Facing a hip surgery or recovering from hip trauma can be a scary thing! Most adults facing this are typically 65 years and older. However, a hip injury or surgery can happen to anyone at any time. Common hip injuries come in the form of:
- Broken hip or hip fracture: This is a break in the upper quarter of the thigh bone, close to the hip joint.
- Snapping hip syndrome: Also known as dancers hip, coxa saltans, or iliopsoas tendinitis, this is when there is a snapping sensation felt when the hip is flexed or extended.
- Labral tear: The labrum of the hip is a crescent-shaped cartilage structure that runs along the rim of the hip socket. It offers the necessary support and cushion to stabilize the hip joint. Tears of the labrum are brought on by a sudden or specific injury. It can also be caused by repetitive motions over time.
- Dislocation: An injury where the hip is displaced from its normal position.
- Bursitis: This is a common type of hip pain, usually occurring outside the hip. It can worsen with activities or long periods of standing and walking.
“Returning to exercise after hip surgery can be beneficial in many ways. Not only is it important in order to get back to your previous level of activity by increasing strength, mobility, and flexibility, but it will improve your cardiovascular health, balance, and endurance,” shares Owner of AIM Orthopedics Dr. Raffaele Lagonigro, PT, DPT. It’s critical to know when it’s safe to return to exercise, as well as how to go about getting back into the swing of things. Often times, people return back to working out either too soon or not at all. In other cases, recovering patients are turning to the wrong workouts when they head back to the gym.
Below, experts share moves that can be done in and outside of the gym to help support a healthy recuperation period after hip trauma.
Whether you have experienced arthroscopic surgery (a minimally invasive surgery performed through small incisions utilizing an arthroscope, an instrument the size of a pencil, which helps to visualize the joint and the surrounding area) or a total hip replacement, some sort of rehabilitation will be required. Therapy sessions usually include in-home or outpatient care. “You will spend time increasing flexibility, joint mobility, strength, and balance. Most spend anywhere from four weeks to three months receiving skilled treatment,” explains Dr. Lagonigro.
Exact recommendations will vary based on age and agility. Many of the exercises prescribed after hip replacement surgery include moves that keep the surrounding area strong and mobile. “Ankle rotations, ankle pumps, and knee bends are some of the more commonly suggested exercises. Once you are further along in healing, consider incorporating yoga into your routine—the gentle stretching can help enhance functionality, increase muscle strength, and improve blood circulation,” explains Dr. David A. Greuner, MD, FACS, FICS of NYC Surgical Associates.
Having a postoperative plan is key. Educate yourself on the in’s and out’s of your surgery in order to recover and heal properly. This will also help to avoid a relapse in the healing process. “Evidence suggests that postoperative therapy exercise can be initiated within hours after most surgeries. Adhering to a prescribed rehabilitation routine after hip surgery helps to offer patients an improvement in gait speed, muscle strength, and quality of life,” shares Dr. Greuner.
To avoid further injury, it’s vital that both strength and functional exercise therapy be under the direction of a trained physical therapist. Therapy sessions should be continued in the postoperative period until maximal recovery of physical function is reached.
When opting for yoga after surgery, a conservative plan should be cultivated and at least a year of healing. Each case is different, so you should definitely consult your physician before diving into your next yoga class. “If it is a hip replacement surgery [that] you are recovering from, there are some things you want to consider in the three to six months post-surgery,” explains Taryn Lagonigro, RYT-200 yoga instructor and owner of Iris Mind+Body. “Be sensitive to adduction (crossing the leg over the midline of the body), internal rotation, and flexion beyond 90 degrees. Ask your yoga teacher for a list of poses they may use in class and discuss with your doctor or physical therapist if you have any concerns.”
Overall, yoga is excellent for reducing stiffness, increasing flexibility, and strengthening the muscles. There are several ways someone can use yoga to gently return to exercise post-op. Lagonigro suggests the following moves that can be done in and outside the gym.
If you’re either still injured or immediately following surgery, seated chair yoga for the upper body is perfect for getting the blood flowing and keeping the arms and shoulders in shape.
Once you can progress beyond chair yoga, the slow, gentle stretching of restorative yoga is a great next step. This type of yoga takes place mostly seated or lying on your mat and involves lots of props to support the body in each pose. Many restorative poses are perfect post-injury, as you bear little weight on the joints. This gentle stretching can increase flexibility and blood flow to the area (which can help the area heal quicker).
As you heal, you can increase the types of poses that you can do to further strengthen the muscles and joints. Vinyasa yoga can also help balance the body, especially the hips, which will improve mobility as you heal.
After you have recovered, it’s important to take extra care of the affected area in the future. You can use foam rollers and fascia release balls in conjunction with yoga stretching to keep the area loose as you increase your activity. It’s important to find a yoga instructor who specializes in fascia release to learn proper technique and complimenting stretches.
Pilates can be performed after hip replacement surgery with discretion. Each case is different, but this type of fitness has been known to help increase range in motion, flexibility, and overall strength. Katy Lush a retired dancer and Pilates instructor says, “Every hip surgery potentially has its own recovery movement protocol. Below are tips that would apply to any type of hip surgery recovery.”
Back your hips up: Check your pelvis alignment. Does your pelvis tend to drift forward over your toes? If so, you could be unnecessarily loading your quads and knees and not placing the proper force over your hip joints affecting bone density and hip health. To fix this, try to move your pelvis back over your heels and become aware when it begins to shift forward.
Hip listing: After stretching your hips out, it’s nice to strengthen the outer glutes to aid in walking and hip health. Begin barefoot with backed up hips. Shift your weight to your right leg. Drive your right heel into the floor so hard that your left foot floats off the floor with a straight knee. Balance and hold for a breath or two. Place the floating foot back on the ground and try the other side. If you need to hold onto a wall, that’s okay in the beginning. However, you want to eventually wean yourself off the assist. Work your way up to balancing on one leg for a minute.
Finding ways to keep the joints mobile post-therapy or in between sessions is important. “Exercise will help minimize muscle atrophy, keep blood circulating, and keep the surrounding healthy tissue strong and flexible so that it can help support the weak or injured area,” says Dr. Greuner. Gentle exercise will help to keep you active until you feel like yourself again.
Dr. David S. Levine of Atlantic Medical Group suggests simple moves 20-30 minutes a day, during the week. Most exercises should focus on the lower leg, hip, buttocks, and core. Starting with simple exercises like ankle pumps can help reduce the risk of forming blood clots following surgery. Other simple moves that can be done at home include knee bending exercises and straight leg raises. The best part is that you can do many of these exercises seated or lying down with little risk of falling. If you are feeling strong, doing these exercises standing also engages the core musculature, which helps support the hip joint. What continues to be the most effective form of fitness is walking. “Walking and stair climbing is also therapy in itself, done safely with the right supervision [it] can help get the patient back to baseline faster,” shares Dr. Levine
It is absolutely critical that you work with your personal doctor and physical therapist to employ the proper rehabilitation techniques for your situation. With the right guidance, and over time, being disciplined about your exercise routine may be the most important thing you can do to speed up your recovery safely.