NCTV Episode 61
Continuing with the series of bitesize health tip videos which can be found here on my YouTube Channel, this episode, includes:-
- Rehabilitation advice
- How to use crutches on stairs
- Tips to help you through the rehabilitation phase
- Timescales for when to resume certain activities
- Do’s & don’ts following hip replacement surgery
If you’d prefer to read the content within, rather than watch the video, then feel free to read the transcript, as follows:-
Hello and welcome to NCTV Episode 61 and part 3 of 3 in the hip replacement series which will be about what to do after you’ve had hip replacement surgery.
To cover this, we’ll break it down into two sections, one being on rehabilitation and the other on the Do’s & Don’ts following surgery.
First of all, it should be known that surgery without rehabilitation will not ensure a successful outcome. Ultimately, years of pain, reduced physical activity or function, muscle weakness and the development of a limp for example, will have become the norm for your body and mind. Rehabilitation will therefore help restore function and re-train your muscles and nerves to work together, which will recondition you to optimal health, function, and well-being.
So when to start rehab? Ideally before you’ve had surgery, with education and strengthening exercises. However, progress through rehabilitation can always be achieved at any time, as long as you start somewhere and the sooner the better. Rehabilitation and physical therapy can start immediately after surgery and continue throughout hospitalisation and at home, for up to a year after surgery. In hospital this could even be as early as 6 hours after surgery with a few exercises in bed to promote blood flow, reduce your risk of developing a clot, and help to build strength. The sooner you mobilise the better and this may be in the form of a short, slow walk around the room to start with, gradually increasing the distance and duration over the next few days.
As your walking gradually improves, you normally continue using crutches or a walker for up to 6 weeks after surgery, sometimes less but that depends on your surgeon’s views as well as your weight and age.
When it comes to tackling stairs you may want to have someone help you until you have regained most of your strength and mobility. Remember the following phrases:
“Up With the Good”
1. Hold the handrail with one hand and a cane or crutch in the other where possible. Otherwise use both crutches together.
2. Step your good leg up first. Then bring your operated leg and the cane or crutch up onto the same step afterwards.
Next is “Down with the Bad”
1. As before, hold the handrail with one hand and a cane or crutch in the other where possible. Otherwise use both crutches together.
2. Step down with your bad leg, along with your cane or crutch at the same time. Then step down with your non-operated leg onto the same step.
This is important to get right because being able to walk and climb stairs safely is one of the mandatory requirements for discharge from hospital.
A few tips to help you through the rehabilitation phase – Firstly, you can ice the operated hip for around 10 minutes especially after exercise and as needed every few hours. Pain medication prescribed by the hospital taken 30-45 minutes before your daily exercise can also help you to control the pain so that you can actually perform your rehab as required.
To control and reduce the swelling, this can be done by lying flat on your back and elevating your leg above the level of your heart with pillows.
If you’re experiencing increased stiffness or soreness, it may be that you’re not doing enough exercises or holding the stretches for long enough so try to increase the number of times you do them and aim to hold a stretch for around 20-30 seconds. Conversely, you’ll know if you’ve done too much because there will be an increase in hip pain and swelling, or an increase in night pain, in which case, respect the pain and increase your rehab more gradually or take more breaks. It’s also wise to avoid being in one position too long.
In terms of resuming an active lifestyle, 6 weeks after surgery you can cycle on a recumbent bike and swim as long as your incision is well healed but avoid breast stroke. 12 weeks after surgery you can look at resuming golf, gardening provided you avoid excessive hip bending, sitting in a bath preferably with grab bars, gentle dancing and cycling on a regular bike, raising the seat to again prevent excessive hip bending.
In summary of the rehab section then, when it comes to your general fitness, remember to start slowly as you’ll have been less active since your surgery. Start with a few minutes of activity and gradually progress. Low impact activities are best, such as swimming, biking and walking.
Now a few Do’s and Don’ts you should know about, firstly the don’ts:-
- To ensure that your hip doesn’t bend past 90 degrees,
1) don’t sit on soft or low furniture or beds
2) don’t bring your knees to your chest
3) don’t squat
4) don’t reach forward while sitting
- Other things to avoid doing are crossing your legs
- Twisting or pivoting on your operated leg
- Pushing or carrying heavy items
- And driving for the first 8 weeks following surgery
Now onto the Do’s and these are:-
- Use a long handled reacher to pick things up off the floor and a sock aid to put your socks and shoes on
- If you side lie in bed, lie on the good side with a pillow between your knees for 4-6 weeks
- Take breaks on long car journeys to stretch and mobilise every 45 mins to an hour
- Recline your car seat a little
- If flying, book an isle seat so that you can stretch the operated leg out into it
- Use a walk-in shower for washing to avoid clambering over a bath for the first few weeks after surgery
- And if you have to kneel, do it on the bad side so that you can push off to lift yourself up on the good leg
…so there we go and that concludes our hip replacement series. I’ll see you next time for some more bitesize bits to help your health flourish. Bye for now.