Hip Replacement: Hip Issues Introduction
If you encounter a student has had hip replacement surgery:
- Unless you are experienced in this area, refer out students who have had hip replacement surgery to a qualified yoga therapist for testing and individual recommendations.
- Or — if you are comfortable doing ROM testing and making related recommendations — schedule individual time with hip replacement students prior to them joining your group class.
- Be very cautious with students who have undergone hip replacement. For the first year, there are typically numerous movement precautions in order to keep the joint stable, as it is prone to dislocation.
- It’s critical that students know what type of hip replacement they had, all medical precautions, and how they are to get up and down to prevent a dislocation.
- For students whose surgery was many years ago, you can learn how to proceed by testing their range of motion.
- In the case of bilateral hip replacement, it is “crucial” to strengthen muscles that cross hip joints.
- Hip replacements have a limited time span before wearing out, and therefore may be scheduled only after pain is no longer tolerable in order to have more chances of the replacement lasting until end of life. (Baxter Bell)
Be Cautious with Hip Replacement
Depending on the surgical approach and the location of the incision, many hip replacement patients are advised to avoid internal rotation, adduction, hip flexion (beyond 90 degrees), or even hip extension. These precautions, especially within the first year of the procedure, are aimed to keep the hip joint stable, since it’s more prone to dislocation than a normal hip. For this reason, it is important to be cautious with a student who has had a hip replacement, especially if she complains of pain. – Marla Apt
In about 1 in 20 cases, the hip joint can come out of its socket. This is most likely to occur in the first few months after surgery when the hip is still healing. But, unfortunately some people’s hips will dislocate very distant to the original hip replacement. My advice here is that a hip doesn’t typically dislocate without warning signs. Pain that increases as an activity is continued is the most prevalent symptom… Start by checking your student’s range of motion while he is lying in a supine position. Test all the movements of the hip… Then look at his hip mobility while standing… Then you can modify the asanas accordingly. – Shari Ser
Types of Hip Replacement Determine Asana Approach
The basic categories of total hip replacement are either: posterior lateral approach, anterior lateral approach, anterior approach, minimally invasive anterior approach or minimally invasive posterior approaches… Which approach is recommended for your particular situation is going to affect your asana practice. Please ask your surgeon what your post-operative physical limitations are and for how long. Make sure you learn how to safely get up and down from the floor so as to not dislocate your new hip and that you learn the specific precautions associated with your category of hip replacements. The key is that you learn to identify what position is your hip in when you do your poses and you need to think of both legs when you do each side (don’t just focus on the surgical side). Shari Ser
Stabilize Hip Joint with Hip Replacement
To reduce risk of dislocation [with bilateral hip replacement], it is crucial to stabilize the hip joint by strengthening the muscles that cross it. Almost all standing postures are good for this, but they should be practiced only part way to avoid extreme actions and overstretch, and to limit specific movements that make dislocation more likely. Postures that strengthen muscles in the hamstring, buttock and side hip regions may be especially helpful after posterior surgery, because these muscles resist adduction and flexion…. Postures that strengthen the hip flexors, adductors, and medial rotators may be helpful after anterior surgery. – Roger Cole