Will a return to exercise damage my new hip?

Jane mugshot for JQAI am 62 and had a hip replace­ment last December, after frac­tur­ing my pel­vis. I was always act­ive, but am now very wary . I want my new hip to last for as long as pos­sible. I am visu­ally impaired which makes going to a gym or swim­ming nigh-​on impossible.

The qual­ity of hip replace­ment sur­gery these days is so good that, bar­ring com­plic­a­tions, you can expect many years of excel­lent ser­vice from your new hip. The key is thor­ough rehab­il­it­a­tion. The post-​op physio­ther­apy is just the start. You will have been given inform­a­tion about what move­ments to avoid in order not to strain your new joint, espe­cially in the first few months. And the physios should also have given you daily strength­en­ing exer­cises.

It is essen­tial to do the strength­en­ing pro­gramme, so that the many muscles all around the hip joint can start to provide proper sup­port and pro­tec­tion, tak­ing undue strain off the joint. As your muscles will undoubtedly have become weakened on that side in the lead-​up to your oper­a­tion, it will take a good few months of daily work to get them back into reas­on­able con­di­tion. But be reas­sured, if your muscles are strong and bal­anced, you will not dam­age your hip.

At first, you should be doing your strength­en­ing work mainly lying or sit­ting – using grav­ity and then a res­ist­ance band or leg weight to build the muscles. But your hip must also get used to weight-​bearing again. Start by repeatedly shift­ing weight from one leg to the other, stand­ing with good pos­ture and hold­ing a chair-​back lightly for sup­port. Progress to indoor, then out­door walk­ing and lots of stair climb­ing. Let pain be your guide for when to stop. I strongly sug­gest you keep a record of your daily walks, so you can check you are mak­ing gradual increases (eg 5 minutes each week), and not over­do­ing things.

Of spe­cial import­ance, but often neg­lected, is your “glu­teus medius” walk­ing muscle, high up on the side of your bum. To strengthen it, lie on the right side, legs bent and feet and knees together, then open the top knee like a clam shell, keep­ing feet together. Hold for 5 seconds, squeez­ing the upper but­tock. Release and repeat 10 times daily. For the full exer­icse, click here. After two months, add in stand­ing on one leg, increas­ing over the weeks from 5 to 60 seconds.

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