3. Go for "pre-hab"
Rita Redding, a 58-year-old nurse who had hip replacement surgery last year after developing avascular necrosis — a malady of insufficient blood supply to a joint — regrets that she didn’t do more to prepare for her surgery. If she could do it over, she says, she would have started seeing a physical therapist several weeks before the procedure for advice on exercises to strengthen the muscles in her hips and legs.
Another good reason for “pre-hab”: A physical therapist who understands your functional ability before surgery is better able to help you recuperate after surgery, says James Dunleavy, administrative director of rehabilitation services at Trinitas Regional Medical Center in Elizabeth, N.J.
4. Lose weight (if you're heavy)
A hip prosthesis is designed to handle normal body weight, says Mark Petty, M.D., of the Orthopedic Institute in Gainesville, Fla. Small wonder that he worries when someone overweight walks into his office. A Body Mass Index (BMI) of 25 or less is ideal. (For a woman who is 5 feet 4, that’s 145 pounds or less.) If it gets high into the 30s, many orthopedists will make weight loss a condition for the replacement.
And a BMI over 40? “No way,” says Petty, adding that if a patient is too heavy he’ll encourage them to lose weight before surgery.
5. Commit to physical therapy
Total hip replacement is usually followed by two to three days in the hospital, two to three weeks in a sub-acute rehabilitation center (which is usually covered by insurance) and two to three months of outpatient care.
Dunleavy puts his patients into one of two categories during the outpatient phase: hearty and passive. The hearty ones need only two, maybe three, visits to the physical therapist each week because at home they religiously follow the prescribed exercise regimen, which typically consists of 15- to 20-minute sessions, three times a day. The so-called passive do little or nothing at home, so they need to see the physical therapist nearly every day.
Some studies have found that patients continue to benefit from physical therapy that focused on improving walking skills after the initial three months of therapy. It’s a time to be fully engaged, says Dunleavy.
Redding was back to work three months after her operation. She says she now walks without a limp, and is almost pain free. “My function has been completely restored,” she says.
Washington was back on the putting green at two months and playing 18 holes four months after his surgery. “I did everything I was told to do and then some, including losing weight before and after the operation,” 30 pounds total, he says. “I wanted a shot at what I used to be before the pain, and I got it.”
Also of interest: Getting back in the game after surgery.
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