Happy Hip Replacements – exercises before and after rehab

It turns out that, along with Gucci handbags, a lot of people are getting hip replacements these days as part of their everyday fashion statement. If you are thinking of adding in a hip replacement/ therapy into your wardrobe, here is a list of the most common choices:

  1. Total hip replacement.
  2. Partial hip replacement.
  3. Hip resurfacing.

There are also other alternatives to hip replacement that have strong evidence of working just as well in certain circumstances.

  1. Prolotherapy injections.
  2. Platelet Rich Plasma injections (PRP Therapy).
  3. Stem Cell Therapy.

But before you go out and get a new hip you might want to know a little about your hips and how they work. The hip is a ball-and-socket joint. This joint has a large range of movement. The ball of the hip joint is the femoral head (top of your femur). This rotates within a socket, in the pelvis, called the acetabulum.  This is where a lot of problems occur either because of genetics, accidents, but most commonly due to improper movements and functions. Over time things become stiff and sore, but I have found in my line of work that age is not an excuse for needing a hip replacement.  It is the activities or lack thereof that lead to needing hip replacement/therapy.

What movements are best to keep your hips happy. Let’s look at what movements of the hip that can be carried out at the joint.

  • Flexion – Lifting the leg up to step on the stairs. Muscles involved; iliopsoas, rectus femoris, sartorius, pectineus
  • Extension – Pushing down on the leg and moving forwards. Muscles involved; gluteus maximus; semimembranosus, semitendinosus, and biceps femoris (the hamstrings)
  • Abduction – Stabilising the leg for balance, pushing the leg out to the side. Muscles involved; gluteus medius, gluteus maximus, piriformis, and tensor fascia latae
  • Adduction – Stabilising the leg and bring the leg back to the centre. Muscles involved; adductors longus, brevis and magnus, pectineus and gracilis
  • Lateral rotation – Rotating the leg outwards as in Ballet dancing. Muscles involved; biceps femoris, gluteus maximus, piriformis, assisted by the obturators, gemelli and quadratus femoris.
  • Medial rotation – As in kicking a soccer ball. Muscles involved; anterior fibres of gluteus medius and maximus, tensor fascia latae.

As you can see there are a lot of muscles involved just to keep you upright and walking forwards. A simplified example is the effect over time from sitting at a desk 8hrs a day. The flexion muscles “iliopsoas, rectus femoris, sartorius, pectineus” become short and tight, pulling on the lower back, and consequently the extension muscles become elongated and weak causing the pelvis to tilt forwards.  This causes the femoral head of the femur to become impacted into the hip socket, ouch!

So, you ask, how do you keep your hips happy without becoming too much of a hippy?   Firstly, try to limit sitting to no more than 90 minutes at a time.  Why 90 minutes you may ask, different story for another time!

Secondly when walking around, keep your hips in a neutral position. Think of the hips (pelvis) as a giant bowl of water and you do not want to spill any. Try to not tilt your hips forwards or backwards. This rule does not apply if you are dancing, but do not quote me on this, we must ask Estelle to get the answer!

Thirdly, there are an endless supply of exercises and stretches that are fantastic for keeping your hips happy and hippy.

Here are a few exercises that you can try at home.

  1. Seated abduction and adduction isometrics. Use a band around the knees press outwards. Use a ball or pillow between the knees and press in. Do both for 4 x 30sec.
  2. Prone hip extension: Lying on your back lift the hips up to the sky. 4 x 10 repetitions.
  3. Prone Knees bend: Lying on your back, bend the knees and gently let them fall side to side.  4 x 5 to each side.
  4. Standing Single leg hip hike: Standing on one leg, lift the unsupported hip up to the side, as if you are dancing.
  5. Standing Hip adductions, abduction, extension, flexion: In a controlled manner swing one leg in all 4 directions, forward, to the side, across the body and then behind.

If you have any question, please do not hesitate to contact us. Alternatively, you can visit our YouTube channel where we have videos of several of these exercises.