HIP
REPLACEMENT

EXERCISE PROGRAMME

We have described here a hip replacement exercise programme for before and after surgery.

Your engagement with the recovery process has been shown to make a significant difference to the results you can expect. So we recommend that you work with your healthcare team to carry out your strengthening exercises, before your operation, immediately after it and during your rehabilitation at home.

Exercises to prepare for your operation

To ensure the best possible outcome from your operation, you should work with your healthcare team to prepare for your surgery, carry out your strengthening exercises, and ask questions so that you are well informed and in control of your own experience.

In preparation for your operation, it is recommended that you try to attempt as many of the exercises below prior to your admission to hospital. Please stop any particular ones that cause you pain.

Exercises ideally to be performed three times a day. Attempt as many of these exercises as you can but stop any particular ones that cause pain.

Exercise 1: Calf Pumps Sets: 2 / Repetition:10

Exercise 2: Static Quadriceps Sets: 2 / Repetition:10

Exercise 3: Inner Range Quadriceps Sets: 2 / Repetition:10

Exercise 4: Active Hip Flexion Sets: 2 / Repetition:10

Exercise 5: Active Hip Abduction Sets: 2 / Repetition:10

Exercise 6: Static Glutes Sets: 2 / Repetition:10

Exercise 7: Standing Hip Abduction Sets: 2 / Repetition:10

Exercise 8: Hip Extension Sets: 2 / Repetition:10

Exercise 9: Gluteus Bridging Sets: 2 / Repetition:10

Exercise 10: Single Leg Stance Sets: 2 / Repetition:10

In hospital

After your surgery, it is important to perform the deep breathing exercises you were shown by the Physiotherapist. This is to keep the lungs clear.

Inhale deeply through your nose, and then slowly exhale through your mouth. Repeat this three times and then huff and cough two times. Perform this exercise hourly while you are awake.

You will be mobilised by your physiotherapist or nurse on the day of surgery once you have returned to the ward and are fully awake. The team will start you on a programme of exercises. You can help your own recovery by carrying these out every 2 hours or as recommended by the physiotherapist.

Exercises when you get home

Please discuss any concerns you might have about returning home with your nurse or physiotherapist.

Before going home, you will practise going up and down stairs, walking independently, getting in and out of a chair, on and off of a toilet and getting in and out of bed safely. The physiotherapy team on the ward will advise on the exercises to carry out daily to aid your rehabilitation.

Exercises ideally to be performed every 2 hours. Attempt as many of these exercises as you can but stop any particular ones that cause pain.

Exercise 1: Calf Pumps Sets: 2 / Repetition:10

Exercise 2: Static Quadriceps Sets: 2 / Repetition:10

Exercise 3: Inner Range Quadriceps Sets:2 / Repetition:10

Exercise 4: Active Hip Flexion Sets: 2 / Repetition: 10

Exercise 5: Active Hip Abduction Sets: 2 / Repetition:10

Exercise 6: Static Glutes Sets: 2 / Repetition:10

Exercise 7: Standing Hip Abduction Sets: 2 / Repetition: 10

Exercise 8: Standing Hip Extension Sets: 2 / Repetition: 10

Exercise 9: Gluteus Bridging Sets: 2 / Repetition: 10

Exercise 10: Single Leg Stance Sets: 1 / Repetition:5

Exercise 11: Standing Hip Flexion Sets: 2 / Repetition: 10

Exercise 12: Standing Knee Flexion Sets: 2 / Repetition: 10

Exercise 13: Standing Half Squats Sets: 2 / Repetition: 10

Outpatient physiotherapy

Make sure you have physio support in place for when you get home, or speak to the physio team in hospital about follow up sessions. If you have any queries or would like further information, please contact the Therapy Department on: 020 7460 5749.

Exercise and returning to daily life 

A total hip replacement is a major procedure, so it will take several months before you can return to a normal level of activity.

It can take up to three months for the discomfort and swelling to go completely. When this swelling is noticeable, use ice and elevate the leg but keep active and enjoy the benefits of your new hip.

Try to go out walking every day and increase the distance you walk each week. Continue to use walking aids as instructed until you are able to walk a good distance without a limp. Your outpatient physiotherapist will be able to advise you on this.

Do not drive a car until you have discussed this with your consultant and insurance company. Do not jump, run or perform other activities that put undue stress on the knee.

The exercises illustrated

CALF PUMPS Sets: 2 / Repetition:10
Lying on your back or sitting, bend and straighten your ankles briskly, contracting your calf muscles. Repeat regularly.

STATIC QUADRICEPS Sets: 2 / Repetition:10
Lie on your back with your operated leg straight. Bend your ankle and straighten your operated leg. Feel your quadriceps muscle (thigh muscle) contract. Hold this contraction as if you were about to initiate a leg raise but without lifting the leg off the bed. Hold for 5 seconds, and slowly relax.

INNER RANGE QUADRICEPS Sets: 2 / Repetition:10
Place a pillow or a rolled up towel under your knee. Activate your thigh muscle, straightening your knee and lifting the heel off the bed/ oor. Your knee should remain in contact with the pillow/ towel. Lock your knee, holding it straight for 5 seconds then slowly lower.

ACTIVE HIP FLEXION Sets: 2 / Repetition:10
Lying on your back, bend and straighten your operated leg by sliding your heel up and down the bed/floor. Ensure you bend within pain limits only.

ACTIVE HIP ABDUCTION Sets: 2 / Repetition:10
Lie on your back with your legs straight and slide your operated leg out to the side as far as comfort allows, while keeping your knee straight. Do not turn your knee inwards. Return your leg to its original position.

STATIC GLUTES Sets: 2 / Repetition:10
Lie on your back and tighten your buttocks as hard as you can. Hold for five seconds and
repeat.

STANDING HIP ABDUCTION Sets: 2 / Repetition:10
Stand on non-surgical leg and hold onto a solid support (e.g. sturdy chair). Slowly lift the surgical leg directly out to the side, keeping the body upright as demonstrated. Hold the position for 5 seconds and slowly return to the starting position. Keep the movement in the pain-free range of motion.

STANDING HIP EXTENSION Sets: 2 / Repetition:10
Stand holding the back of a chair and lift your surgical leg up behind you (knee straight) while keeping your back straight and looking directly ahead of you. Hold for five seconds and slowly lower the leg back to the starting position.

GLUTEUS BRIDGING Sets: 2 / Repetition: 10
Lie on your back with your knees bent. Draw your belly button in towards your spine. Contract your buttocks while lifting your buttocks off the ground until your trunk is aligned with your legs. Hold for 5-10 seconds and then slowly return to initial position and repeat.

SINGLE LEG STANCE Sets: 1 / Repetition: 5
Close to a fixed surface (e.g. a sturdy chair) – Stand straight with your feet close together and lift operated leg off of the floor. Hold this position for 1 minute, lower your leg and lift the opposite leg and repeat the exercise if you are able.

STANDING HIP FLEXION Sets: 2 / Repetition: 10
Stand straight. Hold onto a firm surface. Lift operated leg up bending at the knee – hold for 3 seconds. If your hip joint is painful lift your leg part way within comfort limits.

STANDING KNEE FLEXION ( HAMSTRING STRENGTHENING) Sets: 2 / Repetition: 10
Holding onto a support bend your knee and lift your foot off the floor. Hold 5 secs.

STANDING HALF SQUATS Sets: 2 / Repetition: 10
Stand behind a chair and support yourself with both hands. Contracting your abdominal muscles and your buttock muscles slowly bend your hips and knees – try to keep your head up and push your bottom back. Hold 5 seconds then repeat.

Fortius Joint Replacement Centre
at Bupa Cromwell Hospital

164 -178 Cromwell Road
Kensington
London
SW5 0TU


E: info@fortiusclinic.com

Appointments: +44 (0)203 693 2119

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