Tag Archives: Total Hip replacement Physiotherapy

Hip fracture

Anatomy of Hip
A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is based on the bones and soft tissues affected or on the level of the fracture.
Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.

ϖ Signs and symptoms of a hip fracture include:
• Inability to move immediately after a fall
• Severe pain in your hip or groin
• Inability to put weight on your leg on the side of your injured hip
• Stiffness, bruising and swelling in and around your hip area
• Shorter leg on the side of your injured hip
• Turning outward of your leg on the side of your injured hip

ϖ Causes of Hip fracture
• falling on a hard surface or from a great height.
• blunt trauma to the hip, such as from a car crash.
• diseases such as osteoporosis, which is a condition that causes a loss of bone tissue.
• obesity, which leads to too much pressure on the hip bones.

ϖ Types of Fractures
In general, there are three different types of hip fractures. The type of fracture depends on what area of the upper femur is involved.
Intracapsular Fracture
These fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.

Intertrochanteric Fracture

This fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.

Subtrochanteric Fracture

This fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below .

In more complicated cases, the amount of breakage of the bone can involve more than one of these zones. This is taken into consideration when surgical repair is considered.

Treatment for hip fracture: usually involves a combination of surgery, rehabilitation and medication.

ϖ Surgery
The type of surgery you have generally depends on the location and severity of the fracture. Are the broken bones properly aligned? (displaced fracture. What is your age? What are your underlying health conditions?

The options include:

• Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the upper thigh.

• Partial hip replacement. If the ends of the broken bone are not lined up or damaged, your surgeon may remove the head and neck of the femur and install a metal replacement (prosthesis).

• Total hip replacement. Your upper thigh and your hip socket are replaced with an artificial one (prostheses). Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint. This may have been affecting your hip function even before the fracture.

ϖ Rehabilitation

Rehabilitation is begun as soon as possible after hip fracture surgery, often within a day. The initial goals are to help people retain the level of strength they had before the fracture. You want to keep moving to prevent loss of muscle. You also want to prevent problems that result from bed rest. The ultimate goal is to restore your ability to walk properly without a limp.

Benefits of Rehab

Rehab will help you:

• Restore normal movement in your joint
• Build up strength in the joint and surrounding muscles
• Ease pain and swelling
• Let you get back to your normal activities including walking without a limp
• Help with circulation, particularly right after surgery, so you don’t have problems with blood clots

If you have or someone you know has fractured a hip or had hip replacement surgery, please call PhysioNow. Our experienced physiotherapists would be happy to help with your recovery! Call today to book an appointment!



HIP REPLACEMENT TREATMENT will help speed up the recovery process. Healing and recovery time varies between patients. Proper management is important after hip replacement surgery to minimize complications. Supervised Hip Replacement Treatment will help to restore strength and range of motion.

This guide can help you better understand your exercise and activity program. At PhysioNow, our Registered Physiotherapists will help you return to your daily activities. To ensure your safe recovery, be sure to check with your physiotherapist at PhysioNow or surgeon before performing any of the exercises shown.

After hip replacement surgery precautions must be taken to allow proper healing. It is important that you must follow the safety precaution at all times in the first 12 weeks after your surgery.

– Avoid extremes range of motion at all times
– When seated, ensure your knees should always be lower than your hips
– Use a raised toilet seat
– Use a cushion when sitting in a vehicle
– Sit on a high, firm chair at the level of your knees or higher.
– Do NOT lean forward from a sitting position to reach for items or put on shoes
– Use a long-handled shoe horn or reacher instead
– Do NOT twist your leg or turn your hip or knee
– Do NOT twist your trunk. Move your feet to turn when you are standing
– Do NOT sit cross-legged
– Do NOT cross your ankles when lying on back

Your surgeon will decide your weight bearing status based upon the following:
-The type of surgery and prostheses used
-The condition of the your natural bone
-How the prostheses was fixated to the natural bone

Follow instructions from your surgeon at the hospital and at home upon discharge. Initially you will be advised to put a small percentage of weight on the affected leg. With proper exercise and keeping safety precautions in mind, you should be able to restore strength to your new hip over time.


Slowly point the toes as far as possible then pull them back toward you as far as possible.
Repeat this exercise several times a day, as often as every 10 to 15 minutes.

Ankle Pumps #1

Move your ankle inward toward your other foot and then outward away from your other foot.
Repeat 5 times in each direction.
Perform 3 to 4 sessions a day.

Tighten your buttock muscles.
Hold for 5 second. Repeat 10 times.
Perform 3 or 4 sessions a day

Slide your leg out to the side as far as you can and then back.
Repeat 10 times.
Perform 3 or 4 sessions a day

Tighten your thigh muscle. Try to straighten your knee. Hold for 5 to 10 seconds, repeat 10 times.

Tighten your thigh muscle with your knee fully straightened on the bed. Lift your leg several inches off of floor. Hold for 5 to 10 seconds. Slowly return, repeat 10 times.

Make sure you are holding on to a firm surface such as a bar attached to your bed or a wall when performing standing exercises.

Lift your operated leg only few inches off the floor, below your waist.
Hold for 2 to 3 seconds, and put your leg down. Repeat 10 times both legs.
Perform 3 or 4 sessions a day.

While standing, raise your leg out to the side. Keep your knee straight and maintain your toes pointed forward the entire time. Slowly lower your leg so your foot is back on the floor.
Repeat 10 times on each leg.
Perform 3 or 4 sessions a day.

Standing tall and keeping knee straight, extend one leg back without leaning forward or arching your back. Return to the starting position.
Repeat 10 times for each leg.
Perform 3 or 4 sessions a day.

Always attempt any exercises within your pain tolerance. Hip replacement surgery can be a rewarding experience, as it will allow you to return to your daily living activities. Please contact our Registered Physiotherapist at PhysioNow to help you assist with your safe recovery.

Registered Massage Therapy is another excellent treatment after having had a Total Hip Replacement. The muscles in the low back and hip area tend to get quite tight after surgery and Registered Massage Therapists are very skilled at releasing this muscle tension. This speeds up recovery time! We have Registered Massage Therapists available daily Monday to Saturday.

If you are considering having hip replacement surgery, check out this link to the Mayo Clinic with some information that may be useful .

Total hip replacement surgery

Total hip replacement surgery
In total hip replacement surgery (also called total hip arthroplasty), the affected hip joint is removed and replaced with a metallic implant. Total hip replacement surgery is usually performed in people who have severe arthritic changes. Normally they have a lot of pain in their hip and find difficulty walking or walk with a limp. Its an extensive surgical procedure that involves slitting open the muscles around the hip and buttock. Muscles that are usually cut are those that are required for walking and using the stairs. These are some of the functional activities that can be affected with hip arthritis.

You don’t have to wait until your hip surgery to come and see a Registered Physiotherapist Mississauga. In fact, seeing a Registered Physiotherapist right after your decision to undergo a replacement surgery can get you back on your feet quicker after your surgery. You can set up a pre surgical appointment with PhysioNow to get you ready for your surgery. One appointment before the surgery can save you recovery time after the surgery. We can go over all of the things you need to know for after the surgery.

What to expect
Before the surgery
– Physiotherapists at PhysioNow Mississauga will closely work with you to get you back on your feet early after surgery. Check out this video if you want to see a bit more of what to expect with Total Hip replacement surgery. It is from the University of California, but it gives a comprehensive overview of the procedure and explains it quite well.

Physiotherapy Treatment will consist of:

– Assisting you to get the right size walker/cane to offload excessive stress during the initial phases of recovery
– Managing your pain and swelling during the initial phases of recovery by providing compression to the area using a compression stocking and applying ice around your hip joint
– Electrical modalities such as interferential therapy to decrease post-surgical hip pain
– Registered Massage Therapy to relax the muscles around the surgical area and your low back
– Using different exercise equipment such as theraband , weights and exercise machines
– Strengthening of the muscles around your hip to help you walk without a limp
– Various exercises to strengthen and maintain adequate flexibility in your hip/leg muscles
– Education on home modifications (elevated toilet seat, use of grabber) to facilitate your mobility in the house
– Simple foot/ankle exercises to prevent pooling of blood around your calf

Registered Physiotherapy Mississauga will help with functional recovery after your total hip replacement surgery. Total recovery from Total Hip replacement surgery takes an average of three months. The surgeon should send you home with a list of instructions to follow immediately after surgery. It is very important to follow the precautions that the surgeon gives you to avoid serious complications. Your physiotherapist can review these precautions with you!

After Total Hip replacement surgery, you will be ready to see a physiotherapist for further treatment outside of the hospital within 5- 7 days after discharge from the hospital.
You should expect to see your physiotherapist 1-2 times per week depending on your progress for up to 3 months after surgery.
Total Hip Replacement Surgery
The goals of physiotherapy are:
– to have no limp when walking
– ability to climb stairs with normal alternating gait
– ability to walk as far as you want to walk without developing a limp from fatigue or weakness
– able to get out of a chair easily
– excellent balance while standing on one foot: up to 60 seconds without losing balance

Good Luck with your Surgery! Please call us to get started on recovery or to prepare you for your surgery! Call today! 289-724-0448.