Posterior Total Hip Replacement with PrecautionsTotal Hip Replacement Home Exercise Program – Phase I, Posterior, Page 2 6. Terminal knee extension Action: Lie down. Place rolled

The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem.

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Posterior Total Hip Replacement with Precautions

Therapy Resources

X16590 (3/2014) ©AHC Total Hip Replacement

Total Hip Replacement Home Exercise Program – Phase I, Posterior

Apply ice to your incision area for 20 to 30 minutes after exercising to help lessen discomfort. A heating pad should not be used without your surgeon’s approval.

1. Breathing exercises

Exercise can be done while sitting or lying down. Action: Place your hands directly below the “V” formation of your ribs. Take a slow deep breath in through your nose. Keep your neck and shoulders relaxed. You should feel your stomach push out against your hand. Exhale slowly through your mouth with pursed lips, you should feel your belly move inward as you exhale.

Do repetitions times per day.

2. Gluteal sets Exercise can be done while lying down or standing. Action: Squeeze buttocks together and hold for 5 seconds. Relax and repeat.


3. Quad sets Action: While lying down, tighten the muscles on the top of the thigh and hold for 5 seconds. Relax and repeat.


4. Ankle pumps

Exercise can be done while sitting or lying down. Action: Pull foot up and then point foot down as far as possible.


5. Heel slides

Action: While lying down, slowly bend knee, sliding heel up toward buttock. Do not lift heel from surface. Slowly return to the starting position. (Assistance may be needed from another person for this exercise.)


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X16590 (3/2014) ©AHC Total Hip Replacement

Total Hip Replacement Home Exercise Program – Phase I, Posterior, Page 2

6. Terminal knee extension

Action: Lie down. Place rolled towel under knee. Slowly lift foot up by straightening the knee as far as possible. Hold for 5 seconds, then return to starting position.


7. Supine hip abduction

Action: Lie down. Keep knees straight and toes pointed up to the ceiling. Slide involved leg out as far as possible and return to the starting position. (Assistance may be needed from another person for this exercise.)


8. Bent knee fall out

Action: Lie down. Keep the non-surgical leg straight and position the surgical leg with foot on floor and knee bent. Put hands on pelvis to monitor motion. Gently let the bent knee fall out to the side. Do not force additional movement. The back and pelvis should not move. Return to starting position.


9. Knee extension

Action: While sitting, slowly lift foot as you straighten knee. Hold knee straight for 5 seconds then slowly return to starting position.


10. Sitting push-ups

Sit near the front of a chair that has armrests. Place hands on the armrests and bend forward from the hips. Push with your arms and lift the weight of your body halfway to a standing position. Your feet should stay on the floor. Don’t let your spine round forward. Keep chest lifted up to prevent breaking hip precautions. Hold for a count of 3. Slowly lower body back to the starting position using the arms.


Hip Precautions - Posterior

DO NOT bend your body forward more than 90 as in bending way over.

DO NOT sit with your knees turned inward, as this motion rotates the hips in a poor position.

DO NOT cross your operated leg over the midline of your body such as in crossing your knees or ankles

DO NOT sit on a low toilet or chair.

DO NOT stand with toes turned in.

DO NOT lie without pillow between legs.

PE-2213-01 (3/2014) ©AHC


Continued X32639 (3/2014) ©AHC Transfers/Total Hip Replacement

Bed Transfer with Hip Precautions Lying down 1. Sit at edge of bed. Extend surgical leg out in front of you. 2. Support your upper body with your arms. Slightly lean back and lift your surgical leg onto the bed without bending forward past 90 degrees. 3. Lift your non-surgical leg onto the bed. 4. Using your elbows and forearms, lean back and slowly lower upper body down onto the bed.

Bed Transfer with Hip Precautions, Page 2


X32639 (3/2014) ©AHC Transfers/Total Hip Replacement


Sitting up 1. Prop yourself up on your forearms and move upper body forward without bending past 90 degrees. 2. Swing your non-surgical leg off of the bed. 3. Swing your surgical leg off of the bed. Allow your knee

to relax. Do not hold it out stiff. Remember your hip precautions: Do not bring your surgical leg across the midline of your body, and keep your surgical leg in line with your hip.



X24518 (3/2014) ©AHC Adaptive Equipment/ADL

Adaptive Equipment – Dressing: Hip Precautions You may find everyday tasks, such as dressing,may be difficult and will require some thought and preparation following your surgery. By planning ahead and being prepared, you may find these tasks more manageable. The following suggestions and tips may be helpful.

Dressing • Gather all necessary articles of clothing and equipment and place next to where you will be dressing. • Sit on the edge of the bed or in a chair. • Start by dressing your feet using a sockaide. Do not bend to reach your feet or cross your legs.

• For pants and undergarments, dress the surgical leg first.

Use a long reacher or dressing stick to hold garments down by your feet.

• Pull the clothes up with the stick until you can reach the waistband with your hand. Do not lean forward if you have hip precautions.

• Dress the other leg, using the same technique. • Stand with walker for support and pull over hips. • To undress, use the reacher or dressing stick to push garments

down and over your feet. • Undress the non-surgical leg first, followed by the surgical leg.

Do not lean forward.

• Put on shoes using a long-handled shoehorn. Elastic laces are available to make slip on shoes out of tie shoes.

• To take off shoes, use a dressing stick, reacher or long-handled shoehorn to push off.

The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. Aurora Health Care is a not-for-profit health care provider and a national leader in efforts to improve the quality of health care.


X44248b(3/2015) ©AHC

Recommended Adaptive Equipment

With Pictures

Reacher To assist with lower body dressing For picking up items beyond your reach

Dressing Stick To assist with lower body dressing

Sock Aide To assist with applying socks when unable to reach

Long Handled Shoe Horn To assist with applying shoes and following precautions that limit bending

Long Handled Sponge To reach lower legs and back during bathing

Leg Lifter To assist with getting legs in and out of a bed and a car

The information presented is intended for general information and educational purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. Aurora Health Care is a not-for-profit health care provider and a national leader in efforts to improve the quality of health care. AuroraHealthCare.org X44248b(3/2015) ©AHC

Continued.

Toilet riser with or without handles

To add height to toilet seat Beneficial after back or hip surgery

Without handles With handles and lock

Commode Adjustable toilet seat with grab bars and removable bucket Portable – can be used throughout the home Can also be placed over bathroom toilet

Shower Chair With or Without Back Adjustable chair to be used during showering when unable to safely stand for a length of time

With back Without back

Extended Tub Bench Oversized chair that extends over the tub Used when unable to safely step over the tub

*Items can be purchased at most pharmacies, medical equipment or home improvement stores. *

The information presented is intended for general information and educational

purposes. It is not intended to replace the advice of your health care provider.

Contact your health care provider if you believe you have a health problem.


X24520 (Rev. 4/2014) ©AHC Transfers/Total Hip Replacement/Total Knee Replacement

Toilet Transfer Following Hip or Knee Surgery

After your surgery, you may find it difficult to complete daily tasks such as toileting. The following suggestions

and tips may be helpful to you.

Toileting

1. Use the equipment recommended by your therapist(s).

2. Back up to the toilet with your walker until you feel the toilet on the back of your legs.

3. Extend your surgical leg out in front of you.

4. Reach back for the grab bar, toilet seat, and/or armrests and lower yourself to the toilet.

5. Bend your hip and knee on your non-operated leg as your are sitting down.

6. If you have a hip replacement, follow your hip precautions while completing hygiene tasks.

7. When getting off the toilet, extend your surgical leg out in front of you.

8. Push up from the toilet seat or armrests.

The information presented is intended for general information and educational AuroraHealthCare.org purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24521 (3/2014) ©AHC Transfers / Total Hip Replacement

Tub Transfer with Hip Precautions

You may find everyday tasks, such as using the bathtub,may be difficult and will require some thought and preparation following your surgery. By planning ahead and being prepared, you may find these tasks more manageable. The following suggestions and tips may be helpful.

Using the tub transfer bench

Place rubber bath mat outside the tub and non-slip mat inside the tub to prevent falls. Attach grab bars to the side of the tub to help with balance. DO NOT use towel bars. Back up toward the tub until you feel the bench with the back of your legs. Extend surgical leg out in front of you. Reach for the back of the shower bench. Carefully sit down on the bath seat. Lift legs one at a time over the side of the tub and turn to face the faucets. (DO NOT bend your hips past 90 degrees if one was replaced.) Stand to turn on faucets to avoid reaching forward and bending at the waist.

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Standing Tub Transfer After Hip Surgery

1. Align walker next to tub and use wall, sink or grab bar to support yourself. 2. Step into tub with non-surgical leg first. 3. Slightly lean forward and swing surgical leg behind you over the side of the tub.

Car Transfer You may find everyday tasks, such as getting in and out of a car, to be a little harder after your surgery. By planning ahead and being prepared, you may be able to manage these tasks better. The following may be helpful.

Preparation tips for caregivers • Place firm pillow on seat to make it higher. • Use a slick pillow cover or a garbage bag to

make sliding easier. • Park away from curb. • Move seat back and recline. • Stand by to assist.

Getting into car • Back up to car • Tuck head down and place hand on back of

car seat for support while sitting down. • Use only unaffected leg to push up and back

onto seat. • Caregiver assists as needed. • Slowly swivel around. TIP: Wear smooth

clothing to make this easier. • Once sitting place a pillow between knees. • Fasten seat belt and keep back reclined.

The information presented is intended for general information and educational AuroraHealthCare.org purposes. It is not intended to replace the advice of your health care provider. Contact your health care provider if you believe you have a health problem. X24522 (3/2014) ©AHC Transfers

Special precautions • Keep legs apart. • Avoid twisting affected leg. • Follow hip precautions if

needed.

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X16400 (Rev. 3/2014) ©AHC

Activity Reminders After Total or Partial Hip Replacement (Posterior Approach)

Follow these instructions until you see your surgeon in the office. Discuss any questions or concerns with the surgeon. Be sure to ask when you no longer have to follow restrictions.

While sitting • Sit in chairs where your hips are higher or equal

height to your knees. Chairs with armrests are recommended.

• Do not lean forward. Keep your shoulders behind your hips. Do not reach past your knees.

• Use assistive devices or have someone help you put on your socks and shoes.

• Don’t put your foot on a stool. • Put a cushion on low chairs to avoid sitting with

too much hip bend. • Arrange for a raised toilet seat if needed. • Avoid sitting for longer than 1 hour without

getting up to walk. • Avoid reaching at the kitchen table farther than a

90º hip bend. While lying • Keep a pillow between your knees or the A-frame,

if your surgeon orders it. • Keep your operative leg in a straight, natural

position and do not turn the foot in or out. • You may lie on your side if you use the A-frame

or two pillows between your knees. • Do not twist your upper body from your hip.

Getting in a car • Put the seat as far back as possible. Sit buttocks

down first at the end of the seat, slide in, then turn, bringing your legs around in front of you.

When walking • Do not pivot – take mini steps when turning. • Tell your surgeon if you have any new symptoms

or pain while weight bearing. • Avoid standing longer than 10 minutes without

walking. Exercise • Exercise and walk as much as you are able, not

to the point of being overly tired. Keep active with walks and exercises as instructed. For other exercises, such as bicycle riding, discuss with your therapist or surgeon.

Sexual activity • Most doctors suggest waiting 6-8 weeks after the

surgery before having intercourse. • Activities such as touching, holding hands,

caressing, etc. can begin right after surgery. • Take the passive position, and follow your hip

precautions. • Follow any other limitations given by your

surgeon. • Be well rested before sexual activity and be

prepared to rest after. • Take pain medication before sexual activity. • Certain medications can affect sexual desire or

performance. • Talk about these guidelines and any other

concerns with your sexual partner. Driving • Driving is not recommended for the first 4-6

weeks. Ask your surgeon when you can drive.

Documents

Posterior Total Hip Replacement with PrecautionsTotal Hip Replacement Home Exercise Program – Phase I, Posterior, Page 2 6. Terminal knee extension Action: Lie down. Place rolled