Hi, I'm Bob Schrupp and I'm a physical therapist. My name is Brad Heineck
and I'm also a physical therapist and today, we're going to talk about
precautions with hips.
Particularly specifically after a hip replacement surgery. Alright after it
I don't know if how many of you actually know what goes on when you have a hip replacement, but what they do is
They actually the hip is normally a ball and socket, and I don't know if you can pick this up Lindsay, but here's the ball.
And you see that.
Alright and it fits you know well know well into this socket here. Now with hip replacement
they actually replace this ball with a metal ball, and they actually replace the socket - they actually put a liner in there.
I guess wouldn't you call it and
with all that that goes on and with the surgery where they make the incision there's the
concern that the ball can actually pop out of the socket. If you do things wrong and only if you do things wrong.
So we're going to go over which things you shouldn't do today.
So the first thing that anything else going to add to that Brad? No,
I just wanted to relate this you know I'm sitting here if you can see my skeleton,
this would be doing. Here's the femur all like this okay. When you stand out further. Right exactly.
Cut off like this model, and of course what I'm going to do is
just so you always have a reference where my hip is or if in place. I've got a red flag right here.
So that's we're referring to the hip is right there and right now here. I'm sitting in what we call 90 degree position.
This is a goniometer.
I'm using therapy all the time. We set it at 90 degrees and
this is a 90 degree position
and you will hear that term if you get your hip.
Or a right angle on 90 degree is a right angle, so
his upper body and his legs are forming the right angle, now you do not want to go beyond that that's the key here. You
don't want to have your knees higher than your hips that's now less than a right angle.
And now you are at risk of popping that hip out. So what are some of the things that could cause you to you know?
Cause that hit the pop out? One thing is if you're in this chair if brad would just lean forward and reach forward
it's kind of a reverse situation you can either bring your knee up this way to break the rule or you can keep your
Legs still and lean forward that also breaks that 90 degree rule and right now
I'm stressing that hip and this is what you definitely do not want to do
when you come out of hip surgery. The surgeon will let you know whatever and also many times,
but if you do that you have high risk for taking that hip and popping it right out of socket and then you gotta go
back into the surgery. So even with that if you're going to get out of a chair
a lot of people in order to get out of a chair they lean forward like that.
So the better way to get out of a chair is after you have hip surgery is actually to slide forward a little bit. And now
you can keep this one bent all you want,
but this one is the one you you're gonna have to maybe straighten out, and then you're going to use your arms to push up .and
I was going to lean forward
Yeah. And that's why often you're going to need chairs with arms to get up out [of] a chair initially Brad can do it because
he's strong, and that hip hasn't been replaced, but it's often very difficult [okay] when you're trying to avoid the 90 degree angle or less
With after a hip replacement one thing you gotta be concerned about is soft
cushions or soft couches. That's right Bob see here
we've got a couch here that's soft you think it's getting more comfortable for your recovery, but if you look right here
And here's a red flag showing
This is the hip disc replaced look at the angle gear on the link here and here, and I'm passing a 90 degree.
I'm actually too deep into this chair put my hip at risk for dislocation. So what you do with that
you simply can take a throw pillow or
some firm pillow that's going to lift you up and then when you get down in
there you don't sink so far
you maintain that right angles so you don't put that risk. The same holds true with the toilet.
That's why they're going to I'm sure before you leave the hospital. They're going to probably
Provide you with either a commode or an elevated toilet.
Seat so when you get on the toilet
you're not breaking that rule. Right, the toilet hip, they call them risers.
There's four inches they go on your toilet very easily if you don't have to
have a plumber or anything like that calories just met on purchasing the riser and using it.
Okay. Okay, the next you want to go over with hip precautions is in and out of the car.
Let's say we got a bench seats here for a car, use your imagination.
I open the door up this way and normally we get in the car,
we put one foot in here the other foot in and we hop in. Well
that's not the way we're going to want to do it after a hip replacement.
You're going to open the door up this direction
Okay, and you're going to come in, turn
so your backside's facing towards the seat take your time, sit down slow, keeping up tall,
get on there and back into the seat like so. Take one leg at a time.
Here is the red flag that's my hip, now this you're not going to try and get up here.
You're going to lift it up as little as possible, just enough to clear
the doorway and
get into the car, position yourself.
So let your body back up against the seat and you maintain good posture. Would help with this brand
I manage you know is that by putting the seat all the way back first before you get in, because you don't want to have
to put stress on that hip. If you're real tall it could be kind of struggle,
but even for a short person you want to get the seat all the way back.
Since we're in this position here already - why don't we talk about
you're also not going to be able go into the bathtub.
After you've had a hip replacement
on you just can't get down and lay down and keep your hip at the right angle,
they do have bath benches that you could use. The bath bench
half of it is in the bathtub, half of it is outside the bathtub you get on the bath bench you slide over and
once you're in the bathtub. You can actually use handheld shower
and these are things you got to plan ahead, otherwise
you can have to do just a sponge bath while you know for the short bit of time.
And this is information if you haven't had to get done you it's going to be done
it'll be gone over with you in detail with the therapist involved.
Alright, these are some of the tools that you can use after you've had hip replacement.
To help prevent you from breaking the rules
and
not go beyond that 90-degree angle. Right, I'm just going to go through the use of these tools
it's a very common thing or if you gotta tell you sure you just don't think anything up going down and tying your shoe well
Right there, I dislocated my hip so that's something absolutely want to avoid.
So there's tools for this that you do not have to bend forward you can take your shoes on, off, etc.
So I'm just going to go through it quickly
what we got is I want to take my shoe off so what I'm going to do is
first of all I'm going to have elastic shoe laces, so I don't have to tie my shoes. They just stretch.
Okay, you can purchase those in the store.
Yeah, and you can just simply take your shoe off like that
there's no bending there involved. Now to get your sock off. Well, you connect with this and you can a do that
So what do you do?
Take your handy Dandy stick with the hook on it, lift up your sides and
there you go. This is something takes a little bit of practice.
And I'm going to take my shoe off just like that, and we just throw it.
Okay, so that's that's the use of that stick, the next thing is is a grabber.
Let's say I wanted to pick that stock up if a nice little grab a link just very common tool.
And you can pick up your sock with that.
These are very handy because these these you're going to absolutely need to have not only just for dressing aids,
but let's just say you drop something on the floor.
This could pick this could pick a quarter up. Yeah, they are. They are really nice. Oh, okay very good.
Next!
We got the long shoehorn, okay?
We'll use that and put in the shoe on but before you get your shoe on most people like to put a sock on so
use your sock aid.
Okay,
here's the stockade
Okay, it's just a half
It's like what they call the half moon [the] half barrel thing that they use for like a scoop for
flour well? Yeah, that too.
But its just a piece of plastic, its this [halfmoon] it was couple
Ropes with handles on it you take your sock, and you slide it over like this you're going to slip your toes in there.
Okay, and you're going to do it without bending over.
Slide your foot in there like this, okay, and
voila!
That didn't work as like. I said you do need to practice with this but once you get good with it.
I also need to [deliver] the sock hop up over these quarters
And it would have pulled out or physical therapist occupational therapist. Yeah, it would've put the Sonic arm.
You could have used your reacher then to to maybe pull it up. Yeah exactly.
Exactly.
So any other things that you will practice with therapist afterwards after the surgery.
Okay, and then of course you get your shoe [in] you use the long handle shoe on. Yeah.
The long Handle is going, obviously
you don't keep these things on the floor break the rule every time you bend over like I am.
Bring this in here, and now when [we] go and look at that.
See that's the way I [normally] dress, but I've been getting better since I got married miss you now.
Yeah, identical yeah, the socks are [the] same color today, so anyway that was good and
those are the tools you can use to avoid this with your functional everyday dressing activities.
What general hip precautions
are is that you don't want to break the 90 degree rule which we've already talked about but you also don't want [to]
Bring your leg over like this.
You also don't want to turn it this way or [this] way or [this] way or [this] way?
You know too dramatically so when you're in a chair that
means you can't cross your legs like this because that would bring it over and you can't cross them well
I guess we love them to cross at the angles, but we
basically tell you not to cross your legs at all. The way that I've seen people actually
or heard of people actually dislocated their have more common than anything let's say
this is the hip you had surgery [on] if you're walking along with your walker or your cane
or without anything if you plant on that foot
and then you would cross over like this.
That's actually turning that that hip in that's how I've seen people you know they take a turn like this.
That's how I've seen people actually dislocate their hip so when you're turning around you want to actually take little steps. like this
I always tell people and
avoid you know planting on that hip and turning that's that's the key or crossing over when you have to plant on that.