What surgeons can’t tell you after surgery (because they’ve never had it themselves!)

In this blog post, I share some insights and exercises for recovering mobility after surgery. Replacing a part of your body is a unique blessing – amazing! And, you may need extra support integrating the change and loss, too.

It’s emotional, not just physical, and most of the surgeons and PTs you will meet haven’t actually had the experience themselves. It’s hard for them to know what it feels like on the inside.

FYI, anyone with tights hips and lower back can benefit from the exercises in this blog post and the video, even if your stiffness is not due to surgery.

Let me begin by saying that because I have relatively good healthcare, I’ve been able to do physical therapy every week, and a total of 17 appointments was covered. That has been so helpful for strengthening and recovery. I sincerely hope you have access to healthcare too.

My PT was willing to do the paperwork and request all available sessions to get me back to full functioning. The administrative support at the rehab place would have stopped me after about 6 appointments otherwise. Don’t be afraid to ask, and you shall receive.

I space out my PT appointments at 1 per week, so that I have time to integrate the exercises into daily life. Because I’ve done the exercises in the video between appointments, my mobility surprises my PT, who then happily integrates it into the exercise progressions he gives me.

It’s my range of motion, and my emotional response to the results of the surgery, that is proving more challenging than I thought it would be.

Total hip replacement operations are getting better and better, and I’m mostly happy with my new pain free life. I can sleep without pain killers, and my leg doesn’t buckle from the sharp pain anymore when I get up from the couch, or out of a car, or after I’ve gone for a run.

Still, I want to be honest with you here. There is a hidden world of micro-problems that you have to solve on your own after surgery. My top 2:

1) Grief

I had a posterior-lateral style of surgery, which means my rotators and hip flexors are much tighter than before. It’s a more stable surgery, but the implant feels weird and very tight. There has been a loss of grace, of fluidity, and of interior feeling. There has been grief about that. Minimizing that grief just makes it worse; while feeling it allows it to pass on through.

Talk it out with someone who cares. The doctors and PT’s don’t have the skill to help you with that. You chose this new bionic body, but it’s also a loss of the old “you.”

2) A tight lower back and a super sore sacrum

It’s impossible to stretch your glutes, hamstrings, and big back muscles because you can’t flex your hip joints very much for at least 6 weeks post op. Each type of surgery has a set of precautions you must heed for the first 6 weeks, and flexing past 90 degrees is one of them…but honestly, you physically can’t flex much at all anyway.

Back muscles get tight when your back is always in extension. You start to feel a bit like wooden board. You’ll get most of it back, but it’s going to take about 6 months.

In addition, you will be lying on your back most of the time or sitting at a less than 90 degree flexion. You can’t lie on either side for 2 weeks or so when sleeping either. You are on your sacrum almost all the time and it can get really sore.

Watch the video for my suggested beginning stretches to get you out of this conundrum, or try following the steps below:

– Stand at the side of your bed, with your knees touching the edge.

– Walk your hands forward and out over your bed, looking up and out, until you are stretching your torso into its full length (you won’t be risking flexion past 90 degrees).

– Drop your forehead onto your bed, letting all your back, neck, and shoulder muscles go.

– Slide your hands backwards towards your hips, allowing your elbows to fold, while continuing to release your back, shoulder, and head into the bed. You can turn your head to the side if that’s most comfortable.

– Send your heels back and down, your knees forward, and your pelvis slightly back. It’s like you are trying to push the bed forward.

– Give a gentle push with your hands to send your pelvis back for more relief at your sacrum

– Look up and out, walk your hands forward again and stretch out over your bed, letting your back and arms extend.

– Repeat, gently lubricating your spine, hip joints, knee joints, and ankle joints!

Your hip joints will fold, but nowhere near the 90-degree precaution. You will get a release in all the fascia around your sacrum.

Increase the stretch and relief by releasing the weight of your head forward, not by increasing flexion at the hip. This will lengthen tight and overworked back muscles. Watch the video for more subtle tweaks to increase your bliss, and for tips on how to progress to a lower surface like a couch or table, and then finally to the floor.

THIS SERIES on how to open your hips for meditation will be a second progression to try later – but you will be doing much smaller versions of these movements at first. 4 months post op, I’m not yet able to cross my operated leg over my good one, and cross-legged meditation is still not possible.

Take your time and don’t push. Remember, tight doesn’t mean immobile, it just means range of movement is smaller.

Practice micro-movements to keep all muscles, tendons, and ligaments juicy and lubricated, and every day you’ll get a tiny bit more mobile.

Tip way forward, putting your weight on your hands and arms to get down to the ground instead of squatting, like in a downward facing dog motion. Then fold your operated leg, put your weight on that without flexing too deeply, and second fold your good leg. Watch the video for details. It’s a surprisingly difficult motion to describe!

Once you can get down to the ground again, start mini crawling as soon as possible.

You can crawl without flexing your hip joints past 90 degrees. You have lots of control and you can test mobility slowly and easily. Doctors and PT’s are way less worried about dislocation than they used to be, so…if you can crawl at all without any pain, chances are you can gently test your range in flexion. Try a little bit, with no strain, pushing, or discomfort. Stop when you feel any resistance.

Don’t rush the process of recovering mobility after hip replacement surgery. Instead, use this opportunity to spend more time:

– Planning a movement sequence from beginning to end before actually doing it

– Listening to sensations from your body and interpreting them generously

– Asking for help instead of pushing through a task

– Being creative in using props to accomplish tasks

These are all skills that will come in handy for the rest of your life!