He underwent a hip replacement a couple of weeks earlier, after suffering for 15 years with arthritis-related hip pain. After performing a few light exercises at home, he was referred for outpatient rehabilitation, with his first priority to get back to work, hiking, biking, and riding his motor cycle.
Examination
He arrived in our clinic with limitations specific to hip replacement patients, called “Hip Precautions” after his surgery. For the first 6 weeks after his surgery, he was not allowed to cross his legs, turn his foot in, or bring his knee up further than waist level. Over time, his arthritic hip and become more and more stiff, more and more weak, leading to limited motion and strength into extension (going backward) for both the hip and the back. As if that weren’t enough, he had pain along the outside of the knee on the operated side, associated with tightness and friction of an area called the iliotibial (IT) band.
Treatment
We started his treatment with agility and fine motor skills, then basic standing strength training exercises meant to increase his stability on the operative leg. The first appointments included very light manual stretching, by the therapist, moving into more aggressive stretching to restore the ability of his back and hip to extend.
Once his strength training exercises were mastered, they were moved to home, and we began to focus on hip strength training against gravity and then with weights.
After a couple of weeks, we gave him a break of a week or so to work on his regular home exercises and start his return to work. Then, once he had passed the 6-week mark, he returned to the clinic to work on more aggressive range of motion, balance, agility and strength training that was applicable to heavy household chores and hiking.
By this point, he was working about 30 hours per week, and able to go up and down stairs without any limitation.
Outcome
9 visits spread over 5 weeks returned him to all of the activities he was fond of!
