A joint replacement is a common solution for joint degeneration when the joint no longer can support your activities. To set yourself up for a successful joint replacement you want to prepare your body to influence post-op success and to avoid a long recovery.
Surgery is high stress to your body, so you want to make sure your body is at its best to prepared for surgery and recovery.
Pre-operation conditions that influence post-operation success are:
Malnutrition- good healthy nutrition is necessary to heal muscle and ligament tissues from surgery, and to build and maintain strong bones so that the hip prosthesis will hold in the bone
Obesity- the more body mass you carry around the more complications from surgery and delayed recovery
Depression and anxiety
Weak muscles and poor conditioning- Lack of strength and conditioning effect how successful you recover post-op. Are you able to get yourself up from a chair with your upper body or able to get out of bed transferring to a walker?
Restrictions and Contraindications:
Ask your surgeon if you have exercises or movements that you need to avoid. Find out which movements are temporary and which are permanent restrictions. The surgery approach of the hip replacement (posterior, lateral, or anterior approach) can also effect recovery. There is a greater risk for dislocation with a posterior approach.
Good Circulation and Better Healing
After post rehab you want to increase your activity level. You need to keep moving for good circulation so that blood flow can deliver nutrients to the surgery site. A standard physical therapy program generally only provides minimal gain either due to limited insurance benefit, not doing the physical therapy prescribed exercises, and/or patients discontinuing to perform PT recommended exercises. There is only a 26% enrollment in physical therapy after a joint replacement. These influence how well you will recover from your surgery and well you will function the rest of your life.
When it is your goal to achieve good lower and upper body strength, good balance, mobility and optimal function to resume an active life style then you need to do more than just the standard physical therapy program. The right health and fitness professional will look how your lower body ankle, knee and hip joints work and how to integrate upper body training together for optimal functionality. You may want to consider hiring a physical therapist privately to help you with appropriate exercise progressions. Many fitness professionals, especially exercise physiologist and medical exercise specialists work with clients pre- and post-op to provide the best chance for a speedy recovery.
Exercise Goals for Total Hip Replacement and Total Knee Replacement
Exercise with caution for the first three months and be aware of the contraindications.
Phase 1 Training: begins 4-6 weeks post operation. The goal during this phase is to improve and maintain ankle, knee and hip range of motion, improve muscle activation and strength of the lower body, improve balance and stability, and enhance aerobic fitness
Phase 2 Training: This phase lasts about 4-6 weeks as well and the goal is to maintain and improve joint range of motion, incorporate and introduce strength training exercises with assistance, single leg training, a higher level of core and balance exercises, and continue to improve aerobic conditioning.
Phase 3 Training: this phase may take 4-6 weeks and beyond, and exercises may need to be performed on an ongoing basis to ensure maintaining optimal function. This phase incorporates functional strength exercise utilizing both isometric and isotonic exercise, higher level challenges in training when ready such as power training and reactive training while continuing to improve aerobic exercise.