide variety of devices for her to try, and found her solution.

It is an "upright walker" where one uses primarily the forearms to propel & steer it, and you stand with a very erect posture. She is back to 2 mile walks, and as a side benefit, her husband found it works better for him (with spine issues) than the walking poles he was using. So we see them, every morning, out walking side-by-side through our winter community.

As a side note - I just spent several days at our State Fair, and noticed more people, including young ones with severe challenges, using them. Also, after several hip surgeries, I needed a cane for a while, but arthritis in my hands and wrists caused the pain you mentioned. A friend of mine recommended a forearm crutch, and it was much easier because the wrist was straight. I'll bet it could be fitted with the "sand foot"

Keep on walking - and encouraging others!
Sue

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@sueinmn

Congratulations on staying motivated and active after the challenges! I love success stories - even when "success" looks different than what we anticipated.

I have a friend who had similar misadventures with her hip replacement, and felt she was never going to get back to walking because of the hand/arm pain from using either a walker or cane. She persisted, found a rehab center near her home in Nebraska where they had a wide variety of devices for her to try, and found her solution.

It is an "upright walker" where one uses primarily the forearms to propel & steer it, and you stand with a very erect posture. She is back to 2 mile walks, and as a side benefit, her husband found it works better for him (with spine issues) than the walking poles he was using. So we see them, every morning, out walking side-by-side through our winter community.

As a side note - I just spent several days at our State Fair, and noticed more people, including young ones with severe challenges, using them. Also, after several hip surgeries, I needed a cane for a while, but arthritis in my hands and wrists caused the pain you mentioned. A friend of mine recommended a forearm crutch, and it was much easier because the wrist was straight. I'll bet it could be fitted with the "sand foot"

Keep on walking - and encouraging others!
Sue

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Sue-
Thanks for the good words and advice! I have my generic Rollator walker adjusted so that I am upright when using it and that makes my spine happy. I might try an upright one to take the strain off my shoulders.
I did try a forearm crutch but it put more strain on my thumb than a cane, even thought my wrist was a bit happier with that angle. I have pretty bad thumb-base arthritis (but don't plan on surgery for that as I've learned to "work around" it and use thumb spicas and splints to support them) . Unfortunately, I had to give up the walking poles due to the stress on my thumbs when using them. Maybe I'll add an upright walker to my "arsenal".
Thanks for the suggestions and cheer!
Jan

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@oregonjan

Time for an update on use of a cane: It is a permanent condition. There is no "fix" for the fact that the muscles supporting the opposite hip were not correctly reattached to solid bone but partly to a "floating" fragment, other than very complicated, difficult procedures with questionable results. I went through all the PT and muscle strengthening possible. I will never be able to hold my left foot up off of the ground more than VERY briefly (long enough to move the foot a bit) without the support of a cane or leaning onto something solid. Without such support, I am only able to limp by moving my foot at the most about 6 inches at a time. Fortunately, my balance is very good.
HOWEVER -- I am still having NO hip pain, now 2 1/2 years post-surgery, so that part of the procedure was a complete success!
I will just have to always use a cane (or walker). It does cause hand, wrist, and some shoulder pains with long use (arthritis) but last spring my daughter and I spent a week at the coast and walked many places, including on the beach (there is a "sand foot" which fits on the cane and allows walking in soft surfaces) and also climbed 78 steps back up from the beach so my mobility had not suffered as much as I feared. 5-mile walks do tire my left (cane) hand badly but I use either a wrist brace or a thumb spica on that hand. I only use a walker when I need to carry a lot of things as it tends to cause pains in both shoulders with extended use.
But at 82 years old, I am just hoping my left hand can stay "in action" and I'll "keep on truckin' "
Thanks for all the advice. Best of luck to all the THA recipients! Look forward to being pain-free!

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I love that I can use a cane and still walk on the beach. Amazing that we get to an age where something like a soft pillow or a cane becomes a wonderful blessing for which we can be grateful!

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I have a friend, aged 70, who desperately needs both hips replaced. She won't do it because she fears getting an infection. I'm not kidding. The rate of infection is 1%.

Can anyone tell me what might happen to her is she continues to ignore this? I would think the bones will continue to deteriorate to the point where the socket or the femur/ball could fracture. that would require surgery. would it affect her ability to get the hip replaced?

Thanks all.

Joe

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@heyjoe415

I have a friend, aged 70, who desperately needs both hips replaced. She won't do it because she fears getting an infection. I'm not kidding. The rate of infection is 1%.

Can anyone tell me what might happen to her is she continues to ignore this? I would think the bones will continue to deteriorate to the point where the socket or the femur/ball could fracture. that would require surgery. would it affect her ability to get the hip replaced?

Thanks all.

Joe

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Something I have learned over the past many years - statistics will not convince someone who is living with fear of the unknown. You need to uncover and address the reasons behind the fear...

Have you asked your friend why she is so fearful of infection? Does she have a past history, or does she know someone whose implant got infected? Is she higher risk due to diabetes or an autoimmune condition? Does she fear the pain of surgery, or worry about her ability to do the work to recover?

Ask her what the one reason, above any, why she would like to have new hips - mobility, freedom from pain, independence... Is she a "young 70" with many years of healthy life probably ahead of her? Or does she have health problems that will likely make recovery more difficult, or a long life unlikely?

Your concern about additional deterioration is also real. Replacement is more complicated if there is a fracture, risks of complication go up, and recovery can take longer. Ask her how she will manage if she breaks a hip and it cannot be repaired? Or if the damage gets bad enough that she can no longer take care of herself or needs to be in a wheelchair?

Now that there are more questions for you to ponder, are you more ready to have another conversation with her? Maybe uncover the real thought process behind her reluctance?

You are a good friend to be concerned, and with successful surgeries behind you, you could be in an ideal situation to help her make a decision based on information, not fear.

Sue

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@sueinmn

@oregonjan
I am sorry you are still struggling, but really, a cane at 3 months is not so unusual when there are complications of THR. But the continuing pain sounds like it is a concern to you, as it would be for me.

I have had 5 (not a typo!) hip replacement surgeries, the first 2 at age 55 and the next 3 at age 62 - the first round were not followed by PT, and I never did get a proper gait or full strength. When the implants failed and had to be replaced, the new surgeon was appalled that I had not had PT in the past, and sent me to a very good rehab team.

I did land and water therapy (I too had problems with weight-bearing for some time) and gait training. I had limped for so many years before the surgery, and again after the first round, that I needed a lot of help. Altogether, I spent over 3 months in twice a week therapy, and continued on my own for another 6 months. Needless to say, my results in round two were far superior to the first time. Now, some 7 years later, most days I walk at a brisk pace for an hour a day, or dance for 2 hours pain-free and (until Covid-19) was able to keep up with my 2 young grandsons all day.

If you can find a safe way/place to do PT, I strongly recommend you press your surgeon to refer you for therapy once the femur is healed - my friend had a similar complication back in November, and had to wait 12 weeks to begin therapy. She is still having therapy twice weekly and progressing well. She too has arthritis, and found an upright walker (like this: https://www.healthproductsforyou.com/ar-up-walker-walking-aid-upright-walker.html) was the solution to getting about with less pain.

As @naturegirl5 says, you must be assertive on your own behalf, because you are the one who has to live with the results. Good luck

Sue

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I am curious, how long did it take you to transition from a walker to a cane? Just had THR three weeks ago and I am faithfully doing my PT and going to PT as well. I am still on the walker right now.

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I had total hip replacement last week. I'm in a lot of pain when I try to move that leg. I had anterior surgery. I can walk slightly with a walker but have serious pain when I try to bend the knee upwards, or raise the leg to get in or out of bed. And when I try to walk, even though I try to walk a little each day. I am starting PT soon but wonder what exercises should I/could I be doing to help heal. I hope the PT will offer me some good advice, but frankly, I've not been too thrilled with the aftercare. Thanks for any advice you can offer.

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@cindiwass

I had total hip replacement last week. I'm in a lot of pain when I try to move that leg. I had anterior surgery. I can walk slightly with a walker but have serious pain when I try to bend the knee upwards, or raise the leg to get in or out of bed. And when I try to walk, even though I try to walk a little each day. I am starting PT soon but wonder what exercises should I/could I be doing to help heal. I hope the PT will offer me some good advice, but frankly, I've not been too thrilled with the aftercare. Thanks for any advice you can offer.

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Check out Bob and Brad on YouTube. They go thru a series of post-surgical exercises for after hip replacement.

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My surgery was six weeks ago, and I just began transition from walker to cane in the last couple weeks. You'll get there!

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