• Paulo Andalaft

How Exercise Helps with Hip Replacements


Hello everyone,

I hope y'all had doing great. Today I want to talk about how exercise can help us stay away, or bounce back from a possible total hip or knee replacement.

More and more people are getting these types of surgeries. Some 400,000 will get one this year, and that is expected to double by 2030. ​

As we age, osteoarthritis due to general wear and tear start to take place. Also, it is an easier surgery than it was 20 or 30 years ago. New technology and more experienced doctors make surgeries easier to perform and to recover from.

At Fit Factor, we work with many clients with both hip and/or knee replacements. We have helped them before and after their surgery for the best and optimal outcome so they can continue to enjoy their lives to the fullest.

So, how can we lower the chances we may need a ceramic or titanium replica in our hip sockets? Well, exercise helps reduce the likelihood we will need such a procedure. And if we do need one, exercise -- before and after -- will help us bounce back.

“If you go into surgery weak and de-conditioned, it is very well established that outcomes are not good,” said Daniel K. White, associate professor, department of physical therapy at University of Delaware and the Arthritis Foundation.

You might think exercise is the last thing someone should do if they need a new hip or knee.

But getting stronger is often helpful, as long as the patient does not overdo it and gets a doctor's approval first.

Researchers Daniel Rooks, ScD, of Harvard Medical School, Boston's New England Baptist Hospital, and Beth Israel Deaconess Medical Center studied 108 men and women scheduled for total hip or knee replacement due to severe osteoarthritis. Patients were typically in their late 50s to late 60s.

The researchers randomly split them into two groups. Patients in one group followed a six-week exercise program before their operation. For comparison, the other patients were not asked to exercise before surgery.

Exercise Program

Rooks' team made sure the patients' workouts were done three times weekly for six weeks.

For the first three weeks, patients in the exercise group worked out in a pool; water workouts are easy on the joints.

The patients stood in chest-deep water, exercising their spine, shoulders, elbows, wrists, hands, hips, ankles, and knees.

For the last three weeks, patients exercised in a gym on recumbent stationary bikes or elliptical machines. Those workouts do not pound the joints.

Patients also did strength training and stretching for flexibility during the program's last three weeks.

A physical therapist supervised the workouts, which lasted 30-60 minutes.

Getting Stronger

Before anyone broke a sweat, all the patients rated their ability to do normal chores and activities. They also took tests of their balance, mobility, and leg strength.

They repeated those tests right before surgery, and again afterward.

As expected, patients in the workout group got stronger while those in the comparison group did not.

Also, after surgery, the exercisers were much less likely than the non-exercisers to need to go to a rehabilitation facility instead of going home.

Exercisers who got total hip replacement also showed a significant advantage in their pre-surgery function -- based on the ratings of their ability to handle routine activities -- compared to the non-exercisers.

However, no such function benefit was seen in exercisers who had their knees replaced.

The reasons for that are not clear, the researchers note, although they say the difference may be related to the joint location and function. A longer period of exercise may be needed to help knee function, the researchers write.

"Our findings show that an appropriately designed program of water and land-based exercise involving cardiovascular, strength training​​, and flexibility activities can be a safe, tolerable, and effective approach to improving muscle strength in middle-aged and older adults with severe osteoarthritis of the hip and knee," write Rooks and colleagues.​

And keep our weight down. “Every 10 pounds of weight gain above the waist results in an extra 75 to 100 pounds across the joints,” said Dr. Joanne Halbrecht of the Boulder Institute for Sports Medicine

Talk to us about exercise to help your hips and knees. This will probably include strengthening your glutes (the butt muscles). That is because joints and cartilage suffer normal wear and tear (osteoarthritis) when they have to absorb too much load – and our glutes absorb the bulk of that load. Simple moves like hip bridges and squats when done correctly are great for the hips and knees.