What Does Hip Fracture Mean?
When the upper part of the femur bone (thigh bone) breaks, it is said to be a hip fracture. This kind of fracture usually happens due to a motor vehicle accident or a fall, or due to a direct blow to the legs. It is more common in older individuals as their bones get weak and brittle with aging. Hip fractures cause intolerable pain that may radiate to the back side of the hip, outside of the thighs, and to the groin area, and it requires hip replacement surgery as a first treatment. After the surgery, the doctors usually recommend physical therapy to regain the movements affected by the fracture. Physical therapy will enable the injured and treated person to walk, climb up, stand up, and do exercises comfortably.
When Should a Person Start to Do Exercises After a Hip Fracture?
Rehabilitating exercises should be performed whenever the injured person can start them after the surgery. Most people with hip fractures require immediate surgery within two to three days after the injury to realign the bone for a faster healing process. If the fracture is mild and the doctor allows weight bearing on the treated leg, using a walker within two days after surgery may be beneficial for faster recovery. If the fracture is severe and it is indicated not to bear weight on the injured leg for six to twelve weeks, using a crutches or wheelchair is recommended to get around. A physical therapist may play an important role in providing safe exercises to improve the leg's range of motion and perform daily activities.
What Exercises Should Be Performed After a Hip Fracture?
Physical therapists suggest exercises that improve the full range of motion of the hip and increase the strength of the quadricep and gluteal muscles of the hip. They always advise non-weight-bearing exercises at the start and gradually start the weight-bearing exercises depending on the healing process. The exercises that can be performed after a hip fracture include:
Ankle Pumps: This early postoperative exercise can be done as soon as the person can do it. This exercise helps to increase the blood circulation in the feet and legs after the surgery:
- By resting flat on the bed, the person should slowly push their foot up and down.
- This exercise can be done every five to ten minutes in a day.
Ankle Rotations:
- By resting flat on the bed, the person should move their ankle inward toward the opposite foot and then outward away from the opposite foot.
- This exercise should be repeated five times in each direction and can be done three to four times a day.
Buttocks Contraction:
- By resting flat on the bed, the person should tighten their butt muscles and hold it for five seconds.
- This exercise should be repeated ten times and can be done in three to four sessions daily.
Bed-Supported Knee Bends:
- By resting flat on the bed, the person should slide their operated foot towards the buttocks and bend their knees by placing their heel on the bed.
- Then the person should hold the bending position for five to ten seconds and straighten their legs to the starting position.
- This exercise should be done ten times.
Quadriceps Set:
- By resting flat on the bed, the person should tighten their thigh muscles by straightening their knees.
- Then the person should hold the position for five to ten seconds and repeat it ten times.
Straight Leg Raise:
- By resting flat on the bed, the person should tighten their thigh muscles by fully straightening their knees.
- Then the person should slightly lift their leg for several inches and hold the position for five to ten seconds.
- This exercise should be repeated ten times.
Abduction Exercise:
- By resting flat on the bed, the person should slide their leg out to their side as far as they can and bring it again to the starting position.
- The person should repeat the exercise ten times.
Standing Knee Raise:
This exercise should be performed after the early postoperative period when the person is able to bear weight on the operated leg.
- The person should stand behind the chair and hold the chair for support. Then the person should lift the operated leg towards their chest, hold the position for two to three seconds, and return to the starting position.
- This exercise should be repeated ten times.
Standing Hip Abduction:
- The person should stand behind the chair and hold the chair for support.
- Then the person should slide their leg to the side as far as they can and return back to the starting position.
- This exercise should be done ten times.
Standing Hip Extension:
- The person should stand behind a chair and hold the chair for support.
- Then the person should lift their operated leg slowly in the backward direction.
- Then the person should hold the position for two to three seconds and return their foot to the ground.
- This exercise should be repeated ten times.
Walking Using a Walker:
- The person should stand erect and comfortable by balancing their weight evenly on a walker.
- Then the person should move their walker in front for a short distance, and then they should reach forward by using the operated leg to the walker.
- Then the person should continue walking with the walker.
- Initially, the person should walk for five to ten minutes and slowly increase the duration to 20 to 30 minutes.
Stair Climbing and Descending:
- The person should hold a handrail for support.
- Then the person should step up the stairs with an unoperated leg and descend the stairs with the operated leg.
- It is very important to climb and descend stairs over seven inches.
- The person can take someone's help to climb up and descend the stairs until they regain their mobility and strength.
In addition to these exercises, there are advanced exercises and activities that can regain strength, stability, and mobility after a hip fracture. Some of them include:
- Resistive hip flexion.
- Resistive hip extension.
- Resistive hip abduction.
- Cycling.
- Walking.
Conclusion
If the hip fracture is treated properly through surgery and physiotherapy, it can take hardly three to six months to recover from it completely. Physical therapy for a hip fracture should be started immediately after the surgery. So reaching out to a physical therapist may be beneficial.
