We're here today to look at the
exercises you can do before
and after a total hip replacement. These
exercises are designed to strengthen the
muscles around about the joint, to help
support the joint
and to regain the movement in the joint
after your operation.
So, we're going to look at these
exercises. Graeme the
first exercise we're going to look at. Do
they hurt doing these exercises?
So after you've had an operation, you've
had a major operation, then that exercise
will hurt a bit
but it's really important from our
point of view that you're having your
pain relief within the ward
setting
and also when you go home you're taking
your pain relief regularly so you can
do these exercises on a regular
basis. But if I'm sore and I'm doing
these
I mean can you give me something?
Yeah, we can talk to the nursing
staff and they can
look at your pain relief and if you need
some extra pain relief before you do
your exercises that's absolutely
fine. We can do that for you.
Yeah, but I mean if I'm telling you I'm
sore and I need to stop
are folk going to listen to me?
Yeah of course we are. Yeah absolutely.
We're here to push you as much as we
can as physiotherapists and to push your
range of movement and to push the
strength
but we don't want you being too sore. So if you're
too sore you need to let us know and
then we can have a look at that.
All right, okay. So the first exercise
we're going to do, we're going to look at
the ankles.
So, we're just going to pull the ankles
towards you and then push them away.
Excellent, and we're just doing that
repeatedly and that's just designed to
get the muscle pump working because when
you're not as mobile on your feet the
muscles
aren't doing as much as you normally
would when you're up and about.
Good lovely and relax. Good okay. So the
next exercise.
We're looking at the strength of this
muscle here at the front of the thighs. It
is the quadricep muscle.
So we're looking at pushing down so you
squash down onto my hand.
Excellent, and as you can see your heel
come up off the bed a little bit. That's
excellent.
And relax. Again we're going to push down.
Good and relax. So you're pushing down
holding for about five seconds
and then relaxing two, three,
four, five. Good. All right and for the
purposes of these videos we're going to
do two or three of each
exercise but when you're doing them at
home you're aiming for ten repetitions
of each exercise.
Okay, the next exercise. We're going to
think about the muscles in your buttocks.
Okay, so we're going to think about
squeezing your buttocks together.
Lovely, good and relax.
That's a bit sore. So that one can be a
bit sore because that is sometimes
the muscles that have been cut through
when they've done the operation but it
is really important that we get these
muscles
activating again after the operation and
then strengthening them up.
Okay, so again, squeeze. Good
and relax. So again we're aiming for a
five second hold when you're doing that
on. So one more.
When I'm doing this my legs
are tightening as well is that normal?
Yeah, that's normal. Yeah, it's important
that we get all these muscles working
together.
Good, okay so the next exercise we're
going to look at is looking at getting a
bit of movement back into your hip.
So we're going to look at bending the
hip up, so you're bending the hip and
knee
pulling the heel towards your bottom.
Good and then letting it back out.
Excellent, good. And again, slide it up.
My foot's kind of sticking. Yes, so
back down. Okay, so what you can do at
home, or in hospital
is use a plastic bag and what that does
is just
reduces the friction. It makes it a
little bit easier Okay, so if you use
that now.
Slide up, excellent and push away.
Good. That's better now. It's really
important to do this exercise
to keep the toes pointing towards the
ceiling, okay? That's a bit harder.
That's okay though that means we're
getting the muscles working properly.
It's
really important that we do that rather
than letting the muscles
be a bit lazy at the side there okay?
Good.
One more and push away.
Good. Okay, next exercise we're looking at
a different movement. We're looking at
the muscles at the side of the hip here.
So what you're going to do here is let
this leg, keep it nice and straight, and
you're sliding it out to the side.
So it's sliding out. Lovely and pull it
back
in. Good. Again it's important that we
keep the toes pointing towards the
ceiling
to engage all those smaller muscles
around about the hip. So
I can't- that's easier? Yeah that's easier
but we don't want that. We want to
keep it nice and straight towards the
ceiling okay?
Okay. This is sometimes the most
difficult exercise because these are the
muscles that have been cut through at
the side.
So it's really important that you push
yourself in this exercise.
Sometimes you don't get that much
movement when you start this exercise
after your operation
but it will get easier and easier with
the days going on. So how far am I
trying to go with this? So you're taking
it as far as you're able to, again within
your kind of pain limits.
We don't want to be causing too much
pain. I mean I could get it up
off the bed if you wanted? So we don't
want to take it off the bed. We want to
keep it nice and supported because that
puts different forces through the
through the hip that we're not really
looking for right now.
So if I'm at home and I just go
across to one side of the bed.
Absolutely. Okay good. Actually I mean
I'm on a hospital bed at the moment. Do
I need something like this at home?
No not at all. You can do these exercises
either on the bed your normal bed at
home
or you can do them on the floor if
you're able to get on and off the floor.
Nice and easy.
Okay, okay, good. So in summary the
exercises that we've got for the hip
on the bed. We're looking at your
ankles back and forward.
Good. We're looking at the knee pushing
it down, getting the quadricep muscle
working
and relax. We're looking at the muscles
in your buttocks, squeezing them together.
Good. And we're looking at bending up and
back down. And we're looking at out to
the side
and pull in. Good.
Happy with them? Aye. So how
often am I doing these? So you're aiming
to do them four times a day
and keep that going until you feel
that you don't need to do them anymore,
which is usually about six weeks. Right,
okay.