Please note
- You will be given a paper copy of this leaflet by Trust staff.
Some patients having total hip replacement surgery will be required to follow hip precautions. Your surgeon will make this decision.
Hip precautions will be explained to you in this leaflet and by a therapist.
What are hip precautions?
There are precautions to follow which help to keep the hip in a safe position during the healing process. During hip replacement surgery, the muscles and ligaments surrounding the joint capsule, which keep the ball joint centred in the hip socket, are cut. There is a small risk of dislocation in the six-week period following surgery until the surrounding muscle and tissue has healed. If dislocation occurs, the ball of the joint comes out of the socket and will need to be put back in place under anesthetic.
Important
If you are not required to follow hip precautions, the information in the booklet will still be useful to you in helping with comfort following surgery.
You WILL be informed by a clinician if you are required to follow hip precautions.
When does my rehabilitation start?
Your rehabilitation starts before your operation and from the point of receiving this leaflet. It is REALLY important that the movement restrictions in this leaflet are practiced before your operation so that they are familiar to you. In most cases, you will be able to put your full weight through your leg after surgery.
If you are following hip precautions, there are four movements which MUST be avoided for six weeks (or longer for some people).
- Do not cross your legs (or the midline of your body shown by the dotted line on these pictures).
- Do not bend your hips past 90 degrees (a right angle).
- Do not lift your knee above your hip.
- Do not twist your leg or waist.
The images also have a dotted line through the middle of the bodies which needs to avoid being crossed.
How does this affect performing everyday activities?
It is important that once you go home from hospital, you follow the hip precautions when performing everyday activities.
During pre-assessment, the Occupational Therapist will have measured your leg length and discussed the appropriate heights of your furniture. It is important to remember that these heights will also apply outside of the home environment i.e. family/friends chairs may be different heights to yours.
To check whether furniture is a suitable height for you, when sitting, your knees should always be lower than your hips. Your knees should never be higher than your hips for six weeks post op.
Toilet
Depending on your leg length it is likely that you will need a raised toilet seat to be fitted at home. The Occupational Therapist will assess toilet transfers on the ward and issue you with the appropriate height toilet seat. This can be fitted by a family member, friend or carer, with instructions provided. It is not advisable for you to fit the toilet seat yourself following your surgery. You should use the raised toilet seat for six weeks following your operation.
Chair
- Always make sure that the chair is a suitable height to comply with the hip precautions.
Do not use a rocking/swivel chair, as they are unstable and not safe.
Do not use the recline action of a recliner chair – or any integrated foot stool. - It is recommended that you use a chair with arms.
- When sitting down always feel behind you for the chair arms, take a step forward with your operated leg and lower yourself gently into the chair.
- To stand, keep your operated leg straight in front of you, taking the weight through your non-operated leg. Push up on the chair arms.
- Do not use a footstool for 12 weeks after surgery.
Bed
- You will be able to get in/out of bed the same side as you currently do at home.
- The bed should be a suitable height to comply with hip precautions.
- Do not allow your operated leg to cross the midline of your body when getting in/out of bed.
- You should sleep on your back for six weeks.
Remember you should not bend forward to pull up the bed sheets as this will be breaking the hip precautions, as illustrated in the diagram above. Roll your bedding to the side before you get in.
All transfers will be practiced during your stay in hospital to ensure that you can manage independently and safely when you get home.
How does this affect the way I get washed and dressed
Washing
- It is highly recommended that you purchase dressing aids to use following your hip replacement; including an easi reach, shoe horn and sock aid.
- You will be encouraged to dress in day clothes following your operation as part of your rehabilitation- please bring in your dressing aids on admission for use on the ward.
- You must not bend down to wash your feet or cut toe nails, use aids provided or ask for help.
- It is not advisable to sit on the side of the bath to strip wash.
- If you have a walk in shower, discuss this with your Occupational Therapist, as it is essential that you do not twist or rotate your hip.
- Six weeks after your surgery you may climb over the side of the bath to use an over bath shower. You must not sit in the bottom of your bath for 12 weeks after your operation.
Points to remember
- Always dress your operated leg first and undress it last.
- Always get dressed sitting on the bed or chair, not in standing.
- Arrange items that you need so they are close at hand.
- Avoid twisting or bending to reach for items and have your easi reach readily available.
How will I do housework/kitchen activities?
Continue to be aware of the hip precautions
- We do encourage you to resume your normal daily activities when you return home. Housework such as vacuuming can be resumed as comfortable after six weeks.
- Remove all loose rugs and mats which can be a potential trip hazard when walking with crutches or a stick.
- Avoid standing for long periods; where possible sit to prepare meals.
- We advise that you organise your home environment, particularly the kitchen, so that most used items are within easy reach and accessible to you.
- When cooking or making a hot drink, ensure that you position yourself facing the work surface to avoid twisting.
- In the event that you need to bend to reach for something in a low cupboard or the fridge, place your hands on a work surface for support, and extend your operated leg behind you and lower yourself by bending the ‘non-operated’ knee.
- Kneeling: Not for six weeks, discuss this with your discuss this with your Occupational Therapist. If you do any household tasks that require kneeling, this should be avoided.
Can I still drive after a hip replacement?
Avoid driving for six weeks following your surgery. You should be able to perform an emergency stop without discomfort or hesitation before starting to drive again. It is also advised that you inform your insurance company that you have had a joint replacement procedure, this is to ensure your insurance remains valid.
How do I get in/out of a car?
- Ask the driver of the car to park away from the kerb, to maximize the height from the ground to the top of the seat.
- Always sit in the passenger seat, you should not attempt to sit in the back of a car.
- The seat should be moved back as far as it will go and the back rest reclined.
- Open the car door fully and position yourself square on to the side of the seat, facing outwards.
- Extend your operated leg out in front of you and place your hands on the seat behind you for support, and lower yourself gently down onto the car seat.
- Ensure you keep your operated leg in a safe position, not crossing the midline of your body. You may require some support to lift your operated leg into the car.
- Once you are sitting in the car, keep your legs stretched out in front of you, and avoid bending the knee of your operated leg.
- Raise the seat back to a comfortable position once you are seated in the car. Your knees should not be higher than your hips, and you should not bend more than 90 degrees.
Reverse this process when getting out of the car.
When can I return to work?
- You can discuss this with your Consultant or Occupational Therapist as it will depend on what you do at work.
- It is important to consider your work environment and duties.
- If your work involves desk or administration work you may return as soon as comfortable, however chairs of an appropriate height and stability are required.
- If you are required to stand for long periods at work you may return from six weeks if able.
Remember
The hip precautions are to be followed for six weeks.
Can I still participate in leisure activities?
- Regular exercise such as short walks is encouraged.
- Bowling/Boules – Possible from 12 weeks. Always lead with your non-operated leg. After six months as normal.
- Contact sports – Should be permanently avoided.
- Cycling – Static exercise bike from six weeks, otherwise 12 weeks using low profile crossbar.
- Dancing – Cautiously from six weeks.
- DIY – From six weeks if able.
- Gardening – Can be resumed from six weeks as comfort allows, avoid digging for 12 weeks.
- Golf – If comfortable from six weeks. Spikes not advised.
- Horse riding – From six months (experienced).
- Keep fit/Gym – LOW impact, from eight weeks.
- Racquet sports – From six months; discuss with Consultant.
- Sailing – From six weeks, always wear a life jacket.
- Skiing – From six months if an experienced skier.
- Swimming – From eight weeks, however breast stroke not recommended for one year.
Additional information
How long will I be in hospital after my operation?
We aim to discharge you from hospital as soon as you are safe to go home. In some cases this may be as early as the evening of the day you have your surgery.
Pain Management
Make sure you take pain medication around planned daily activities. Controlling pain after your operation will help with the healing process. When returning to daily activities, try to pace them and ensure you are taking a break regularly as this can actually mean you can keep going for longer.
Work roles
It is important to remember that the pain from this surgery will be temporary and that your focus should be on the increased function you will ultimately achieve after your operation.
Flying
Short haul flights: less than four hours Avoid until 12 weeks. This can be discussed with your consultant.
Long haul flights/coach holidays Avoid until six months.
Sex
Sexual relations can resume cautiously from six weeks to three months. The person with the hip replacement should lie on their back whilst their partner is on top. There are no limits after six months.
Further information
If you require any further information or advice please discuss this with your Occupational Therapist.
Following your attendance at pre-assessment, the Occupational Therapy Team will contact you by telephone to discuss your individual care.
You may receive a text message for this appointment. Do not come to Chapel Allerton Hospital for this as we will contact you by phone.
Occupational Therapy Pre-assessment Team
Ward C3 Occupational Therapy Team
Hip school video – YouTube transcript
welcome to the elective total hip
replacement education session this DVD
will help you to prepare for your hip
surgery it is important that you prepare
yourself and your home before coming
into hospital to make the best recovery
if you’re watching this DVD at home you
OCCUPATIONAL THERAPY PRE-ASSESSMENT TEAM
can call the occupational therapy pre
assessment team on the numbers shown if
you have any questions in order to
Your hip requires 6 weeks to heal and regain stability following surgery
replace your hip joint some of the
muscles and ligaments that normally
provide stability to the joint are cut
these tissues need at least six weeks to
heal and become strong again in order
for your hip to function well as a
There is a small risk of dislocation during this 6 week period
consequence of your hip muscle being
weak following your operation there is a
small risk of dislocation hip
precautions are recommended during this
time to protect your hip while it heals
and reduce the risk of the hip
dislocating these precautions are
recommended by your surgeon and followed
Adhere to the following precautions to reduce the risk of dislocation
for six weeks
you must avoid crossing your legs at the
knee or ankle
do not bend your hip pass 90 degrees
do not lift your knee above your hip
do not twist your leg or waist
it is also recommended that you sleep on
your back following your surgery
do not use footstools or the recliner
X Do not use footstools
action of recliner chairs and ensure
that you rest on your bed for two hours
in the afternoon
the leaflet provided will explain your
precautions in more detail so please
read this prior to your operation to aid
your recovery in order to follow hip
precautions you will need to ensure that
your furniture at home is at the correct
height so that your knee isn’t higher
than your hip when you are sitting this
will also promote successful healing
following your operation the
precautionary height is the measurement
from the back of the knee crease to the
floor plus 2 inches it is easier if
someone measures this for you
you should have been sent a furniture
Heights form which looks like this we
require the height of your chair and or
sofa toilet and bed to ensure they are
suitable and meet your precautionary
height following your hip surgery we
will now discuss appropriate furniture
and demonstrate the correct way for you
to measure it your chair should have a
firm and level seat arms and high back
the seat should not slope down at the
back you can sit on a sofa but a chair
is much easier to stand up from as you
can push up on both arms and this is
often more comfortable than sitting on a
sofa to measure your chair have someone
sit on the seat and measure from the
lowest point to the floor if there is
nobody available to help you then push
the seat down with your hand to compress
it a measure from the lowest point to
the floor please measure all the chairs
that you sit on at home such as your
dining chair and stair lift seat if your
chair is too low you can add height with
extra cushions or fold up blankets under
the seat ask family or friends if they
have a suitable chair that you can
borrow alternatively certain types of
chair can be raised on blocks available
from your local equipment store measure
your bed in the same way either have
someone sit on the bed when measuring or
push the mattress down with your hand
and measure at the lowest point on the
mattress down to the floor this
technique is applicable to all bed sizes
if your bed is too low you can buy a new
mattress add height with a mattress
topper or second mattress onto the
existing one use an alternative bed at
home if it is a suitable height your
local equipment store may be able to
raise some types of bed by putting
blocks underneath it please be aware
that some furniture is not suitable for
raising and this is decided by the
equipment store fitters
to measure your toilet first measure
from the seat down to the floor then
lift the seat up and measure from the
bowl down to the floor
if your toilet is too low appropriate
toileting equipment will be provided by
the occupational therapists following
your surgery on the ward prior to coming
in for your surgery we would advise that
you organize your home environment in
particular the kitchen to ensure that
you can get to everything you need with
these you need to think about what items
you use regularly and ensure they are
within easy reach for you in the kitchen
rearrange cupboards so the items you use
regularly are easily accessible and
place commonly used items on the worktop
to minimize any need to bend
when preparing food or drinks always
remember to position yourself facing the
worktop to avoid twisting try to avoid
standing for long periods it can be
helpful to have a suitable height chair
to rest on in your kitchen if you have
space if you live alone or anticipate
Prepare meals for your freezer prior to your admission
difficulties with cooking after your
operation prepare frozen meals or
purchase ready meals you may need
assistance with both shopping and
laundry after your operation now is the
time to arrange help from friends and
family as you walk around your home
remove any obstacles ensure any repairs
are carried out eg if your stair rail is
loose from the wall and remove any loose
rugs as they are a trip hazard
if you have pets consider how or who
will look after them you may need to
consider temporary pet care when feeding
your pets a long-handled dustpan can be
used to place the food down onto the
floor and lift it back up again if you
do need to bend then you should study
yourself on a sturdy surface then slide
your operated leg behind you while
spending your good leg towards the floor
please refer to your hip replacement
booklet as this will provide you with
more information regarding managing your
domestic activities at home following
your hip replacement you are advised not
to attempt getting into a bath or over
bath shower for 12 weeks as you will
compromise your precautions by
attempting this you can use a walk-in
shower or shower cubicle once you are
confident you can stand without your
elbow crutches
if you do not have access to a suitable
shower then you will need to strip wash
you should either stand at the basin or
position a suitable height chair at the
basin you should avoid sitting on the
edge of the berth to wash in case you
slip always ensure that you have your
toiletries close by to avoid twisting or
overreaching for items and remember you
must not bend down below your knee to
wash your feet or cut your toenails
if you do not have anyone who can assist
you with this then it is possible to
wash below your knees with a
long-handled sponge or a sponge in your
easy reach and dry with a towel or
hairdryer
during your hospital stay we encourage
Loose fitting day clothes are
you to wear day clothes on the ward
bring comfortable loose-fitting clothes
and underwear with you
eg tracksuit bottoms shorts loose
trousers elastic waist skirts your feet
Loose fitting, supportive footwear is
can swell up after the operation
therefore we advise loose-fitting
supportive Footwear to accommodate for
this we recommend you bring slippers
with a BAC or shoes that can be easily
taken on and off
the day after the operation the
physiotherapy team will help you to move
yourself to the edge of the bed ensuring
you maintain your hip precautions the
physiotherapist will aim to walk you a
short distance using a walking frame and
sit you out in a chair
the occupational therapy team will
assess you washing and dressing to
ensure you can manage independently
whilst maintaining your hip precautions
you will require long handled dressing
aids to enable you to do this if you’re
watching this at home we will arrange
provision for your dressing aids when we
speak to you on the telephone please
Bring these aids into hospital with you
remember to bring your dressing aids
with you when you come in for your
operation when dressing sit on an
appropriate height chair or bed dress
your top half sitting to conserve energy
and maintain your balance remain seated
to dress your bottom half
removing your Footwear with a
long-handled shoehorn
using the easy reach gather the leg of
your undergarment or trouser and place
it over your operated leg
you can then pull this upwards past your
knee
when you can reach with your hand feed
the second side of the undergarment or
trouser leg onto the easy reach
bring the garment back down to your feet
and slip your own operated leg through
pull the garment up using the easy reach
until you reach your knee now you are
able to stand to adjust your clothing
remember do not bend forward
hold the curved sock aid in your hand or
hold it between your knees loose socks
will work best and a small amount of
talcum powder in the sock aid will help
your foot to slide place your sock onto
the sock aid and slide it until the sock
Aid is right to the toe area the heel of
the sock should be to the bottom and the
top of the sock should be concert enid
into the groove near the strings
using the strings drop the sock aid to
the floor place your foot into the
opening and walk your foot into the
gutter until your toes are right to the
end
pulling the opening wider using the
strings will help lift your foot off the
floor slightly and pull evenly on the
strings to pull the sock onto your foot
taking socks off is done most easily
using your shoehorn or easy reach
remember the golden rule dress your
Dress your operated leg first
operated leg first
undress it last never sit down or stand
up with your arms still in the crutches
instead hold the handgrips in one hand
and reach down or push up from the chair
with your other hand the physiotherapist
will work with you to progress your
walking from using a frame to using
elbow crutches and practice going up and
down stairs your forearm should sit
within the cuff and the hand grips
should face forward when walking put the
crutches forward together then step your
operated leg up to the crutches your non
operated leg then steps up to the
crutches and your operated leg using the
crutches allows weight-bearing through
your operated leg and helps to gain a
correct walking pattern and avoids a
limp the crutches issued to you will be
measured to you please do not alter them
once you are at the bottom of your
stairs if you have a handrail or
banister take out the crutch at that
side and hold it in the opposite hand
make a t-shape with your crutches and
ensure you hold the spare crutch on the
outside of your other crutch if you did
drop the crutch it would then fall away
from your feet place your non operated
leg up onto the first step followed by
your operated leg lastly your crutch
joins them on the same step follow this
procedure until you reach the top of the
stairs when you can pass the spare
crutch back to the other hand and
mobilize as usual to come down the
stairs reverse the process
hold your spare crutch in the same way
place your crutch on the step below then
step on to that step with your operated
leg lastly your own operated leg follows
onto the same step make sure your hand
holding on to the handrail or banister
is at the same level as your elbow
crutch to reduce any twisting when
coming downstairs
follow this procedure until you reach
the bottom of the stairs the
occupational therapist will check that
you can safely transfer on and off your
chair bed and the toilet whilst you are
on the ward and will practice these with
you until you are independent any
toileting equipment you will need will
be assessed for and issued at this time
the expected length of stay following a
The expected length of hospital stay is 3 days
hip replacement is three days some
patients recover sooner and a discharged
home on day two while others need longer
in hospital and may require further
rehabilitation or support when they go
home you will be discharged home once
your wound is healing you’re able to
walk with elbow crutches and manage
stairs if applicable you are independent
transferring on and off a chair bed and
toilets you are able to wash and dress
independently any aides or adaptations
are in place at home please plan your
Plan your transport home
transport home with family or friends if
you are unable to organize your own
transport then please inform ward staff
when you come into a hospital you are
Practice getting in & out of your car prior to your admission
able to travel in a car as a passenger
following your hip replacement practice
this before the operation low sports
cars and people carriers are not advised
as they are more likely to compromise
your hip precautions getting into a car
we suggest you park away from the curb
slide the front passenger seat back as
far as it will go
and recline the seat back
place your back to the car remove elbow
crutches
and sit on the edge of the car seat
sideways placing a plastic bag on the
seat can help you move around more
easily just remember to remove it before
you set off slide your bottom back onto
the seat this will help your operated
leg over the door sill and into the foot
well be careful not to raise your knee
above your hip at this time
it is important that you leave your leg
straight out in front of you for the
whole journey remember remove the
plastic bag before you set off adjust
the back of your seat to a more upright
position for your comfort during the
journey an information leaflet on car
You may recommence driving approximately 6 weeks after your surgery
transfers is available you may drive
again approximately six weeks after your
surgery providing an emergency stop is
To safely recommence driving you must be able to perform an emergency stop
performed without hesitation or
discomfort test this out while the car
is stationary you are advised to inform
your insurance company before returning
to driving
the physiotherapist will now demonstrate
your hip exercises so these are the four
exercises that we want to get started
with from now you need to do each of
them ten times and repeat that three or
four times a day once you’ve had your
surgery
if fizzy will be able to advise you on
which exercises you should be doing and
how often how frequently you should be
doing them so start with these exercises
hold on to a table or a kitchen worktop
the first exercise is taking you need
pump in front of you making sure it
doesn’t come high and then your hip and
back down and repeat that 10 times
exercise number two stand up nice and
tall to pick your leg out to the side
and back to the middle nice and slowly
and again repeat ten times
exercise number 3 tip and you like
straight backwards make the treat
yourself not nice and tall and don’t
lean forwards and exercise them before
and then you need to heal up to your mom
once you have watched this DVD please
contact the department on this number to
book a telephone assessment appointment
the occupational therapy pre assessment
team will then assess your needs and
answer any questions you may have
Returning equipment
If you live in Leeds and want to return equipment, please contact Leeds equipment on the telephone number below.