Pilates Exercises to Avoid After Total Hip Replacement

If you’ve just had hip replacement surgery and are considering adding Pilate exercises to your recovery routine, you’ve made a great choice. But Pilates isn't exercise you should try on your own without guidance. Doing the wrong Pilates after hip replacement surgery can do more harm than good. Understanding Pilates well, with your physical therapist's help, is key to a smooth and successful recovery. In this post, we’ll show you which Pilates exercises to avoid and the best way to get in shape and start moving easily with these workouts.

How Does Hip Replacement Recovery Happen?

Did you know about 5% of people have elective total hip replacement surgery? Your hip is a ball-and-socket joint, with the ball being the top part of your thigh bone (femoral head) and the socket being a part of your pelvis (acetabulum). This design helps your leg move in different directions — forward, backward, and sideways. If you have a healthy hip, there’ll be cartilage covering both the ball and the socket. The cartilage helps them move smoothly against each other. But if it wears down or is damaged, the bones start to rub against each other, becoming rough.  This leads to osteoarthritis, which causes pain and makes it harder to move. An arthritic hip can make walking or even getting out of a chair painful. If you’re dealing with hip arthritis, you might not need surgery right away.  Medications like NSAIDs and physical therapy might help. However, if these don't bring relief, it's time to talk to an orthopedic surgeon.

The Healing Process After Total Hip Replacement 

After a total hip replacement, the healing process begins quickly. Your surgeon will typically use one of two main methods:

• the posterior approach, where they make an incision at the back of the hip.
• the anterior approach, where they make the incision at the front.

Both methods help relieve pain and improve movement within weeks, with low complication rates. Sometimes, surgeons use robotic technology during the procedure. The surgery itself lasts about an hour and a half, but with preparation and anesthesia, you spend around two hours in the operating room. You may even be able to go home the same day. Rehabilitation starts within 24 hours after surgery. You may start walking with a cane, walker, or crutches within a day or two. As days go by, you'll gradually walk more and further. Full recovery takes two to eight weeks, depending on your overall health. Sticking with the necessary precautions can significantly affect your physical and psychological recovery after a total hip replacement. These precautions are a standard part of post-surgery care and are typically recommended for 6 to 12 weeks to support healing and prevent hip dislocation.

Pilates Exercises to Avoid After Hip Replacement (and Why)

While the following pilates exercises may be tempting, it is best to avoid them for a full and faster recovery. They include:

1. High-Impact Exercises

As the name implies, high-impact exercises are not suitable for your recovery. 

• Jumping Jacks: This puts a lot of pressure on the hip joint. After a hip replacement, your new joint needs time to heal. Jumping can increase the risk of dislocation or damage.
• Reformer Jumping: This involves sudden movements that strain your hip joint. This can be too stressful, leading to hip complications and a delayed recovery process. 
• Running on the Reformer: Like running regularly, this exercise pressures your new hip and increases the risk of injury to the new joint.

2. Exercises Involving Deep Hip Flexion

• Single Leg Circle: This exercise involves deep hip flexion, which can put a strain on your hip joint.
• Double-Leg Circle: Similar to the single-leg circle, the double-leg circle involves deep hip flexion. This movement can be risky post-surgery as it may overstress the joint, leading to pain or complications.
• Frog: The frog exercise requires deep hip bending, which can place too much pressure on the healing joint. Avoiding such movements helps ensure that your hip heals correctly without unnecessary strain.

3. Exercises Involving Hip Rotation

• Seated Twist: When performing the seated twist, you have to rotate your hips, which can be dangerous after a hip replacement. Twisting movements can lead to dislocation or other issues, so it’s best to avoid them during recovery.
• Supine Leg Twist: Like the seated twist, this exercise involves rotating the hip. This type of movement can be harmful to a new hip joint, increasing the risk of injury or prolonging recovery.

4. Exercises Involving Lying on Your Side

• Side-lying Leg Circles: Lying on your side can put pressure on your hip, and the leg circles can add further strain. This combination might cause discomfort or even damage the new joint.
• Clam: The clam exercise also involves lying on your side, which can put stress on your hip joint.

5. Other Exercises to Avoid

Any exercise that causes pain is a red flag. Pain indicates something is wrong, and continuing could lead to further injury or slow your healing process. Also, you should note that stability is crucial after hip replacement surgery. Any exercise that makes you feel unsteady could cause a fall or other injury. This could be a setback in your recovery.

How to Safely Use Pilates Exercises for Hip Replacement Recovery

If you've just had hip replacement surgery or are preparing for it, it's wise to take a break from Pilates for 8 to 12 weeks. Your body needs time to heal, and while Pilates is safe, you might feel tired quickly.

"We encourage "active" recovery meaning not only physical therapy but beginning to incorporate other forms of exercise. The surgery, though, means we have to avoid certain positions and movement during the early phase of recovery." 

— Jeffrey J. Cherian, D.O. (Specialties: Hip and Knee Conditions)

6 - 12 weeks

By six weeks post-surgery, you should move around more easily without crutches or a cane. At this time, Pilates can help you regain strength and balance, especially for tasks like climbing stairs. Focus on exercises that improve your balance and keep your posture straight, like standing on one leg or doing half squats. Avoid twisting your hips until you’re at least 12 weeks post-surgery. You might be ready to try more challenging moves, but it’s okay to tailor them to be easier on your hip.

3 Months

At the three-month mark, you should be back to most of your daily routines. But you need to stay off high-impact sports. Keep up with your rehab exercises and focus on steady progress. Concentrating on the basics will help you the most at this stage.

6 Months

Six months after surgery, you should be able to return to most activities, though it’s still best to stay away from high-impact sports. If your hip muscles feel weak, Pilates can help build strength and stability. Exercises like swimming, leg stretches, and gentle bridges are great for this.

1 Year

By a year after your surgery, your hip should be fully recovered. This means you can do any Pilates exercises without special adjustments. You can advance to more challenging moves when you feel ready, and your hip should no longer limit what you can do. Consulting with a physical therapist, like the professionals at Lancaster Orthopedic Group, is necessary when adapting Pilates exercises after hip replacement surgery. Every person’s recovery journey is different, and your physical therapist can assess your specific needs, limitations, and progress.  They can recommend which exercises are safe and effective for you, ensuring that your Pilates routine supports your healing rather than hindering it.

Get Care from the LOG Total Joint Replacement Program

When practiced correctly, Pilates can significantly help with your healing process after hip replacement. That said, listen to your body, be mindful of any discomfort, and adjust your routine as needed to avoid setbacks. If you’re looking for top-notch care before, during, and after hip replacement surgery, consider Lancaster Orthopedic Group’s Total Joint Replacement program. Our dedicated team of doctors provides personalized treatment plans, so you have nothing to worry about. With their expertise, they’ll support you throughout your recovery, helping you return to your daily activities with confidence. Request an appointment today!