Dr. Phil Page, PhD, PT, ATC, CSCS, FACSM
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“I had hip replacement surgery about 6 months ago. I seem to have poor balance and I fell the other day. That scared me. Are there some exercises I can do to help my balance?”
Total hip replacement surgery is quite common, particularly with the increase in the aging population. In fact, over 325,000 hip replacements are performed in the USA each year according to the US Department of Health and Human Services.
While many patients experience pain relief and improvement in their daily activities such as walking, some still have deficits in strength and function. In fact, some people continue having weakness and balance issues up to a year after their replacement despite rehabilitation (Page & Rogers, 2006).
These residual deficits are possibly caused by limited physical therapy after surgery. The number of physical therapy visits can be reduced because of insurance restrictions; this is particularly limiting to Medicare patients due to the cap on therapy expenses each year. In addition, the number of in-patient days after surgery continues to decrease in efforts to reduce hospital costs.
Many hip replacement patients suffer from pain for several years before surgery, which also changes how they walk. Over time, this compensated gait pattern to avoid pain leads to muscle imbalance; therefore, many patients remain quite weak and unstable after surgery compared to those without hip problems. A special exercise program from Germany called “Hip School” has shown improvements in strength and balance after hip replacement.
Total hip replacement patients who have balance problems after their rehabilitation may be at increased risk for falls. And those who had a hip replacement as a result of a hip fracture after a fall are definitely at increased risk! To reduce the risk of falling, total hip replacement patients should continue exercises at home even after they are discharged from therapy.
It’s important to talk with your therapist about continuing a home exercise program after you are discharged from therapy. Here are some common exercises you might perform at home to continue improving your strength and balance. Good luck!