Tag Archives: Hip Surgery

Arthritis, Custom Knee Brace, Custom Knee Bracing, Hip Pain, Knee Pain, Physiotherapy, Surgery, Total Hip replacement, Total Hip Replacement Surgery, Total Knee Replacement

Hip and Knee OA: Can Physiotherapy Prevent Surgery?

Getting that x-ray back with a diagnosis of osteoarthritis (OA) of the knee or hip can be alarming. Maybe you’ve also started to notice some persistent pain, and daily movements like stairs are starting to become harder. Rest assured, surgery is not the immediate next step. Physiotherapy treatment and conservative management is the first line treatment for hip and knee OA.

Understanding hip and knee OA

Simply put, OA involves natural wear and tear in the joints over time. The cartilage and joint surfaces change over time and show signs of degeneration. Thankfully, we now know that these structural changes are not the whole story. Even though an x-ray may show these signs, it does not automatically mean there is an issue. More importantly, you can have signs of OA without feeling pain or discomfort at all and there is something you can do about it. Ultimately, the strength of the muscles and tissues around your joint is what matters the most to how you move and function.

How does physiotherapy treat OA?

Single leg glute bridges are great strength builders, working the core, glutes, and lower body all at the same time.

More and more we are understanding that regular strength training is the key to building resilience around the joint. Here’s how physio can help:

  1. Strengthen: Even though the joint changes may be there, the load support comes from the surrounding musculature. This means strengthening the quads, hamstrings, calves, hips, and core. These muscles can replace the shock absorption for the joint, offloading stress from it
  2. Mobility: Motion is lotion, joints need this stimulation to stay healthy. Movement helps produce the joint fluid that lubricates the joint and gives it nutrients. A regular mobility program can improve lost range of motion and reduce morning stiffness.
  3. Education and activity modifications: OA is not a condition that goes away completely, it’s something that you will have to manage. Your Physiotherapist will help you figure out what activities in your life may have to be temporarily sidelined to avoid overuse, and when it is safe to go back to it again
  4. Gait aids and braces: We want you to be as independent and stay in touch with all your favourite activities as much as possible. Sometimes, this may involve doing things with a bit of help. Whether it’s going for a walk outside, or playing tennis, an aid like a walker, cane, or custom brace may help.

How does physiotherapy prevent or delay surgery?

Physiotherapy can either delay, or completely prevent the need for a total joint replacement. The earlier you start with rehabilitation and strengthening, the better it is. Major health organizations like the Osteoarthritis Research Society International (OARSI) recommended structured physical therapy and exercise plans as gold standard treatments for OA.

People who participate and complete these programs can delay their surgery for years, or even are able to forgo it completely. Worst case, if surgery is still necessary, research has shown that patients who engage in training beforehand have quicker recovery and better outcomes post-surgery.

What can I expect in a Physiotherapy session if I have hip or knee OA?

If you’re new to Physiotherapy, no worries! We’re here to help you and answer every question you may have. Here’s a general outline of what to expect at your first session.

  1. Comprehensive assessment: Your physio will ask you questions about your current symptoms, function, and goals. They will gather any relevant information about your medical history, previous injuries, and more. Afterwards, they will conduct a physical evaluation of your range of motion, strength, balance, and function.
  2. Creating a treatment plan: After the assessment, your physio will use this information to create a personalised plan for you. Based on your areas of weakness and goals for the future, a week by week plan will be presented to you.
  3. Treatment: Treatment will happen on the very first day. This part will be very individualised based on your unique factors. This part may consist of manual therapy, electrotherapy, cryo or heat therapy, and exercises. Here, your physio will also teach you your home exercise plan including cardiovascular training, strength and mobility work, and more!
  4. Outline for the future: Finally, there will be time for questions and your physio will educate you on what to expect in the future. They will tell you how often you will need to come in, and what the expectations for progression are.

Looking for help with a hip or knee OA?

Your hip or knee is something we can work on, it doesn’t have to be what stops your life. If you’re looking to improve your quality of life, get stronger, and delay a surgery, look for PhysioNow! We have expert clinicians at 10 locations across the West GTA to help. Look for us in Burlington, Oakville, Mississauga and Etobicoke. Book with PhysioNow today for your first assessment and treatment!

Hip Pain, Physiotherapy, Total Hip Replacement Surgery

Total Hip Arthroplasty: What you Need to Know!

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What is a total hip arthroplasty?

Total Hip Arthroplasty (THA), or a hip replacement surgery is a procedure that replaces damaged bone and cartilage in the hip joint. Instead, it replaces it with prosthetic components mainly using two techniques. The type of technique used will be discussed between you and your surgeon and is influenced by demographic and lifestyle factors.

1: Cemented: Used more in geriatric (older) populations or patients who have a more sedentary lifestyle 

2: Non-cemented: Indicated for younger populations, or patients having active lifestyles

Why do people get hip replacements?

On the left shows a healthy hip with an intact joint surface, the middle shows degeneration of the surfaces in the hip, the final image shows the outcome of the surgery where the hip surfaces are replaced.

Usually, the reason people get hip replacement is due to severe osteoarthritis (OA) that is causing high pain, loss of function, and disability. For example, when someone is having trouble walking and being independent with their daily activities due to issues with hip OA. Other reasons may include rheumatoid arthritis induced cartilage or bone damage, after a slip and fall on the hip (especially in older populations), and femoral neck fractures. However, some people may be ineligible for this surgery if they have peripheral vascular disease, history of blood clots, an ongoing infection, or septic arthritis.

Generally, hip replacements/THAs are safe procedures with great outcomes. Post-surgery, the most common complications to watch for include deep vein thrombosis which is a blood clot in the leg, or a post-surgical infection in the joint.

Physiotherapy Rehabilitation After Total Hip Arthroplasty

Total Hip Replacement Surgery

Total hip arthroplasties are highly effective surgical procedures designed to alleviate pain and restore function in patients with severe hip arthritis or hip joint damage. Initially, post-operative rehabilitation is crucial to ensure the continued success of the surgery and to optimize the patient’s recovery. Physiotherapy plays a vital role in this rehabilitation process, helping patients regain strength, mobility, and overall function. Read on to learn more about the phases of rehabilitation with Physiotherapy!

1. Immediate Post-Operative Phase

First, the immediate post-operative phase begins as soon as the patient wakes up from anesthesia. Then, physiotherapists start with gentle exercises to promote blood circulation and prevent complications such as deep vein thrombosis (DVT). Simple movements like ankle pumps, quadriceps sets (squeezing the big thigh muscle), and gluteal sets (squeezing the buttocks muscles) are encouraged. These exercises are designed to improve blood flow, reduce swelling, and initiate muscle activation without putting undue stress on the new hip joint.

Early mobilization is a critical component during this phase. Within 24 to 48 hours after surgery, patients are usually assisted to sit up and begin walking with the help of a walker or crutches. The goal is to start weight-bearing activities as tolerated, promoting healing and preventing stiffness.

2. Early Rehabilitation Phase

The early rehabilitation phase spans the first few weeks after surgery. During this period, physiotherapists focus on gradually increasing the intensity and range of exercises. Patients are taught specific hip-strengthening exercises such as leg raises, hip abductions, and gentle stretching. Additionally, simple balance and coordination exercises are also introduced to enhance stability and prevent falls.

Not only this, but pain management is a significant focus during this phase. Physiotherapists work closely with the medical team to ensure that pain is adequately controlled, allowing patients to participate actively in their rehabilitation. For example, ice therapy, electrical stimulation, and manual techniques may be used to manage pain and reduce inflammation.

3. Intermediate Rehabilitation Phase

The intermediate phase, typically from 4 to 12 weeks post-surgery, aims to build on the progress made in the early phase. Now, physiotherapy sessions become more intensive, incorporating resistance training and functional exercises. Furthermore, activities such as stationary biking, swimming, and gentle aerobics are introduced to improve cardiovascular fitness and endurance.

During this phase, the focus shifts towards improving gait and mobility. For example, patients practice walking without assistive devices, concentrating on proper walking mechanics and posture. Also, stair climbing and descending exercises are introduced to further enhance functional independence.

Strengthening exercises for the hip and surrounding muscles are progressively intensified. At the same time, core strengthening exercises are also incorporated to improve overall stability and support the hip joint.

4. Late Rehabilitation Phase

The late rehabilitation phase, typically beyond 12 weeks post-surgery, focuses on preparing the patient for a return to normal activities and, if possible, sports. Now, physiotherapy sessions aim to restore full strength, flexibility, and function. Advanced balance and proprioception exercises are introduced to ensure the patient can handle more complex movements and environments.

At this stage, patients may engage in low-impact sports such as golfing, cycling, and swimming. High-impact activities, such as running or jumping, are generally discouraged to protect the new hip joint from excessive wear and tear. However, each hip rehabilitation is different and should be discussed with your surgeon to understand your specific limitations.

Education on lifelong joint protection and healthy lifestyle choices is an essential part of this phase. Patients are taught strategies to prevent injury and maintain joint health, such as maintaining a healthy weight, avoiding high-impact activities, and incorporating regular exercise into their daily routine.

Getting a hip replacement soon?

If you are getting a total hip replacement soon and are looking for some advice and help, look for PhysioNow! Physiotherapy can help you maximize your strength and function prior to surgery to ensure that recovery is as smooth as possible. Then, after the surgery, we will work with you to return your hip back to its normal function with an individualized care plan. Our Physiotherapists are ready to get you started. Book with PhysioNow for your first assessment and treatment today!