On the Road to Recovery
Everyone’s recovery rate is different. How quickly you recover depends, in part, on your physical health before surgery and how complex your hip surgery was. The hospital staff will continue your care by
- helping you move and turn in bed
- reminding you to cough and do deep breathing exercises
- reminding you to pedal your feet
- helping you get out of bed and walk
Surgery is only half the battle of getting a new hip joint—the other half is physical therapy. A physical therapist will work with you daily on getting out of bed and walking. It is very important that you get out of the bed as early as the day after surgery. The therapist will teach you exercises to strengthen your hip and leg. Exercise also helps blood circulation and prevents pressure sores. Your participation in the therapy sessions and exercises is a very important part of your recovery. You will begin special exercises in the hospital and continue them once you get home.
Before you go home the hospital staff will teach you how to
- get in and out of a bed and a chair
- walk with crutches or a walker
- get in and out of the shower
- go up and down steps
- get in and out of a car
—using your hip precautions, of course!
Taking Part In Your Recovery
As you become more active, you can become more involved in your recovery — even while you are in the hospital. You can
- eat plenty of fiber and protein, and drink plenty of fluids
- get out of bed as soon as you can so your muscles stay strong; start slowly — sitting on the side of the bed, then the chair, then short walks, then longer walks
- wear elastic or support stockings if your surgeon has ordered them
- keep your lungs free of fluid by doing your deep breathing and coughing exercises
It is important that you take deep breaths and cough several times each hour in order to keep your lungs clear of fluid. You may be given an incentive spirometer to help you breathe the right way.
When You’re Ready to go Home
You can go home when your temperature is normal, you are able to get into and out of bed by yourself, and you can get to the bathroom by yourself. As you near the end of your hospital stay, you will be anxious to go home and your mental outlook will improve. Once home, your physical recovery may speed up as family, familiar surroundings, and peace and quiet can help a lot. Before you leave the hospital, your healthcare team will talk with you about
• how to care for your incision
• following your hip precautions
• using your abduction wedge or pillow at night
• an exercise program (physical therapy) to do at home
• special equipment recommended by your surgeon
• when to make your first follow-up visit with your surgeon
• medicines you will be taking
• how much weight you can put on your affected leg
Before you go home, your physical therapist will watch you do your exercises to be sure you are doing them the right way. Ask your family to bring bed pillows for you to use in the car during your ride home. Your stitches or staples will be removed 10 to 14 days after your surgery. Keep your incision dry until the stitches or staples are removed. Be sure to keep all follow-up appointments with your surgeon.
Physical Therapy Exercises At Home
As your hip heals, the muscles, ligaments, and tendons will grow stronger. Make your exercise program part of your daily routine. You can apply heat before exercising to help with range of motion. Use a heating pad or hot, damp towel for 15 to 20 minutes. Sticking to your exercise program will speed your recovery and allow you to regain your independence more quickly. However, too much activity and weight bearing can lead to muscle aches. Muscle aches are a sign that you should cut back on your activities, but don’t stop doing your exercises!
Swelling is normal for the first 3-6 months. To reduce swelling, elevate your leg slightly and apply ice for 15-20 minutes several times a day. Use an ice pack or wrap the ice in a towel, don’t put the ice directly on your skin. Call your surgeon if you have excess swelling or stiffness after exercise.
When You Get Home
Once you’re at home, pace yourself. Be aware of how you feel doing everyday activities. You’ll know when you can increase your activity level—however, don’t use pain as a guide to how much you can do. Rest when you feel tired. Ask for help when you need it. Don’t risk your health by doing too much too soon. Following your surgeon’s instructions and advice is very important; it can help you avoid problems.
you must keep the area around your incision clean while it heals. You will need someone to help you care for your incision. You should look at it every day to see if you see swelling, redness or fluid draining from it or if it feels warm or painful. Change your bandage the way your Healthcare team showed you; do not put any cream or ointment on your incision. If you have very star-strips they will fall off as your incision heals. You don’t have to take them off and you don’t have to replace them.
keep wearing the white elastic socks got at the hospital. You should wear them until your 1st Dr. visit after surgery. You can take the socks off for about 15 min. each day. Get someone to help you take them off and put them back on.
When you leave the hospital go back to your regular diet as soon as possible. A well-balanced diet It will help you recover more quickly. Be sure to eat plenty of high fiber foods. This will help your bowel movements a regular while you are in active and on pain medicine. High calcium foods will help your bones get strong. Iron rich foods will replace iron lost in the blood during surgery.
It’s okay to take a quick shower if you cover up your incision with the plastic bag and don’t let the water spray directly on the area. But do not soak in the bath tub until your doctor says it’s okay. If you have staples or stitches be sure to keep them covered in the shower. Use a tub or shower chair for support. You can also purchase temporary handrails at your local drugstore.
Preventing falls is very important in protecting your new hip. You can prevent falls by wearing shoes with nonskid soles and low, closed heels; using your crutches, walker, or cane; holding onto hand rails; and keeping rooms well lit, even at night.
Watch out for
- electrical cords in your path
- ice or mildew on outdoor steps and walkways
- loose rugs and carpets
- pets that may jump on you or run in your path
- spills on bare floors
- toys or magazines on floors and stairs
Until you build up your strength, plan some rest periods between activities. Your body needs energy for healing. Also, if you get too tired you increase your risk of injury from falling.
Many people use a walker for the first several weeks after hip surgery; a walker helps you with your balance and to keep you from falling. After that, you may use a cane or a single crutch for several more weeks until you get your strength and balance back.
When you’re going up and down stairs remember “up with the good” and “down with the bad.” Go up the step with your good leg first. Then bring your other leg up to the same step. Go down with your bad leg first, then bring your good leg down to the same step. Always hold onto the handrails for support. Do not try to climb steps that are higher than the standard 7 inches high.
When to Call Your Surgeon
Keep 24-hour phone numbers handy. Call your surgeon’s office if you feel you are not healing as you should. Check your incision every day. If you think you have a fever take your temperature. If you have signs of infection or other complications, call your surgeon right away. Also, call your surgeon if you fall.
These are warning signs of infection and other complications:
- pain in your calf or a lot of swelling in your leg and foot
- pain in your hip that is not relieved by pain medicine
- smelly discharge coming from your incision
- red, hot, and swollen incision
- chills or a fever over 100.4˚F or 38°C
- chest congestion, coughing, or problems breathing while at rest
- chest pain
If the signs tell you it’s an emergency and you cannot reach your surgeon, call 911.
Long Term Care for Your Hip
For the rest of your life your new hip will need special care and attention. It is vital that you prevent your new hip from becoming infected. Call your regular doctor if you think you have any kind of infection, such as a urinary tract infection or strep throat (remind him of your hip replacement). When you make an appointment to see your dentist, even for teeth cleaning, remind him of your hip replacement. To prevent infection you may need antibiotics before having dental work, an “invasive” medical test, such as a biopsy, sigmoidoscopy, cystoscopy, colonoscopy, proctoscopy, urinary catheterization or surgery of any kind. If you change doctors be sure to tell your new doctor about your hip replacement.
A major long-term problem for your new hip joint is loosening. You should minimize any type of stress on the hip that can cause loosening. The hip joint bears much of your body weight. Therefore, it is important to control your weight. Excess weight increases stress on the hip and can cause loosening of the hip joint.
Even after your hip heals, avoid activities that involve jumping, bending the hip joint too far, or twisting of the hip. Keep in mind, your new hip is made for the activities of daily living and limited sports! Walking and swimming are among the best exercises for your hip. When walking, wear shoes that fit right and absorb shock. Walk during the day to reduce your risk of falling. You can ride a bike, but make sure the seat and pedals are adjusted for the length of your body. You can play golf, but wear spikeless shoes. Regular spikes may catch the ground and cause a fall. Also, ride in a cart instead of walking and carrying your golf bag. Avoid sports or exercises with a high risk of falling or that overwork your hip such as tennis, racquetball, jogging, high impact aerobics, soccer, basketball, and volleyball. If you have questions about beginning a new physical activity talk with your surgeon first.
Your new hip joint is a large metal object and may set off security system metal detectors in office buildings, airports, or other facilities. Your surgeon can give you a card or note stating you have a hip joint replacement. You may have occasional discomfort in the hip area as well as some numbness around the surgical scar.
Bookmark this article and review it every year on the anniversary of your hip replacement.