How to Speed Up Hip Replacement Recovery Time | Lifemoves
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How to Speed Up Hip Replacement Recovery Time with a Kinesiologist-Led Exercise Program

Last Updated: June 14, 2023

Are you feeling frustrated while waiting six months or more for hip replacement surgery?  Even though your Doctor will recommend Physiotherapy to recover post-surgery, there is something you can do today.  

Taking part in a Kinesiologist-led exercise program will speed up hip recovery time.

Ease the Stress of Waiting for Surgery

Deciding to have major surgery isn't easy. There are many things to consider before a joint replacement. The pain often needs to be quite debilitating before having a joint replacement.

Clients often describe the stress of waiting for and having surgery as being both physical and psychological. Also, people hope that the surgery will resolve their chronic pain.

A Kinesiologist-led pre-surgery exercise therapy (prehab) makes hip replacement recovery time quicker, more effective, and less stressful!

Even better, a prehab program can be started immediately!

A prehab program with a Kinesiologist has several benefits. It increases upper-body and lower-body strength. Participants leave feeling more confident and prepared for surgery.

Their goals include the desire to maintain their current level of function and manage their pain.

Patients seek the expertise of a Kinesiologist because they want to learn how to keep moving and make recovery from hip replacement faster.   Also, they want to exercise without the fear of further injury.

Can Exercise Delay Hip Replacement?

Yes,  it is possible to delay surgery.  In an article in the December 2018 issue of Canadian Family Physicians, Aaron Jattan and Brent Kvern describe the case of a woman who was on the waitlist for total knee arthroplasty. They also recommend exercise specialists, chiefly Kinesiologists be part of your health care team.

Her self-described pain level was a "9 out of 10 pain" before she started an exercise program. A year after regular participation her self-reported pain lowered to "1 out of 10." So, in the long run, she didn't need surgery!

What is Prehab for Hip Replacement Surgery?

A pre-surgery hip replacement exercise program prepares people for surgery.  In prehab personalized exercises, assisted fascial stretch therapy, and combine with a home exercise plan. The goals program goals are to strengthen the muscles of the hip and upper body, increase mobility, and improve aerobic capacity. 

Our Kinesiologist-guided exercise rehabilitation program also focuses on increasing upper body strength and core stability.

Who Benefits from Hip Replacement Prehab ?

Most people with significant pain from osteoarthritis need hip replacements when it is difficult to do most daily activities.  For example, they have trouble walking, putting on their shoes, getting in and out of the shower, or going up and down stairs. 

Clients seek pre-joint replacement exercise programs for several reasons. First, they want to continue to be independent and daily activities. 

Second, many people who take part in a prehab program led by a Kinesiologist are active. They also want to reduce the recovery time for hip replacement. Many enjoy gardening, hiking, golfing, and tennis. Prehab empowers them to recover faster from their hip replacement.

I needed to prepare for hip surgery and get in better shape, however I was unable to exercise due to having so much pain.

 I needed a trainer who would understand my limitations but help with strengthening my legs and arms.

 I had already tried to work out on my own and nothing seemed to work.

My Kinesiologist Alfred plans the sessions to meet my specific needs. 

Alfred challenges me within my capabilities but makes sure there is no risk of damage to my hip.

Brenda, Total Hip Replacement

5 Key Benefits of Exercise Before Hip Replacement Surgery 

1. Lowered Risk of Needing Inpatient Rehab

First, completing six weeks of strength training before surgery reduces the need for in-hospital rehab.

Between 2001 and 2003, Daniel S. Rooks compared two groups who needed hip or knee replacement surgery.

One group was given a comprehensive exercise program. To compare, the second group had access only to educational materials.

The exercise program took place three times per week for six weeks. It included land-based and water-based strength training, aerobic exercise, and stretches. 

Notably the group with an exercise program lowered their odds of needing inpatient rehabilitation by a whopping 73 percent!

2. Reduce the Need for Post-Acute Services

Second, prehab reduces the need for post-acute care. Snow et al. (2014) looked at the link between preoperative physical therapy and the use of post-care therapy. They found preoperative exercise therapy reduced the use of post-acute care services by 29%.

Prehab decreases hip pain and increases function for those waiting for joint replacement surgery. This was also true in patients who were most disabled by their condition, Desmeules et al. (2014).

Furthermore, a study on total joint replacements by Swank et al. (2011) found that hospital stays decreased for patients who took part in prehab.

3. Reduce Disability, Keep You Active

Completing strength training and flexibility activities at least twice per week up to the surgery date prevents further disability and manages chronic joint pain. Staying strong and mobile helps you continue to do the activities you enjoy.

4. Minimize Strength and Muscle Loss After Surgery

Although there is some loss of strength and muscle during the early recovery period because patients are moving around less, there is can be minimized.  

Weight training before surgery puts strength and muscle into a savings account.    

Accordingly, patients then withdraw the savings after surgery when they are less mobile, with the purpose of preventing frailty.

5. Maintain the Ability do the Activities You Enjoy and Get Back to them Faster

In 2009, Topp et al. looked at improving function before knee replacement surgery. Their research suggests prehab leads to improved functional tasks. For example, self-care, walking, and climbing stairs.

The prehab intervention group maintained their pre-surgery exercise gains. They also showed significant functional improvements 3 months after surgery.

Other Reasons to Exercise Before Joint Replacement

Several other benefits of participating in an exercise program led by a Kinesiologist include:

  • Maintain or improve hip movement
  • Strengthen hip and leg muscles
  • Control hip pain
  • Build knowledge of how to exercise before and after surgery
  •  Improve sleep. Sleep is important for stress and pain management as well as for healing

Why People Get Hip Replacements

Older adults need hip replacement because of severe osteoarthritis, previous hip injuries, fractures, and vascular necrosis.

Vascular necrosis is a drastic decrease in the blood flow to the joint. The soft tissue and bones start to die because of the reduced blood.  For this reason, a key treatment for this progressive disease is emergency surgery.

Why Active Adults Have Hip Replacements Earlier

Also, active individuals consider hip replacements earlier because they have a high level of pre-surgery fitness.

 A combination of several new surgical techniques, new prosthetics, and their fitness levels, enable them to recover from hip replacements faster.

Also, choosing to have surgery earlier surgery prevents further disability.

How Many Hip Replacement Surgeries Take Place Per Year in BC?

Hip replacements are on the rise in Canada. For instance, there has been an increase of 17.8% in hip replacement from 2011-2015.  

According to the 2016-17 Canadian Joint Replacement Registry (CJRR) Annual Report, 52,000 first-time hip replacements were done during five previous. 

In fact, 7,572 of these were first-time surgeries in British Columbia.

52,000
 Canadian Primary Hip Replacements
7,572
 BC Primary Surgeries
9,400
 Canadian Hip Replacements Revisions

Why Are More Joint Replacements Being Done in Canada?

Joint replacement surgeries are becoming more common in older adults because they lead increasingly more active lives.

Namely a growing number of Canadians will suffer from debilitating degenerative osteoarthritis as the population ages. As a result, 1 in 4 Canadians 65 and older will need hip replacements by 2031.

Other joints replaced include wrists, elbows, and shoulders.

What Happens During Hip Replacement Surgery?

Hip arthroplasty is a complex orthopaedic procedure, but replacing a damaged joint reduces pain which helps a person feel and move better.  

First, parts of the joint are removed partial and total hip replacements.  Afterward, the surgeon places a metal, plastic, or ceramic device known as a prosthesis to match what they took out. These artificial joints are designed to reproduce the movement of a healthy joint.

People are often encouraged to stand and walk with aids on the first recovery day. Each joint replacement only requires a 1-4 day hospital stay.  Patients are then discharged into an outpatient physical therapy program. 

At about 8-12 weeks, once the wound is fully healed it is safe to begin Kinesiology based post-surgery exercise rehabilitation.

Close of joint replacement parts

What Types of Partial and Total Hip Replacement Surgeries?

There are two main types of hip replacement surgeries which are divided into subcategories. The key difference between the direct approaches is where that the surgeon cuts, the front, back or side of the hip. While a new less invasive surgery uses either one or two incisions. 

Direct Approaches

Anterior (Front)
  • This approach is becoming more popular around.
  • It reduces muscle damage, speeds-up return to normal walking, and lowers dislocation rates. 
  •  A front approach keeps the glute muscles needed for walking out of harm's way.
Lateral Approach (Side)
  • Around 60% of Canadian orthopaedic surgeons use this method.
  • Clinical follow-ups report very-low dislocation rates.
  • An advantage is that the femur and acetabulum (hip socket) are more exposed. This gives surgeons more room to work.
Posterior Approach (Back)
  • Most common type practiced worldwide.
  • Interestingly, only 36% of Canadian hip replacements use this approach.

Minimally Invasive Method

  • There is less damage and cutting of the tissues surrounding the hip than in traditional surgery.
  • The artificial implants used are the same ones used during traditional hip replacements. 
  • Surgeons use special surgical instruments to prepare the socket and femur. These tools also help to precisely place the implants. 
Single-incision Surgery
  • The surgeon makes a single cut that usually measures 3 to 6 inches. The length of the incision depends on the size of the patient and the difficulty of the procedure.
  •  An incision is placed over the outside of the hip. The muscles and tendons get cut or detached from the hip, but not as much as in traditional surgery.
  • Muscles are repaired after the implant. This encourages healing and helps prevent hip dislocation.
Two-incision Surgery
  • Two small incisions are made during this hip surgery. First, a 2-3 inch cut near the groin to place the socket, and second, a 1-2 inch cut over the hip to insert the stem of the femur.
  • X-rays are often used to perform the two-incision procedure., the surgeon may need guidance from X-rays.
  • One disadvantage is that it frequently takes longer than the traditional hip replacement.

Hospital stays are similar for all types of hip replacements, 1-4 days.

What are the Risks of Hip Replacement Surgery?

All surgeries carry inherent risks. The Arthritis Society of Canada outlines two categories of risks for hip replacements.   

Surgical and Recovery Risks Include:

  • Blood clots
  • Wound infection
  • Nerve injury
  • Hip dislocation during the early recovery phase
  •  A difference in leg length

Long-term Risks (months or years)

  • Loosening of the implant in the bone
  • Joint infection
  • Allergic reaction to the materials in the new joint

Because of the risks and longevity of the artificial hip, it's important to consider if you need joint replacement surgery now or if you want to postpone.

How Long Does a Hip Replacement Last?

Technological advances in hip replacements and surgeries mean that they are lasting longer and longer these days. However, a revision within 10-15 years is likely.  This all depends on what rehabilitation is completed and how active the individual is.

Since waitlists are often six months or longer, it is wise to explore other options in the meantime.

Remember, it may be possible to delay a hip replacement. exercise program.  Consider a pre-op exercise rehab program with a Kinesiologist.

Hip replacement prehab programs reduce the need for inpatient rehab by 73% #arthritis #hipreplacementsurgery

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We've had clients come to us who want to stay motivated while maintaining their ability to walk, climb stairs and even dress while they wait for their surgery date.  

Our Kinesiologist-guided prehab program focuses on increasing upper body strength because you still need it for getting in and out of bed, ambulating  with crutches, walkers and canes and sitting and rising from chairs and the toilet.

man using crutches during hip replacement rehabilitation

How to Recover from Hip Replacement Surgery

So, you've been discharged from the hospital and now you want to speed up hip replacement recovery time. 

Even if you didn't take part in a prehab program physical rehabilitation is still extremely important. 

Patients are first referred to an outpatient Physiotherapy program for 6-8 weeks. This is where you will visit the hospital 1-2x per week.  In most cities, there are also home-visit Physiotherapists available.

The role of these sessions is to get you walking, climbing stairs and being able to take care of yourself again.

Returning to Recreational Activities and Hobbies After a Hip Replacement

After the first 8-12 weeks you are likely looking forward to and ready to do more. Kinesiology sessions are right for you if you want to get stronger, fitter and more mobile at this stage.

A Kinesiologist will help you safely learn to exercise with your new joint so you can return to golfing, playing doubles tennis or gardening.

9 Moves to Avoid After a Hip Replacement

There are a few precautions and guidelines to follow while moving around during the first 6-8 weeks to lower the risk of dislocation. 

The risk is lower for an anterior (front of thigh) than a lateral (side of body, hip) approach. Health Link BC even says it may be safe to have sex after the first 4-6 weeks post-hip replacement. Consult your surgeon and physiotherapist for more details. 

  1. 1
    Always have a pillow between your legs when lying on your non-operated side. It keeps the legs parallel.
  2. 2
    Avoid standing for long periods of time.
  3. 3
    Don't cross your legs or ankles past your mid-line
  4. 4
    Try not to bend down low when sitting or picking something up. There are assistive devices for this.
  5. 5
     Get someone else to lift heavy objects. Don't over-exert.
  6. 6
    Avoid forceful movement or jarring of hip.
  7. 7
    Be mindful of twisting the hip.
  8. 8
    Don't lie on the operated side.
  9. 9
    Sit in a firm chair. Use a chair wedge. Rent or buy something to make the toilet seat higher.

Education and Exercise Improves Long and Short-term Quality of Life 

Long wait times and uncertain outcomes are disappointing and frustrating.  As a result, patients consider different treatment options to deal with their pain and decreased quality of life while they wait for hip surgery. 

It is clear that the combination of exercise and patient education before joint replacements has positive effects on quality of life and long-term outcomes.

The key benefits are:
  • Reduced hip pain
  • Improved functional capacity (the ability to complete daily activities
  • Increased muscle strength and cardiovascular endurance
  • Faster hip replacement recovery time

Those who take part in prehab recover from hip replacement faster. Lastly, they return to activities and get back to fitness-based exercises with a Kinesiologist sooner than those who don't.

Get started today. Book an assessment online or call.

Authors: Madani Diarra, a 4th-year Kinesiology student researched and wrote the original article as a practicum project. Contributions, design and edits by Alfred Ball, Practicing Kinesiologist and Certified Fascial Stretch Therapist. 

Updated by Alfred Ball in June 2023.

References


Before, During and After Hip and Knee Replacement Surgery. A PATIENT’S GUIDE. (2019). Retrieved from http://oasis.vch.ca/media/OASIS-before-after-hip-knee-surg.pdf

Desmeules, F., Hall, J., & Woodhouse, L. J. (2013). Prehabilitation Improves Physical Function of Individuals with Severe Disability from Hip or Knee Osteoarthritis. Physiotherapy Canada, 65(2), 116-124.

 Exercise Guide for Hip Replacement Surgery. (2019). Retrieved from https://vch.eduhealth.ca/PDFs/FB/FB.863.Ex37.pdf

Hip and Knee Replacements in Canada, 2016–2017. (2018). Retrieved from https://secure.cihi.ca/free_products/cjrr-annual-report-2018-en.pdf

Jattan, Aaron and Kvern, Brent. Exercise Specialists Should be Members of Our Health Care Team. Canadian Family Physician December 2018, 64 (12) 879-880;

Minimally Invasive Total Hip Replacement - OrthoInfo - AAOS. (n.d.). Retrieved from https://orthoinfo.aaos.org/en/treatment/minimally-invasive-total-hip-replacement/

Petis, S., Howard, J., Lanting, B., & Vasarhelyi, E. (2015). Surgical approach in primary total hip arthroplasty: Anatomy, technique and clinical outcomes. Canadian Journal of Surgery, 58(2), 128-139.

Rizzo, T. (2019). Prehab for Surgery. [online] Arthritis.org. Available at: https://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/preparing/prehab-surgery.php 

Swank, A. M., Kachelman, J. B., Bibeau, W., Quesada, P. M., Nyland, J., Malkani, A., & Topp, R. V. (2011). Prehabilitation Before Total Knee Arthroplasty Increases Strength and Function in Older Adults With Severe Osteoarthritis. Journal of Strength and Conditioning Research, 25(2),

Topp, R., Swank, A., Quesada, P., Nyland, J., & Malkani, A. (2009). The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty. PM&R1(8), 729-735. doi: 10.1016/j.pmrj.2009.06.003

Alfred Ball

Practicing Kinesiologist | Certified Fascial Stretch Therapist | Clinical Pilates Instructor. He has worked in the health, fitness and rehabilitation industry for over 20 years. Alfred started Lifemoves in 2007 to provide exercise therapy and fitness programs for people with injuries, chronic diseases and disabilities. His focus as a Kinesiologist is to empower and to guide people to learn to move with more strength, confidence and ease.

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