I would like to know who spe­cial­ises in advising people with hip replace­ments about gym ses­sions and exer­cise. I am wor­ried in case I go some­where where they are not qual­i­fied to give advice for my needs. I need to exer­cise but do not wish to do more harm than good.

Anyone with health com­plic­a­tions or on med­ic­a­tions should take a close interest in how well qual­i­fied their exer­cise instructor is. Different health cir­cum­stances mean that not all kinds of exer­cise are equally suit­able.

Unfortunately the exer­cise pro­fes­sion does not yet have a single or simple set of qual­i­fic­a­tions, and there isn’t a spe­cific cer­ti­fic­ate for train­ing people with joint replace­ments. So you are going to have to help your­self in two ways.

Firstly, you’ll have to be very “un-​British” and be pre­pared to inter­rog­ate any instructor from whom you are seek­ing advice. Ask to have a word BEFORE they start put­ting you to work, and explain that you need to have full con­fid­ence in the instructor you work with. Don’t get over-​impressed by their gen­eral qual­i­fic­a­tions. Instead, ask them spe­cific­ally what they know about hip replace­ments and exer­cise. Here’s a sample check­list:

• Are you a REPS Level 3 instructor? (This is the UK min­imum stand­ard for advising someone like you)
• What spe­cial train­ing have you had for advising seni­ors /​people with med­ical con­di­tions or dis­ab­il­it­ies?
• Have you ever advised or taught any­one with an arti­fi­cial hip?
• Can you explain the main exer­cise do’s and don’ts for someone like me, and why they apply?

Their answers should give you a bet­ter sense of whether you trust their advice or not. And if you don’t, you must say you don’t feel com­fort­able work­ing with them and ask to be seen by a more senior col­league.

While this may seem a scary, even rude, thing to do, I prom­ise you it isn’t. Any decent pro­fes­sional will not be offen­ded, and all you are doing is pro­tect­ing your own well­being. There are very many excel­lent instruct­ors who will be able to offer you good and safe exer­cises; your job is to weed out the ones who don’t have the right know­ledge for your needs.

The second way you can help your­self is to be armed with some know­ledge of your own. For arti­fi­cial hips, a good instructor should know the fol­low­ing basic do’s and don’ts. You will need to have com­pleted your physio, and have the OK from your GP to exer­cise. You should avoid high-​impact activ­it­ies (eg, jog­ging, bad­min­ton or jump­ing) and any­thing risk­ing a heavy fall or knock, (eg, foot­ball, ski­ing or horse-​riding). While swim­ming is great, breast-​stroke leg kick is not recom­men­ded. Until your hip is 100% back to good work­ing order, it’s best to avoid line-​dancing and aer­obic /​step classes because of the many cross-​over leg move­ments. Extreme leg pos­i­tions of any sort may cause prob­lems, so be cau­tious for instance with yoga or mar­tial arts. Your exer­cise ses­sions should focus on build­ing up the muscles sup­port­ing your hips and legs (plus gen­eral heart and lung health).