It takes about five to six months to get into sports, gym activities or outdoor fitness routines after hip replacement surgery
Written By Neha Jain
With Quotes from Dr Darshan Angadi (orthopedic) and Gayathri Mahalingam (physical therapist)
Structured rehabilitation is crucial after hip replacement surgery to avoid the risks, especially in the initial phase. Individuals must strictly follow the timelines and precautions suggested by their surgeon. Over time, and with proper rehabilitation, the risk related to physical activities or exercise after hip surgery comes down. Then, the activities can be slowly increased, under the guidance of health professionals, and taking into account certain factors, say experts.
When is hip replacement surgery prescribed?
When the hip joint is damaged beyond what the body can repair it becomes extremely painful. The movements of the hip joint get restricted which affects day-to-day activities.
“The reasons why people opt for hip replacement surgery are due to arthritis of the hip joint known as osteoarthritis or degenerative arthritis and inflammatory arthritis like rheumatoid arthritis,” says Dr Darshan Angadi, a consultant orthopedic surgeon at Altius Hospitals, Bangalore. “The other causes are significant trauma to the hip joint after an accident where it was severely damaged.”
Stages of rehabilitation after hip surgery
Recovery and rehabilitation after hip replacement surgery are done in stages. A few things are encouraged initially, and many are strictly restricted. The stages are broadly divided into early, middle and late stages.
Dr Angadi says the early stage corresponds to the first two weeks when wounds are fresh and new. “When it comes to exercise after hip surgery, simple, gentle movements like getting up and walking for a short distance are recommended,” he says. “As there is some element of pain during the phase, the person will be on medications to control the pain.”
People may need support or assistance with a walker or crutches to help them balance and slowly regain their strength while moving.
“The two-six-week period [one month], when things settle down following the surgery, and the wound heals, is considered as the intermediate stage where the individuals will progressively walk or move around and climb stairs,” Dr Angadi.
There are generic and specific exercises that are introduced as a part of physiotherapy. These exercises are important to strengthen the muscles to help move the joint.
“The late stage of recovery is between six to 12 weeks when individuals move around without any assistance,” says Dr Angadi.
The muscles having gained strength with the structured exercise program after hip surgery, strength, joint movement, and balance all start to improve.
“After 12 weeks, the ability to do simple day-to-day activities that they had done before the surgery improved. Individuals heal differently and respond to treatment differently. The timeline is just an approximation,” adds Dr Angadi.
Fitness routine after hip surgery
Depending on how the individuals have progressed around the three-month mark, they are recommended to do light aerobic and low-impact exercises after the surgery.
However, the rehab exercises start at an earlier stage. Some are suggested based on the underlying cause of the joint replacement. Certain generic exercises, like strengthening the abductor muscles, are recommended because they aid in maintaining balance while walking.
“The initial rehabilitation starts the day after the surgery. It is usually bed-based exercises known as isometrics, which are done for two weeks; later, we add resistant isometric exercises with TheraBand and weight cuffs. We avoid stretches and active resistance exercises,” says Gayathri Mahalingam, senior physical therapist at Apollo Spectra Hospital, Bangalore.
“Static quadriceps, static hamstrings and abduction of the hip are important post-surgery to maintain leg length. After two weeks, we recommend active assisted exercises and range of motion exercises. Depending on the recovery, strength, and individual capacity, we recommend what they can do next,” adds Mahalingam.
“The exercises we recommend are individualized and tailor-made. It depends on the person to person, but it usually takes three months before they get back to their normal state. For a person to hit the gym, cycle or do any outdoor activity, it takes at least four to six months,” elaborates Mahalingam.
One of the common exercises suggested is static bike-based ones, which are low-impact and help regain range of motion. One can also incorporate swimming, except for the butterfly stroke.
Avoid impact-based exercises
It is advised to avoid high-impact activities or contact sports even after the recovery phase. These activities can lead to the dislocation of the ball of the hips and damage the implant. While doing these activities, people are at risk of other injuries, such as a periprosthetic fracture, which can be damaging.
High-impact exercises after hip surgery also affect the wear and tear rate. The implant, which is a weaker surface, tends to wear out quickly.
“There is a limit at which your joint can move. Beyond that, the joint will send biofeedback to the brain. With artificial joints, the proprioception feedback is not there. Hence, if one continues to move that joint, bend, or twist and if that safe zone is breached, the joint can come out without one being aware,” explains Dr Angadi.
Implants, which are a bit stronger, can sustain some impact-based activities. However, activities like cross-running or other intense activities should be avoided.
Takeaways
- Exercises for rehabilitation are recommended soon after hip replacement surgery. However, it takes more than five months for people to get back into a gym routine or elaborate fitness.
- The exercises recommended after hip surgery are tailored to strengthen the muscles around the joint. It takes three months for them to return to their normal state.
- Depending on the type of trauma, the injury, age, and type of implant, a call is taken whether the person can return to high-impact activities.
