HIP REPLACEMENTPOST-OP EXERCISE BOOK

This booklet belongs to:

YOU MUST BRING THIS BOOK WITH YOU TO ALL YOUR THERAPY APPOINTMENTS IN THE HOSPITAL

AND TO ALL YOUR OUTPATIENT APPOINTMENTS

You have an appointment to see your surgeon/physiotherapist at the Surgical Assessment Center on:

If you need to change this appointment, please call 306-766-0401

Licence Plate number

2

This booklet will guide you in your physiotherapy journey from after your surgery to your first follow up appointment with your surgeon and outpatient

physiotherapy appointments.

If you have any questions or concerns after discharge please call 766-0432.

You will be receiving a phone call from the Surgical Assessment Center 48-72 hours after you are

discharged from hospital to check on your recovery.

As part of your recovery, you are expected to complete your prescribed exercises twice a day, practice walking and apply ice as needed to your

surgical area.

3

Date Morning Exercises Ice/ElevationAfternoon Exercises Ice/Elevation

Walking as

tolerated

Average Pain

Today 0-10

Use this chart to keep track of your activity

4

DO NOT BEND your hip past 90

Avoid sitting on soft or low furniture or low beds. Do not bring your knee towards your chest. Do not squat. Do not reach forward while sitting. Do not reach for items on the floor; use a long-handled reacher. Use a sock aid to put on socks and shoes. Use elastic shoelaces.

DO NOT CROSS your legs

While sitting, do not cross your legs at the knees or the ankles. In bed, use pillows between your legs when lying on your side. Do not let the operated leg fall over the other leg.

DO NOT TWIST on your operated leg

When turning, step around instead. Avoid dancing or pivoting on the operated leg. Keep your nose and toes facing in the same direction.

DO NOT JAR your hip

Avoid slippery surfaces. Wear shoes with a non-slip sole. Avoid impact activities like dancing, jumping and sports.

DO NOT PUSH OR CARRY heavy items

Precautions following Hip replacement surgery

5

Understanding Your Pain

There are several things that contribute to pain and management. Up to now, you have been experiencing arthritic pain, which is often described as a dull aching pain. This pain should cease with surgery. Post operatively, you will be experiencing pain for a different reason this is surgical pain. This will improve with time.

How to Reduce Pain and Swelling

Ice and Heat Apply ice for 10-15 minutes to the operated hip, especially after exercise. You can use ice as needed every 1-2 hours. Do not apply heat to your incision area. Talk to your physiotherapist before using any heat.

Pain Medication Pain medication should be taken as prescribed in hospital. It is important that your pain is controlled so that you can complete your 2 exercise sessions every day. Take your pain medication 30-45 minutes before your exercise session.

Swelling Control You can help control/reduce the swelling in your hip by elevating the leg above the level of your heart. Elevate your entire leg by placing pillows underneath the entire operated leg, not just under the knee.

6

WALKING

Soon after surgery you will begin to walk short distances in your room. It is important to know your weight bearing status when you begin to walk. This means how much pressure you can put on your operated leg.

YOU MUST CONTINUE USING YOUR WALKER OR CRUTCHES FOR SIX WEEKS AFTER SURGERY

Your surgeon or physiotherapist will instruct you when to start using a cane.

Weight Bearing As Tolerated:

Stand up straight as you can. You are allowed to put as much weight as you feel comfortable with on your operated leg.

Partial Weight Bearing:

You are allowed to put a maximum of 50% of your body weight through the operated leg.

How much should I be walking/standing?

Start with walking short distances in the hospital. Once discharged, gradually increase your walking in your house, within your tolerance. Prolonged standing can also increase your pain. An increase in hip pain and swelling, or an increase in night pain may indicate you have been doing too much.

You may begin walking short distances outside your house when tolerated, continuing to use your walker or crutches. Gradually increase this distance, respecting your pain.

7

Sit to Stand

When rising from a seated position you must place the foot of your operated leg ahead of the other foot. Put most of the weight through your arms and non-operated leg as you push up into a standing position.

Walking with your walker:

Sequence: 1. Walker 2. Operated Leg 3. Non-operated legKeep your head up. Advance the walker about an arms length away. Step halfway into the walker with your operated leg, followed by your non-operated leg. Stand up tall and straight. Wear good supportive footwear with non-slip soles whenever possible.

8

STAIRSGoing Up

1. Hold the handrail with one hand and a cane or crutch in the other.2. Step your non-operated leg up first. Then bring your operated leg and the cane or crutch up onto the step.

Going Down

1. Hold the handrail with one hand and a cane or crutch in the other.2. Step down with your operated leg, along with your cane or crutch. Then step down with your non-operated leg.

9

My Hip is Getting More Stiff and Sore! What do I do?

If you experience the following after you are discharged from hospital, see your family doctor or walk-in clinic ASAP*

Increasing redness and/or increased temperature around your hip Increased incision drainage Generally feeling unwell

If you are experiencing an increase in hip stiffness and no increase in range of motion are you doing the following:

Doing enough exercises? If your hip is becoming more stiff you should increase the frequency of exercises you are doing. It is necessary to hold the stretch for

20-30 seconds at the end of your range of motion. It is normal to have pain while doing the exercises.

Taking your pain medication as prescribed in the hospital? Icing your hip frequently? You should ice your hip for 10-15 minutes, especially

after the exercises. You can ice every 1-2 hours. Elevating your leg above the heart level? Ensure you are laying down with your

entire operated leg elevated for 20 minutes, 2-3 times per day. Doing too much other activity? Often a sudden increase in activity is the reason

for an increase in hip swelling and stiffness. Take more rest breaks. Staying in one position? Be sure to change positions regularly as staying in one

position for too long can increase your stiffness.

10

Imm

edia

te P

ost O

p Ex

erci

ses

Bre

athi

ng E

xerc

ises

Sit

or li

e do

wn.

Inh

ale

deep

ly th

roug

h yo

ur n

ose.

With

out e

xhal

ing,

take

3 s

mal

l sn

iffs

to fi

ll yo

ur lu

ngs.

Hol

d 2

to 5

sec

onds

, the

n ex

hale

.

Do

this

10

times

eve

ry h

our t

hat y

ou a

re a

wak

e w

hile

in h

ospi

tal.

Circ

ulat

ion

Exer

cise

s

Pum

p yo

ur fe

et u

p an

d do

wn.

Do

this

10

times

eve

ry h

our t

hat y

ou a

re a

wak

e

whi

le in

hos

pita

l

11

Kne

e Sq

ueez

es

With

you

r leg

s st

raig

ht o

ut in

fron

t of y

ou,

squ

eeze

the

mus

cles

on

the

front

of y

our t

high

s

and

but

tock

mus

cles

.

Hol

d fo

r 3 s

econ

ds. R

elax

.

R

epea

t 10

times

, 3-4

tim

es p

er d

ay.

Ank

le c

ircle

s

D

o an

kle

exer

cise

s in

eac

h di

rect

ion

D

o th

is 1

0 tim

es e

very

hou

r tha

t you

are

aw

ake

whi

le in

hos

pita

l

12

Hip

Exe

rcis

es

You

will

beg

in th

ese

exer

cise

s w

hile

in h

ospi

tal a

nd w

ill c

ontin

ue to

do

them

at h

ome

once

dis

char

ged.

Do

only

the

chec

ked

exer

cise

s.

Seat

ed K

nee

Stra

ight

enin

g

1. S

it in

a c

hair

or o

n yo

ur b

ed w

ith g

ood

post

ure.

2. P

ull t

he to

es u

p an

d st

raig

hten

you

r kne

e.

3. H

old

for a

cou

nt o

f five

then

slo

wly

low

er y

our f

oot.

4. A

ltern

ate

with

the

othe

r leg

.

5. S

tart

with

10

repe

titio

ns.

Gra

dual

ly p

rogr

ess

to

30

repe

titio

ns o

n ea

ch le

g, 2

tim

es p

er d

ay.

Kne

e Sq

ueez

es

1. L

ie o

n yo

ur b

ack

with

you

r leg

s st

raig

ht.

You

can

plac

e a

smal

l rol

l un

de

r you

r kne

es.

2. P

ull y

our t

oes

up, p

ush

the

back

s of

you

r kne

es d

own

tight

enin

g yo

ur

th

igh

mus

cles

. Gen

tly s

quee

ze y

our b

utto

ck m

uscl

es a

s w

ell.

3. H

old

for a

cou

nt o

f 5, t

hen

rela

x.

4. S

tart

with

10

repe

titio

ns.

Gra

dual

ly p

rogr

ess

to 3

0 re

petit

ions

, 2 ti

mes

pe

r day

.

13

K

nee

Stra

ight

enin

g

1. L

ie o

n yo

ur b

ack

with

a ro

ll un

der y

our k

nees

. Th

e ro

ll sh

ould

be

ab

out 6

-8 in

ches

in d

iam

eter

a

cof

fee

can

wor

ks w

ell.

2. P

ull y

our t

oes

up a

nd li

ft yo

ur h

eel o

ff th

e be

d, s

traig

hten

ing

yo

ur o

pera

ted

knee

. Kee

p th

e ba

ck o

f you

r kne

e on

the

roll.

3. H

old

for a

cou

nt o

f 5, t

hen

slow

ly lo

wer

the

foot

.

4. A

ltern

ate

with

the

othe

r leg

.

5. S

tart

with

10

repe

titio

ns.

Gra

dual

ly p

rogr

ess

to 3

0 re

petit

ions

, 2 ti

mes

per

day

.

K

nee

and

Hip

Ben

ding

1.

Lie

on y

our b

ack.

2. K

eep

your

toes

poi

nted

tow

ards

the

ceili

ng a

s yo

u sl

ide

th

e he

el o

f you

r ope

rate

d le

g to

war

ds y

our b

utto

cks.

3. H

old

for a

cou

nt o

f 5 th

en s

low

ly s

lide

your

foot

bac

k

to

the

star

ting

posi

tion.

4. A

ltern

ate

with

the

othe

r leg

.

5. S

tart

with

10

repe

titio

ns.

Gra

dual

ly p

rogr

ess

to

30

repe

titio

ns o

n ea

ch le

g, 2

tim

es p

er d

ay.

14

S

idew

ays

Leg

Slid

e

1.

Lie

on y

our b

ack

2. K

eep

your

toes

and

kne

ecap

poi

nted

tow

ards

the

ceili

ng a

s yo

u sl

ide

your

legs

apa

rt.

3. H

old

for a

cou

nt o

f 5, t

hen

slow

ly s

lide

your

legs

bac

k to

the

mid

dle.

4. S

tart

with

10

repe

titio

ns.

Gra

dual

ly p

rogr

ess

to 3

0 re

petit

ions

, 2 ti

mes

per

day

.

H

ip S

tret

ch

1. S

it on

the

end

of y

our b

ed.

Pla

ce th

e fo

ot o

f you

r non

-ope

rate

d le

g

on

a s

mal

l ste

p st

ool.

2. L

ay b

ack

on th

e be

d, le

tting

the

oper

ated

leg

hang

dow

n.

Yo

u sh

ould

feel

a s

tretc

h in

the

front

of y

our o

pera

ted

leg.

3. R

elax

in th

is p

ositi

on fo

r 5 m

inut

es.

Do

not s

win

g th

e op

erat

ed

le

g ba

ck a

nd fo

rth.

Do

this

stre

tch

2-3

times

per

day

.

If th

e st

retc

h is

too

inte

nse,

pla

ce m

ore

pillo

ws

unde

r you

r he

ad a

nd s

houl

ders

.

15

DO

NO

Tpr

ogre

ss to

the

follo

win

g ex

erci

ses

until

dire

cted

by

your

phy

siot

hera

pist

16

M

ini-S

quat

1.

Sta

nd ta

ll w

ith g

ood

post

ure,

feet

sho

ulde

r wid

th a

part

2.

Usi

ng c

hair

or c

ount

er fo

r bal

ance

, ini

tiate

squ

at b

y be

ndin

g at

the

hip

3.

Ben

d kn

ees

slig

htly

low

erin

g in

to a

min

i-squ

at4.

D

o no

t ben

d yo

ur h

ip p

ast 9

0 de

gree

s!5.

H

old

the

squa

t pos

ition

for a

cou

nt o

f 5 th

en re

turn

to s

tand

ing.

6.

D

o __

____

set

s of

___

___

repe

titio

ns.

S

tand

ing

Hip

Ext

ensi

on

1 U

se a

cha

ir or

cou

nter

for s

uppo

rt.2.

K

eepi

ng y

our k

nee

stra

ight

, lift

the

leg

back

war

ds fr

om th

e hi

p. K

eep

your

toes

po

intin

g fo

rwar

d.3.

D

o no

t ben

d fo

rwar

d at

the

hip

ke

ep y

our t

runk

upr

ight

.4.

H

old

the

leg

lift f

or a

cou

nt o

f five

, the

n re

turn

to th

e st

artin

g po

sitio

n.5.

D

o __

____

set

s of

___

___

repe

titio

ns o

n ea

ch le

g.

Pro

gres

sion

: Add

a re

sist

ance

ban

d or

ank

le w

eigh

t.

17

S

tand

ing

Hip

Abd

uctio

n

1 U

se a

cha

ir or

cou

nter

for s

uppo

rt.2.

K

eepi

ng y

our t

oes

poin

ted

forw

ard,

lift

one

leg

out

to th

e si

de.

3.

Kee

p yo

ur tr

unk

uprig

ht

do

not l

ean

over

.4.

H

old

the

leg

lift f

or a

cou

nt o

f five

, the

n re

turn

to th

e st

artin

g po

sitio

n.5.

D

o __

____

set

s of

___

___

repe

titio

ns o

n ea

ch le

g.

Pro

gres

sion

: Add

a re

sist

ance

ban

d or

ank

le w

eigh

t.

S

tand

ing

Hip

Fle

xion

1.

Use

a c

hair

or c

ount

er fo

r sup

port

2.

Sta

nd o

n yo

ur n

on-o

pera

ted

leg

and

lift y

our o

pera

ted

leg

off t

he fl

oor,

bend

ing

at

the

hip

and

knee

.3.

D

O N

OT

bend

pas

t 90

degr

ees

at th

e hi

p.4.

D

o __

____

set

s of

___

___

repe

titio

ns

Pro

gres

sion

: Add

an

ankl

e w

eigh

t or r

esis

tanc

e ba

nd

18

M

arch

ing

1.

Sta

nd ta

ll w

ith g

ood

post

ure

2.

Ben

d at

the

hip

and

knee

to li

ft on

e le

g of

f the

floo

r. A

ltern

ate

legs

so

that

you

are

mar

chin

g on

the

spot

.3.

D

o no

t ben

d yo

ur h

ip p

ast 9

0 de

gree

s un

less

inst

ruct

ed to

by

your

phy

siot

hera

pist

.4.

D

o th

is e

xerc

ise

in fr

ont o

f a m

irror

to e

nsur

e yo

u ar

e no

t roc

king

from

sid

e to

sid

e.5.

D

o __

____

set

s of

___

___

repe

titio

ns

H

ip H

ike

1.

Sta

nd w

ith g

ood

post

ure

on a

ste

p th

at h

as a

raili

ng o

r wal

l for

sup

port.

2.

Kee

p th

e op

erat

ed le

g on

the

step

and

slo

wly

low

er th

e no

n-op

erat

ed le

g

partw

ay to

war

ds th

e flo

or.

3.

Kee

p yo

ur u

pper

bod

y st

raig

ht a

nd re

turn

to th

e st

artin

g po

sitio

n.4.

D

o __

____

set

s of

___

___

repe

titio

ns

19

B

alan

ce

1.

Use

a c

hair

or c

ount

er fo

r sup

port.

2.

Lift

one

leg

off t

he fl

oor,

mai

ntai

ning

you

r bal

ance

.3.

Tr

y to

hol

d th

e po

sitio

n fo

r 5 s

econ

ds to

sta

rt, w

ork

up to

hol

ding

the

posi

tion

fo

r 30

seco

nds.

4.

Do

____

__ re

petit

ions

on

each

leg.

S

tep

Up

Taps

1.

Sta

nd in

fron

t of a

ste

p2.

S

hift

wei

ght t

o no

n-op

erat

ed le

g.3.

Li

ft op

erat

ed le

g an

d ta

p fo

ot o

n st

ep, t

hen

retu

rn fo

ot to

sta

rting

pos

ition

.4.

D

o __

____

set

s of

___

___

repe

titio

ns.

Pro

gres

sion

: S

tand

on

oper

ated

leg

and

lift a

nd ta

p no

n-op

erat

ed le

g on

ste

p.

20

L

ater

al S

tep

Up

1.

Sta

nd s

idew

ays

next

to a

ste

p w

ith th

e op

erat

ed le

g on

the

botto

m s

tep.

2.

Ste

p up

by

stra

ight

enin

g th

e kn

ee o

f the

ope

rate

d le

g.3.

S

low

ly lo

wer

the

non-

oper

ated

leg

back

to th

e flo

or b

y be

ndin

g th

e op

erat

ed k

nee.

4.

Do

____

__ s

ets

of _

____

_ re

petit

ions

Pro

gres

sion

: P

lace

a re

sist

ance

ban

d ar

ound

the

knee

of t

he o

pera

ted

leg

S

idel

ying

Hip

Abd

uctio

n

1.

Lay

on y

our n

on-o

pera

ted

side

with

a p

illow

bet

wee

n yo

ur k

nees

.

Ben

d th

e bo

ttom

kne

e fo

r sup

port.

2.

K

eepi

ng y

our t

oes

poin

ted

forw

ard,

lift

the

top

leg.

3.

Kee

p yo

ur p

elvi

s ro

lled

slig

htly

forw

ard

do

not

let y

our h

ips

roll

back

4.

Hol

d th

e le

g lif

t for

a c

ount

of 5

, the

n sl

owly

low

er th

e to

p le

g to

the

st

artin

g po

sitio

n.5.

D

o __

____

set

s of

___

___

repe

titio

ns o

n ea

ch le

g.

Pro

gres

sion

: To

mak

e th

is e

xerc

ise

mor

e ch

alle

ngin

g, a

dd a

n an

kle

wei

ght

21

C

lam

shel

l

1.

Lay

on y

our n

on-o

pera

ted

side

with

a p

illow

bet

wee

n yo

ur k

nees

and

you

r hip

s an

d kn

ees

slig

htly

ben

t.2.

K

eep

your

feet

toge

ther

as

you

sepa

rate

you

r kne

es.

3.

Do

not l

et y

our h

ips

roll

forw

ard

or b

ack.

4.

Hol

d fo

r a c

ount

of 5

. 5.

D

o __

____

set

s of

___

___

repe

titio

ns

B

ridge

1.

Lay

on y

our b

ack

with

you

r kne

es b

ent a

nd y

our a

rms

at y

our s

ides

.2.

Ti

ghte

n yo

ur a

bdom

inal

mus

cles

then

lift

your

hip

s of

f the

floo

r by

sque

ezin

g yo

ur th

igh

and

butto

ck m

uscl

es.

3.

Hol

d th

e br

idge

for a

cou

nt o

f 5 th

en s

low

ly lo

wer

you

r hip

s.4.

D

o __

____

set

s of

___

___

repe

titio

ns

22

P

rone

Hip

Ext

ensi

on

Ben

t Kne

e

1.

Lie

on y

our s

tom

ach.

2.

Ben

d th

e kn

ee o

f you

r ope

rate

d le

g a

nd li

ft yo

ur le

g fro

m th

e hi

p

tow

ards

the

ceili

ng.

3.

Kee

p th

e fro

nt o

f you

r hip

s ag

ains

t the

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Resuming an Active Lifestyle

Activities allowed at 6 weeks after surgery: Cycling on a recumbent bike ensure the seat is back far enough that your hip is

not bending past 90 degrees when pedalling Swimming your incision must be well healed before you swim to avoid infection.

No whip kick

Activities allowed at 12 weeks after surgery: Golfing Gardening raised garden beds and long handled tools recommended to avoid

excessive hip bending Sitting in the bathtub grab bars strongly recommended Gentle dancing Cycling on a regular bike raise the seat to prevent excessive hip bending Unrestricted sexual activity

Discuss higher impact activities, such as skiing and tennis, with your surgeon.High impact activities such as jogging or racquetball should never be done following your surgery, unless specifically approved by your surgeon.

General FitnessYou can return to the activities you used to do before your surgery, following the guidelines above. Keep your current hip precautions in mind.Remember to start slowly as you will 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. Talk to your physiotherapist about any specific questions you have.

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CEAC #### MMS-5901-14-ddh

September 2014