After a Hip Replacement Operation - Going home advice by physiotherapist Shirley-Ann Walters MCSP
Many people have a lot of questions, especially in the first week home after a Hip Replacement operation. It is good to plan in advance as far as possible before going into hospital, and then review things again once you are at home.
You are likely to feel very tired, you have probably had quite a long anaesthetic, strong pain relief, and the process of getting home. It is important to gently look after yourself whilst prioritising your home exercises which are essential to a good recovery. You probably will need someone to stay with you at first if you live alone. Listen to your body. Rest as you need to, lying back on the bed with your leg raised for short spells if necessary as you did in hospital. It is also important to sit up in a chair too, with the hip and knee at right angles to get used to this, such as for meals, and to walk around frequently to keep your circulation going and use your muscles.
Do you want, and can you cope with visitors? It might be a good idea to spread them out so that they do not overtire you, and this can be planned in advance. Are they coming for your benefit, or their own in some way? You will be rehabilitating for some weeks and they don’t all have to see you at once. Arrange visitors around your exercises or continue with them anyway.
You will need enough pain relief as prescribed to you in order to do your exercises and walking practice without pain being the limiting factor. People commonly say “I don’t like taking too many tablets - it is not natural” which it isn’t, but nor is surgery, and it is an essential part of the over-all procedure in order that you keep moving and make the best recovery overall. If you under-medicate and experience more pain, it can waste precious days of progress and loose you range of movement, and limp more. Stopping or reducing pain relief too soon is one of the most common mistakes made following joint replacement.
Arrange to use a chair that is at a suitable height and access for you to get up and down from, with solid arms if needed. Have a table nearby so that you can reach the things you need.
Do not put your leg(s) up on a footstall for long periods, you probably did not do this in hospital for good reason. Sit with you leg down and gently bend and straighten it frequently. If you have swelling it is important to have a lie down on the bed with your feet higher than you heart for a while, a few times a day. (water drains down hill J )
Move around little and often and gradually increase this as your muscles gain strength and you improve confidence. Use both walking aids you have been given (sticks or crutches) until you can walk with one, or none without any limping, and you may need them even then when going outside or in crowds for a bit longer. Focus on the quality rather than the quantity of your walking and build it up steadily each day.
Make sure you are increasing your range of hip movement every day. This is as important as the strengthening exercises you have been given in hospital. Find a good routine to do the exercises a few times a day or as you were advised to. You might time them for after your painkillers for best advantage. Some people find it helps to do either exercising or walking alternately on the hour, to spread it out.
Rest when you need or feel to. Be active when you feel to, as much as you can.
Once your wound has healed, you may have been advised to use cold on your op site such as a gel pack or a bag of frozen peas well wrapped in a towel, keeping the dressings dry based on instructions. Check you skin regularly for redness as ice can burn and make sure you can feel the coldness so you can tell if it gets too much, it is not meant to be severe. Be gentle with yourself about it, but regular, and once the sutures are out and the skin is fully healed you can massage it gently with a moisturising cream or olive oil.
When can I do this or that?
There maybe rules by the surgeon to be followed about when you are allowed to drive, or remove your pressure stockings so you are likely need help with these things in the early stages. Take notice of the trends in your recovery, as if you have your own line graph, and this will help you anticipate when you are ready for new things, like a trip out in the car such as to have your hair done or visit a local shop. Bigger shopping trips or outings will take longer. It can be inspiring to have something to look forward to that you enjoy.
How much should I be doing?
There will be good days and maybe days when you feel you have done a little too much the day before, learn from them, but your body will gradually get used to your activity again.
Use your un-operated leg up first going up, operated leg down going down – in order to use the strongest leg to do the work. Eventually you may return to alternate legs again as you regain your strength and confidence, usually going up with the operated side recovers faster than going down leading with the other, where the operated leg has to do the lowering work under control.
The first 6-12 weeks following a Total Hip Replacement is the most intensive period of recovery, but you may still look back after 6 or 12 months and see that you have continued to progress considerably, so be patient with yourself.
Shirley-Ann Walters Grad Dip Phys MCSP