A client of mine is going to have a hip replacement next year. Although I have found articles on your site useful, can you give me some pointers I can do right now to assist with speeding up her rehab phase?
Congratulations to you and your client for wanting to go into the surgery as prepared as possible. “Pre-habilitation” pays off huge dividends for those smart enough to prepare for surgery.
As a practitioner, the first question I ask is: “What has led her to need a hip replacement?” What information in her health history and past musculoskeletal assessments might give me insight into the mechanical stress that is manifesting itself in her hip?
And my second and equally important question is: “Which of these issues will be resolved with the prosthesis, and which are likely to carry over?” You want to begin your pre-habilitation with these dysfunctional characteristics that are likely to carry over post op. For example, if your client has been walking with the torso translated away from the painful hip for years, that habitual motion will not suddenly go away post op. Or if she has tight hip flexors that have negatively affected the articulation of the hip joint, that dysfunction is not likely to go away post op either.
Also, functional strengthening of the hip joint complex is always prudent since they will be directly affected by the surgery. Strengthening should be within pain-free ranges to avoid eliciting reflexive inhibition or protective guarding. Unless you have received clearance from her doctor, working in painful ranges is outside the fitness professional’s scope of practice and promotes further compensation.
Finally, the surgery itself and immobilization post op will reduce proprioception of the hip joint and the rest of the involved lower extremity. Challenging her proprioceptively and increasing her static and dynamic balance above current levels will provide her with a slight “cushion” toward more quickly returning to baseline levels post op.