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If you have hip pain, you may benefit from physical therapy to learn specific exercises and strategies to help manage your condition. While physical therapy can be very successful, sometimes the damage to your hip due to osteoarthritis (OA) is too great, and more invasive measures need to be taken to help you get back to your normal lifestyle.
If OA is causing your hip pain and you are having difficulty managing basic functional tasks, you may benefit from a surgical procedure called a total hip replacement (THR).The procedure involves removing your arthritic hip joint and replacing it with an artificial hip.
The hip is a big joint in your body, and the THR surgery is a big surgery. There will likely be some post-operative pain, and you will have difficulty moving around after the procedure. The good news is that you can start working on your rehabilitation very soon after you have a THR.
After your THR surgery, you will likely encounter a physical therapist in many different settings. An acute care physical therapist may visit you in the hospital immediately after your surgery. You may or may not require acute or sub-acute rehabilitation, or you may simply be discharged from the hospital direactly home. Either way, you may benefit from physical therapy to help you regain your normal function. Outpatient physical therapy is usually your final step before returning to full function after a total hip replacement.
Whatever setting you are in after your THR, from the hospital or the outpatient clinic, a physical therapist can help you get back to your normal lifestyle along the way.
Immediately after your THR surgery, a physical therapist will likely visit you in your hospital room. He or she can help review your total hip precautions and start some gentle exercises to improve your hip range of motion (ROM) and strength.
After a THR, you will likely require an assistive device like a standard or wheeled walker for mobility. Your PT can ensure that your device is the correct size and can help you use it properly.
The THR hospital is usually one night, but that depends on the patient, with some patients needing two or three days after the procedure. Your physical therapist will likely work with you every day in the hospital.
Hopefully, after a few days in the acute surgical hospital, you will be ready to go home. Sometimes mobility limitations may prevent you from going directly home. In this case, you may be sent to a sub-acute rehabilitation hospital to continue working with a physical therapist (and other rehab professionals) to regain your basic functional mobility.
You can expect the physical therapy sessions at the sub-acute rehab hospital to be a little more intense than those at the surgical hospital. Many sub-acute hospitals require physical therapy sessions to be performed twice daily.
Your PT at the sub-acute rehab hospital will continue to work with you to improve your hip range of motion and strength and will continue to advance basic functional mobility like walking, dressing, and stair climbing.
The main goal at the sub-acute rehab center is to help you regain safe functional mobility so you can return home.
Once you return home after your THR procedure, you may benefit from home physical therapy to continue working on improving your functional mobility and strength.
Your home care physical therapist can teach you how to climb stairs safely, how to move in and out of bed, and how to use the proper assistive device for walking. Your physical therapist can help you progress from using a walker to using a quad cane or standard cane for walking.
Home care physical therapy after THR is usually reserved for people who cannot leave their house due to travel limitations. If you have family members or friends who can drive, you may be able to skip home physical therapy and proceed directly to outpatient physical therapy.
Your final step in your THR rehabilitation is physical therapy at an outpatient clinic. There you will continue to maximize your hip ROM. Advanced hip strengthening exercises can be performed, and you can focus on maximizing your balance and proprioception.
You may start using a stationary bicycle or a treadmill to help improve your muscle endurance and walking ability while in outpatient physical therapy. Your physical therapist will continue to reinforce your total hip precautions as well.
By the end of outpatient physical therapy for your THR, you should be walking normally with no assistive device. Your pain level should be under control, and you should be ready to return to your normal activities.
A total hip replacement can be a painful experience that may make simple tasks like walking and dressing difficult. By working hard in physical therapy every step of the way, you may be able to quickly and safely return to your previous level of function and mobility.
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By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.
