PHYSIOTHERAPY REHAB AFTER HIP ARTHROSCOPY

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1 PHYSIOTHERAPY REHAB AFTER HIP ARTHROSCOPY Information Leaflet Your Health. Our Priority.

2 Page 2 of 6 Introduction This leaflet has been compiled by the Physiotherapy Team to help you understand the hip arthroscopy procedure and the importance of the post-operative rehabilitation. Anatomy Key anatomy of the hip includes articular cartilage (joint cartilage), labrum (thickened cartilage that helps stabilise the joint), acetabulum (hip socket), femoral head (thigh bone) and capsule (surrounds the joint). It is a large, deep stable joint due to the bony structure, strong ligaments and many muscles crossing the joint. Common problems Recent tear to labrum due to injury Subtle difference in shape of acetabulum or femoral head or both Due to the subtle different bony shapes, repeated load and stresses, degenerative (wear and tear) labral or articular cartilage damage can occur Surgery The keyhole surgery aims to address the above common problems. Any subtle bony differences such as a femoral head bump or a deeper hip socket can be dealt with by removing the excess bone present. Any areas of roughened articular cartilage can be smoothed and the joint generally washed out. Degenerative labral tears are often debrided (tidied up). This level of surgery is often classed as simple surgery and influences the rehab process. Less frequently any recent labral tears can be repaired. If significant loss of articular cartilage has exposed the bone this can be microfractured (bone is drilled). This type of surgery is classed as moderate surgery. The rehab process is slower and you will remain on crutches for longer. This is to protect what has been done during surgery. For further details about the surgery see the patient information leaflet for hip arthroscopy

3 Page 3 of 6 Recovery Surgery will involve an overnight stay. You will see someone from the Physiotherapy team to show you your exercises and make sure you are safe with the use of crutches. They will clarify whether you can put any weight through your operated leg. You will have post-operative pain and it is important to manage this pain well. You will have 2-3 portal wounds. Your hip may be bruised and swollen. The aim of physiotherapy at this stage is to help the natural recovery process that occurs after the body experiences surgery. Even if you had good strength in your muscles before surgery they will not function as well afterwards. They will take time to build up again. Week 1-2 If you do have swelling and bruising, use an ice pack. This can be a bag of frozen peas wrapped in a damp towel. Leave no longer than 20 minutes. You can repeat this several times a day. You will see a Specialist Physiotherapist in the outpatient department. Please attend in loose trousers or preferably with shorts to change into. Your Physiotherapist will check your wounds, exercises and progress as appropriate. The exercises are to make sure you regain good movement and build up strength. The types of exercise are: movement stretching strengthening work for the buttock muscles and deep supporting muscles known as core muscles The movement exercises should be gently worked into pain but not forced. The strengthening exercises should cause little pain. Do inform us if you experience any pain during strengthening exercises. Stitches will be removed days after surgery. If well healed, olive oil can be applied to the wound. This will improve the flexibility of the scar tissue (new healing tissue). If on a simple regime, weight bearing and reduction in the use of crutches will be as pain allows. However, it is normal to have generalised aching in the hip and crutches may be used for several months. You will then progress from two crutches to one and then none. If on the moderate regime, you will be non-weight bearing for 4-6 weeks (determined by your Consultant). Reduction of the use of crutches will be as pain allows, but they will be used for several months. You will then progress from two crutches to one and then none.

4 Page 4 of 6 Week 3 onwards The exercises will be progressed as appropriate depending on your surgery and how inflamed your hip is. It is normal to experience inflammation of the hip, especially as your activity levels increase (particularly around 6-8 weeks). Most inflammation of the hip will be resolving by 12 weeks. Rehab may continue for several months depending on recovery and return to sports. It is important that all movement stretches are continued for up to six months post-surgery to ensure good flexibility. Everyday activities Driving If on a simple regime, driving can be commenced when the stitches have been removed and you feel safe to do so. With the moderate regime driving can be commenced once safe and weight bearing (about 6 weeks onwards). Sports This can be discussed with us as it will depend on which regime you are following and how your hip is responding to the surgery. Impact sports, such as running or contact sports, and any sports that involve rotation should not start until at least 12 weeks post-surgery. Gym work and swimming can be gradually introduced from about 6 weeks onwards. Sitting Sitting in low chairs or putting your hip into a very bent position can aggravate pain, so avoid squatting until about 6 weeks. Avoid sitting with your legs crossed or tucked under you to one side. Both these positions could aggravate the joint and create a further weakness on the important buttock muscles that support your hip.

5 Page 5 of 6 Trouble shooting Please raise any concerns over your recovery with us or your Consultant. Bruising and local swelling This is common and will improve with time. If a particular problem, use local ice packs. Varying and generalised hip pain aggravated by activity This is normally related to the inflammatory process especially if you have overdone it. Take appropriate pain relief and moderate your activities for a few days until it settles. Groin pain on physiotherapy exercises There should be minimal groin pain on any of the strengthening exercises. Please tell us if they do cause pain. It may be that your technique is incorrect or simply the exercise is too challenging for your present stage. This can even vary from day to day. There is no benefit in continuing with the exercise if it increases groin pain, but do try the exercise again another day. Your recovery from the surgery will be much better when all the exercises are done. Remember that recovery takes time as muscles weaken quickly but are slow to regain full strength. Stick with it! Contact us Please speak to your Physiotherapist if you have any questions or queries. The department is open 8am-5pm weekdays

6 Page 6 of 6 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: Information Leaflet. PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number TO72 Publication date May 2014 Review date May 2016 Department Physiotherapy Location Stepping Hill Hospital