Just a few years ago, almost all patients who received a hip fracture and who suffered from arthrosis were limited in movement. They had no choice but to lock themselves at home and not go out. Such patients were assigned disability status. But today, thanks to modern developments, which have also touched on medicine, there was a hope that the bed patient after rehabilitation will get a chance for a normal, full life. Exercise therapy after hip replacement is a way out for those who have been sentenced to restrictions after a similar injury. The procedure is prescribed by a doctor for each patient.
Why is rehabilitation necessary?
Endoprosthetics is a surgical procedure involving the replacement of a joint with a prosthesis. Such a decision allowed a chance to those to whom the verdict was passed - a lying lifestyle. However, with such a pathology, not only the operation itself is important, but also rehabilitation after endoprosthetics. Exercise therapy of the hip joint will give good results, but only if the patient follows all the recommendations.
Joint replacement surgery is a technically difficult procedure, it is traumatic for the patient. After her, severe pain worries, but this is not the only inconvenience, other problems may also appear:
- muscle atrophy is significantly exacerbated;
- in rare cases, there are changes in the indicators of blood coagulability;
- intestinal motility is disturbed;
- in elderly people, malfunctions of the heart are observed;
- blood pressure jumps.
That is why rehabilitation should be comprehensive. Each patient is individually selected complex of exercise therapy after endoprosthetics of the hip joint, its concomitant diseases are taken into account. The complex can include not only exercises, but also the intake of drugs, as well as physiotherapy. But the most important stage can be considered physiotherapy exercises, which is aimed at restoring the mobility of joints and limbs. It is a mistake to consider that after the operation it is necessary to lie longer. A long stay in a lying state leads to thrombotic complications and problems with the restoration of joint mobility.
In order to achieve maximum results and begin a full life after hip replacement, light physical exercises are recommended for exercise therapy, which should begin to be done almost the next day after surgery. The main principle of exercise therapy is the observance of stages, it is better to divide all exercises into phases, it is easier to get positive results without negative consequences for the patient.
Rehabilitation periods
Exercise therapy after hip arthroplasty consists of three stages:
- early, it is also called gentle, begins on the 2nd day after the operation and lasts no more than a week;
- early tonic flows 7 days after the start of the exercise complex;
- late postoperative begins two weeks later and can last up to three months;
- distant, or adaptive, occurs three months after surgery, and its duration is three months.
To understand how the restoration of the joint works, you need to consider each stage in more detail.
Early stage after surgery
As mentioned above, it begins one day after the patient leaves the anesthesia. It lasts until the third week. A few basic rules will help you prepare for the main set of exercise therapy exercises after hip replacement:
- sleep a few days after surgery is desirable only on the back;
- in the early days it is better to turn to a healthy side with the help of a health worker, and to the stomach - only on the fifth day;
- no sudden movements of the hip joint;
- no need to bend the sore leg;
- legs cannot be joined and crossed, it is better to put a small pillow between them;
- from time to time during the day you need to do simple exercises that will not allow blood to stagnate.
Early Goals
Why you need to start exercise therapy after hip replacement immediately on the second day:
- this will help improve blood circulation in the thigh area;
- will allow you to learn how to sit on the bed, and then get up so as not to harm the joint;
- help prevent the development of complications, including thrombosis, pleurisy and pressure sores;
- accelerate healing of the suture;
- will contribute to the early reduction of puffiness.
The main set of exercises
These exercises will help develop and strengthen the artificial joint:
- The movement of the toes. It is necessary to bend and unbend the fingers on both legs in a sitting or lying position.
- Pump. This exercise is allowed to be performed after recovering from anesthesia: the ankle foot needs to be bent forward and backward. You need to perform it for an hour for 6 approaches, until that moment when there is a slight fatigue.
- The rotation of the feet in different directions 5 times.
- The quadriceps muscle tension. Proceed with a healthy foot. Press the popliteal fossa to the bed as much as possible and hold the tension for several seconds. Only on the third day can you do the same only on a sore leg.
- Contraction of the muscles of the buttocks. Alternately tighten the muscles of the buttocks and hold the tension for several seconds.
- Bending the knees. This exercise should be done slowly, without jerking. Slowly sliding along the bed, raise each leg in turn, bending at the knee.
- Abduction of a flat leg to the side. Slowly each leg should be taken to the side and returned to its original position.
- Extension in the knee. Under the kneecap put a small roller, rolled up from a towel. Slowly straighten the leg, an exercise is done on both legs.
- Lifting a smooth leg. Take turns to raise a couple of centimeters of each of the legs.
How to carry out exercises so as not to harm?
Exercise therapy after hip joint surgery will be beneficial if everything is done correctly:
- you need to do the exercises several times a day, spending at least 15 minutes each;
- the pace of exercise should be slow, without jerking;
- classes should be combined with breathing exercises: when muscle tension - a deep breath, and when relaxing - exhale;
- breathing exercises will not allow stagnation in the lungs;
- exercises from an early stage are best done only lying down (but get out of bed to at least stand), after moving to a sitting position.
This complex is best performed strictly according to the list that was presented above. It will help the muscle tension build up gradually.
Late stage of rehabilitation
It starts about a month after hip replacement. The late period of exercise therapy lasts about three months. This period has two main goals:
- muscle training and tone increase;
- restore the range of motion of the joint.
After the patient has already got out of bed, easily sits down in a chair, walks on crutches confidently, the motor regimen just needs to be expanded with training on an exercise bike, but each lesson should last no more than 10 minutes and should be carried out better in the morning and evening. Also, the patient should gradually learn to walk up the stairs.
You need to start climbing the stairs with a healthy leg, substituting the patient. And it is better to go down the stairs like this: crutches, after the operated leg and healthy.
Adaptation (remote) period
3 months after hip replacement. The rehabilitation phase is adaptive and lasts three months, and in some cases, much more. Its main goals are:
- full restoration of the artificial joint;
- accelerate bone restoration;
- improve the condition of muscles, tendons and ligaments.
This period involves the thorough preparation of the operated patient for more intense exertion and adaptation to the usual life. Exercise therapy at this stage is supplemented with physiotherapy: applications using mud and paraffin. Balneotherapy, laser therapy and other procedures are also recommended.
A set of exercises for the home
Workouts at home should always be complemented by more complex exercises:
- Lying on your back, you must take turns bending and pulling your legs to your stomach, imagining that you are riding a bicycle.
- Remaining in a prone position, bend your legs and pull them to your stomach, while you need to help yourself with your hands.
- Lie on a healthy side and put a roller between the legs. Raise your leg a little and stay in this position for as long as possible.
- Lying on your stomach to bend and extend your legs at the knees.
- Remaining in the supine position, alternately raise the straight leg, slightly backward.
- To stand at attention, the back is even, hands to hold the back of the chair, slowly squat.
- To stand upright, put a stand with a height of no more than 10 cm near the feet. Step on the stand, starting with a healthy leg, and lower yourself from the operated one and so walk slowly.
- Stand next to a chair and lean on its back. At the ankle of the operated leg, put on a loop of elastic cord, and fix the other end to the furniture leg. Pull straight leg forward, and then toss and turn to bring it back.
Exercises that need to be done with a straightened leg are excellent for patients after hip replacement. Exercise therapy at home will help you recover faster and return to your usual lifestyle.
A set of exercises on simulators
In the adaptation period, the complex expands, exercises are performed not only at home, but also in the gym on simulators. By this period, the muscles and joints are already quite strong after surgery, so the load can be increased. This set of exercises will help to develop the joint and strengthen muscles as best as possible:
- Bike. First, on the simulator, you need to pedal backwards, if efforts are not applied, then you can proceed to scroll forward. Gradually, you need to increase the training time, and conduct classes at least three times a week.
- Hip extension. Put the sick leg on the roller of the simulator - the roller should not be fixed, be under the thigh closer to the knee, while hands should hold onto the handle. Press the roller, imagining that you are pumping. Movements should not be sharp and with effort.
- Exercise bike with low pedal position. Need to simulate a ride. The pedals must be adjusted so that when lowering the pedals the leg is straight.
- Walking on a treadmill. You need to start with a walk back. The pace is initially slow, with gradual acceleration.
Conclusion
At each stage of exercise therapy after total hip replacement, the control of the attending physician is important. He will help and tell you what exercises are best to do and when to start adding loads. It is impossible to independently decide on classes on simulators. Any sudden movement can lead to serious and irreparable consequences. Following all the recommendations and not being lazy, after six months you can completely forget about the operation.