a community of practitioners

New Client : Hip Replacement

I am to see a new client tomorrow who is 3 months out of hip replacement. He has been released for normal acivity by his doctor and has gone back to playing golf. I am seeing him specifically for low back pain that started 4 days ago. This will be an abreviated clothed session, so my plan is to only do light PNF stretching. I am sure there have been some overcompensations due to the surgery. Target areas will be quads, hams, psoas and Lt QL (the non-surgery side). Does anyone see any contraindications in this plan? Thankful for all input.

▶ Reply to This

Replies to This Discussion

Permalink Reply by Robin Byler Thomas on December 21, 2009 at 3:02pm

Hi David,

No, good plan. I've had several hip replacement clients. Go slow, get lots of feedback. He's probably also sore due to getting back to golf. I'd also work the right neck as it usually tightens with left hip pain as well, and throw in some gentle, graduating firm compression to the areas you mentioned.

Good luck,
Robin

▶ Reply

Permalink Reply by Bert Davich on December 22, 2009 at 1:20am

David, If you are doing supine work that involves hip flexion, there is a limitation just past 90 degrees of flexion for most hip replacements. I would call his doc or limit to 90 degrees or less. Also do not position him into hip flexion and adduction.

▶ Reply

Permalink Reply by lee kalpin on December 23, 2009 at 4:07pm

It may be different depending on where you practice, but I have found it pretty much impossible to get in touch with clients' doctors in anything like a timely manner. Plus I would need a signed Release of Information form before discussing a client with anyone.
For first treatment, best to work within the limits that you know are safe and to get good feedback from the client.

Bert Davich said:

David, If you are doing supine work that involves hip flexion, there is a limitation just past 90 degrees of flexion for most hip replacements. I would call his doc or limit to 90 degrees or less. Also do not position him into hip flexion and adduction.

▶ Reply

Permalink Reply by David Wells on December 24, 2009 at 9:30am

Well, ROM for all of the mentioned before was non-existent. Managed a little release in the Quads, but everything else was like trying to stretch a piece of oak. My impression is the client had no idea how restricted he is. Gave him one stretch for psoas (the most restricted) to do at home. I was cautious around the replaced hip, but the client had no pain while working on that side. Will see the client again next week and re-assess

Rick Britton said:

how did the session go? what did you notice? how did the client react?

Interested as I have worked on lots of hip replacements when I was working post-op rehab in a Physio clinic