After a hip replacement, every exercise you do in your PT sessions will target one or more of the following objectives:
- Regaining your balance on your new hip
- Strengthening the muscles around your hip, including the flexors for lifting your leg, the extensors for pushing it back, and the abuductors for moving it to the side
- Reaching the full range of motion in your new hip
Regaining balance
You might be unsteady after surgery. Balance is critical to getting you back home and resuming your life. So balance will be the first order of business with your physical therapist.
When you’re ready, your therapist might have you stand on one leg (usually starting with 20 to 30 seconds to a minute and progressing to longer periods) near a counter so that you can grab it if you need support.
You may also try what’s called a three-way stance: You hold onto a counter or your walker, then extend the leg behind you, to the side, and then to the front. With your therapist’s supervision, you might march in place or do mini-squats.
“Recent evidence supports substantially reducing restrictions for most primary total hip replacement,” Dr. Mansour says.
Strengthening your glutes
Your glutes—the group of muscles that form your buttocks—are the main muscles that support your hips and the movements that come from them. You’ll need to strengthen them in order to be stable on your new hip and use it to its fullest potential.
“Your glutes are the most crucial muscle group to strengthen after total hip replacement as they improve pelvic stability and gait balance,” Dr. Mansour says.
Your physical therapist will provide specific glute-strengthening exercises that are safe and appropriate for you. One option may be to lie on the floor and squeeze, hold, and release your glutes several times.
Increasing range of motion
Range of motion, which can be active or passive, refers to the full movement potential of a joint; it’s the angle in a specific direction a joint can move. After a hip replacement, the range of motion you use will increase gradually over the first few weeks. It’s important to do only the prescribed range-of-motion exercises while your hip is still healing to reduce the risk of dislocation.
Make sure you understand what you should and should not do as part of your at-home exercises and day-to-day activities. Also check with your physical therapist to make sure you have the proper form when you do your exercises.
After primary total hip replacement, you can expect your range of motion to return to a normal, functional level within three to six months. Your walking speed and stride should feel like they’re back to their baseline by the three-month mark, Dr. Mansour says.
