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In this video, Farnham’s leading over-50s specialist physio, Will Harlow, reveals a major problem that affects people after a total hip replacement and shows how to fix it. Perfect for ages 50+ and seniors.
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*About Will Harlow*
Will Harlow is a physiotherapist, best-selling published author and YouTube creator who specialises in helping people over the age of fifty. Will is a fully qualified physiotherapist with a Master’s degree from Brunel University in London. His credentials include a BSc and MSc. More about Will Harlow here: https://willharlow.com/
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there is one major problem that affects most people after a total HP replacement that almost no one speaks about luckily it’s fixable and in this video I’m going to reveal what it is and how to solve it if you don’t know who I am my name is will harow and I’m the over 50s specialist physio here at HD physio INF farum today we’re going to be talking about one major problem that affects people after a total hip replacement now total hip replacement surgeries are really really common they’re fantastic surgeries for people who have pretty bad hip arthritis however the rehab afterwards is not always what it should be and that can leave one thing to be very wrong in many people who’ve had this surgery so I’m going to show you what that thing is and how to fix it in just a moment I just wanted to let you know first that the exercises I’m going to show you are not suitable for everybody make sure you get checked out before you give them a try especially if you’ve just had surgery and if they cause you pain just avoid them anyway let’s have a look at the problem and how to fix it now so the major problem that affects so many people after a total hit replacement is weakness in the glutes now this is unbelievably common yet I see almost no one talking about this online and it does represent a huge risk for people who’ve had a total hit replacement surgery so let’s talk about why the glutes get weak after a replacement surgery and what to do about it so the glutes get weak because obviously with the hip replacement surgery there’s an incision that’s made into the hip either at the back here or at the front here depending on how the surgeon went about it so once you’ve had your joint replaced that represents a massive shock to the whole body and what the brain does when it interprets all this trauma that’s happened is it temporarily shuts down all of the muscles around the hip now when you’re in the hospital and you’re doing your rehab to get you moving you will have noticed that slowly slowly slowly the strength in your leg starts to come back over a couple of days and then you’re able to go home but one of the biggest things I see is that in the hospital no one gets you doing exercises to strengthen your glutes so what happens is you start moving around again and the other muscles of your body are very good at compensating for weak glutes so I find people who come and see me 12 weeks or even a year after a hip replacement and they’ve never regained the strength in their glutes but they don’t even realize that they’re weak and the reason they don’t realize is because their back has started to take over the hamstrings have started to take over and the other muscles at the front of the hip have started to take over from the glutes so if you’ve had a total hip replacement I reckon at least 75% of you have got weak glutes and that’s what we’re going to talk about improving today if you don’t improve your glute strength you are at risk of back problems you’re at risk of knee problems and your hip your new hip is not going to be getting getting the protection that it needs to keep it healthy so with all of that bad news out the way let’s talk about what we can do to fix the weak glutes if you’ve had hip replacement surgery one of the best exercises for you to strengthen your weak glutes is the clam and the clam is a really good exercise that involves basically you lifting your leg like this which should be a safe movement for people who’ve had hip replacement surgery no matter how early it’s done just provided it’s after for the first week or two however there are rules with hip replacements that people shouldn’t cross their leg over the midline so if you’ve recently had your hip replaced I’m talking the last 12 weeks I would recommend using a pillow between your knees like this so I’m going to show you how The Exercise Works you’re going to lie down on your side you can have another pillow here to support your head and we’re going to roll the body forward so that we’ve got our body slight tipped further forward than feels natural you can use your hand here just to support you if that helps then what we’re going to do is we’re going to keep our feet together so the feet aren’t going to separate we’re going to keep the body forward as we move and we’re just going to lift that top knee off the pillow as high as we can hold for a second and then pop it back down like this and this is a nice early stage glute exercise for people who’ve had their hip replaced many people who do this they’re surprised at how difficult this feels because they’ve just never used this muscle in isolation before and even though the leg feels nice and strong when they isolate the glute there’s almost nothing there in terms of strength now when I’m giving this exercise to people who’ve had hip replacement surgery what I like to tell them to do is experiment with the angle of the hip so they might want to do it with a 90° angle here and try that you’re going to feel that the muscle is working differently when you do it in this way you can also try with the legs right down there so you’re almost flat and then trying to lift again again you’re going to feel that the glutes are working differently but any angle works well I would try and do a variety of them so you might do three sets 10 or 15 repetitions each time with a different angle of leg whenever you’re doing it now if you’re beyond 12 weeks after surgery it should be safe to do it with the knees together and that allows you should just get a little bit more of a range of motion on that hip obviously check with your physio or your consultant before you try this but for most people after 12 weeks this is going to be totally safe making sure you’re keeping that body forward I tell people to have a hand flat CU that obviously just helps with control if you’re happy just keeping your hand like that you can but really the goal is to take this muscle here to the point of fatigue you should feel the ache just below the Belt Line definitely not above the belt and not down in the hamstring as well if you can feel it in here or here then you need to slightly change the angle or slightly change the position of your legs until you feel it right there so do that exercise three times over so three sets of 10 repetitions and that’s a great way to start a glute strengthening program before we go any further I just want to tell you about three tip Friday three tip Friday is my weekly email that I send out to my list and it features three of the most interesting things I found that week it could be a health tip it could be a piece of research I’m reading or it could be a new tool that I found to be really useful for helping people get more mobile it’s totally free I just send it out once a week There’s No annoying promos inside and you can sign up for it by going down below this video and entering your email in the three tip Friday link once you’ve been doing the clam for a while and it starts to become easy we’re going to move on to the hip abductions lying on your side and this is a much more difficult exercise for people when they’re just getting started so you probably won’t want to do this until about 8 weeks after your surgery for most people I would say to make sure you’ve got a nice solid foundation before you use the wrong muscles but here is how the exercise looks again if you want to do this before the 12we Mark we’re going to use a pillow which goes between your legs like this and we’re going to light right flat on our side just like we did before for the clam the hand position is the same so it comes in front of you and you roll your body a bit further forward than feels natural and just support your body with your hand from this position we’re going to lift the top leg which is the one you’ve had operated up and ever so slightly behind you until you reach your maximum now you can see here that I’m just slightly leading with my heel so it’s my heel Which is higher than my toes and then I’m going to let it drift back down like this and when I’m doing the exercise correctly in the right angle the area I can feel it is almost exclusively here just below the belt line on the glute at the top so we call this the gluteus medius and the gluteus Minimus and those are the ones for most people that get particularly weak after a hip replacement surgery now what the pillow is doing here is it’s just preventing my leg from Crossing over the midline which again can in some cases be dangerous for people who’ve had a hip replacement in the last 12 weeks so we’re just preventing anything bad from happening but make sure you’ve got good control over this movement when you do it if you don’t feel you’ve got control you’re probably not ready for it yet so don’t do it until you are absolutely certain you can control the movement throughout now if you feel this in the wrong place if you feel it at the front of the leg or in your lower back you’re using the wrong muscles so if you feel it at the front of the leg you probably started to drift forward which is what most people do when they start and that is because you’re not tipped forward far enough and you’re not going ever so slightly behind you as you lift and if you feel it in your lower back what’s happening is you’re probably getting to here and then going Beyond and just pinching the back at the top trying to use those back muscles to lift you up which again is a bad thing and could lead to back pain so it should be a nice controlled movement it should isolate the glue you don’t need to go right up here you can just take it to here that’s fine and then pop it back down again if you can do 10 of these in a row for three sets per day that’s a great way to progress the strength of your glutes after hip replacement the final exercise we’re going to do today to build strength back in your glutes after hip replacement surgery is the bridge and we’re going to do two variations of the bridge the first is the basic variation and the bridge looks something like this so we’re going to on a flat surface you can have your head supported on a pillow or you can have it flat if you want to do it in the absolutely correct way but if you’ve got neck problems I would suggest a pillow pop your hands down by your sides like this you want your knees bent as much as you feel comfortable lifting them just going to make sure that you can lift your toes up off the bed to make sure that most of the weight’s going through the heels going to flatten your back push through the heels lift your pelvis up in the air just until the body is straight and at the top you’re going to try and squeeze your butttocks together as if you’re grabbing a pencil between them hold for a couple of seconds and then slowly reverse your way down and this is a lovely exercise post hip replacement to get you strengthening your glutes again now many people have shown this exercise by the hospital which is great but if you want to progress it and you really want to get those glutes working we can add a resistance band in to make this more effective so I’m going to use one down here and what you’ll probably want to do is get someone to help you tie it because doing it up like this sometimes isn’t comfortable but if you can you want to tie the band just above the knees and you probably want quite a strong band because we’re not looking to get loads of movement we’re just looking to add quite a bit of tension so you’re going to tie the band like this okay you’re going to start again this time taking the legs out to begin with so we’ve already got some tension on the band there then what we’re going to do is flatten down push through the heels lift to a straight line and at the top again we’re just going to slightly push out again just to increase that tension on the glutes now I can really feel a good contraction back here going to hold for a second bring the leg in slightly bring it all the way down to the bed and then relax and again push out flatten the back through the heels and up to the top hold out again just to increase that contraction hold for a second and then in down and in simple as that I would recommend again working up to 10 repetitions in a row three sets per day you should feel a nice working burn in the glutes by the end of your set that’s a great sign that you’re onto something good and then practice that daily to build your glutes back up so that’s the major problem that affects people after total hit replacement surgery I hope you found this video useful if you’ve just had surgery do drop a comment below and let me know if you found it helpful and if you want to get more from me there’s loads more exercises like these ones in my book it’s called thriving Beyond 50 and you can find it on Amazon using the link below anyway thank you so much for watching I really appreciate your time and I’ll speak to you on the next video
43 Comments
The gluteus medius primary abducts the leg as shown in these exercises but in real life function it works differently and this needs to be understood. Many PTs forget how the gluteus medius really works in gait and don’t include a very important exercise.
When walking during the stance phase on the right leg the right gluteus medius contracts to keep the pelvis from dropping on the left side. It isn’t abducting the leg but is lifting the pelvis.
So these abduction strengthening exercises need to include hip hiking. As a PT of 42 years I have seen a positive trendelenburg sign on hip replacement patients that only did hip abduction exercises.
1 week after, pain in right buttock. I will be starting these. You are in Farnham, Sy ? We are Ash, thanks for the vid
Had second total hip replacement early Feb. Done all exercises given by physio daily. Generally strong and age 59, and recovery was going great. Unfortunately my new hip dislocated after 3 weeks whilst sitting on a settee, after I had been lifting my leg to gain strength. Seemed to be when leg was relaxing and foot went over on its own. Unsure why this happened? Massive pain and fortunately after 3 Ops the hip went back into place. Very scary time…Now 3 days later and feel very bruised and beaten. Will try these exercises to help my recovery.
Thank you I just had hip surgery 2.5 wks I will try this. Thank you
Hello from Eastern Canada. I am 12 weeks out from my surgery and I have been given some great exercises but I was intrigued by your vlog. I am glad that I stopped for a look because I realized that I was not doing the bridge correctly. I am an avid golfer and I cannot wait to get back to it. I have signed up for your 3-Tip Friday and I plan on getting your book thank you for popping up on my screen this Saturday morning.
I am at 1:05 and I still do not know what this major problem is. What is your purpose: to inform me or to make me waste time?
I’m getting anterior hip replacement in 4 weeks. I’ve been pre habbing my glutes with these exercises and have built up to using a 20lb dumbbell with a longer range of motion. I realize I will be starting over when I able after surgery but hopefully I will have retained a good degree of strength.
Thanks Dr.still weak gluteus after 8 months.
My body feels heavy. Am79kgs.
Am 65 yrs .any hope?am limping slig
Thanks Dr.still weak gluteus after 8 months.
My body feels heavy. Am79kgs.
Am 65 yrs .any hope?am limping slig
3.5 yrs after bilateral anterior hip replacement. My left knee is so painful I can't walk and my gluts hut when I walk. And my low back is weak. No one has suggested to exercise my gluts! Thank you for this suggestion!
I had right hip replaced on 31st January. Have had no physio, getting a phone appointment in another 2 weeks. Feel completely let down by the nhs. I don’t even know if I am doing the exercises correctly or just causing damage.
13 years on … this is my problem.
I recently had a THP. One of my nurses immediately started working my glutes. Another one started work on my tute, and would regularly play it like a flute. She wasn’t the best looking nurse, but after my meds, she started looking kinda cute.
I'm one day post posterior THP. Is it too soon to start PT in a week?Thinking the first 2-3 wks mainly for healing with minimal exercise movements. TY
Should I be using a glute weight machine pre surger?
Any advice for those trying to exercise with CFS and Fibromyalgia?
So so true !!!!!!!!
3 weeks out THR left leg, 51yr male
I can walk now , progress is slow patient’s is a virtue
Crazy how the brain does shout down the trauma area , great video 🙏🏽🙏🏽
It’s true that after surgery the leg is shorter then before ? People Walking limping afterwards I see many tend to lean on the shorter side
I am 1 year post op Hip Replacement. For the first 3 months it was wonderful, but then I twisted my hip slightly one day in the kitchen and it hasn't been right since. I went thru weeks of PT and honestly it has gotten so much worse. I can hardly walk going from a sitting position to a standing and walking position and the pain is mainly in my groin. Would this be related to the glute weakness?
Please suggest an option for someone whose lower back rotates out when on their side. My waist is 10” smaller than my hips and when I lie on my side as you’re doing it cause pain in my lower back, and can cause it rotate out of position. This means I’m off to the chiropractor for an adjustment. My hip surgery was 9 weeks ago and it’s achy somewhat. I did really well in PT but now I’m on my own
Thank you for this info! I'm getting my left hip replacement in two weeks.
Thank you Will, Yes, I found this video really helpful as I felt I was stiffening up a little. This is the first I've watched but found it great and it's explained what the pain in my lower back (glutes) probably is!
Thank you, very good information.
❤
My right hip bone been put back with out surgery it's been a week now when discharge from hospital & I have this swallon leg with tight button.. No pain around the groin area ,can I start walking?
I had hip replacement surgery 2 months ago. My recovery has gone pretty well. However, I have some advice for people who are planning on hip surgery in the near future. Do all the exercises you're advised to do by your surgeon and physical therapist, but I also strongly advise you to strengthen your upper body as well. After surgery, your arm and shoulder muscles are going to work hard, filling in for your lower body muscles while you recover. I didn't strengthen my arms and shoulders before surgery, and those muscles got really sore, especially my upper arms. As I put my heating pad on my arm, I thought – if I ever get the chance to pass on some advice to pre-surgery folks, I'll tell them to strengthen their arms and shoulders as well as legs and hips. Cheers.
5:54 it’s been a year since my THR. It was bone on bone. I was up and walking the next day and I’m pt two days later. Other than being sore I was doing fine. Now my entire body hurts!! I’m weak, when I go to stand up I cannot stand up straight and hunched over for a few minutes till I walk it out. I have zero strength in my leg and yes I’m still in pt. What could cause my entire body to hurt so bad??
I had posterior total hip replacement 16 years ago, and have stayed very active physically. I’ve been suffering from piriformis pain for several years now. I have not found anyone that can tell me what I can safely do for this. I have had three dislocations, and have no trouble remembering the pain from each.
I had a surgeon where as long as everything was a positive outcome he was fine, but this wasn't my experience sadly. I told him I fell down the stairs 4 weeks post op, I expected him to respond appropriately as I know that's a big deal for a THR. He sat there silent, then changed the subject and told me, soon I'd be walking like a model and started to escort me out of the room. I couldn't even speak, as I was stunned. I've worked in hospitals for years with some really amazing surgeons who could have a huge ego, but this doc.was beyond a simple ego issue. I never went back and found a better surgeon who couldn't believe what I told him. I had an anterior approach procedure. It's been a year and so far I've had a partial MCL tear on the opposite knee, my pelvis is tipped. The surgical side leg is a bit shorter now which I'm sure is the root of my knee injury and radiating pain from my low back to the back of my knee. I feel like my whole body is inflamed and yet my labs are normal. Sorry, I just had to complain. I need to go back for PT and tell her about what you're saying. I'm jealous of everyone else here who's doing well, and what's with the 80 mile bike ride? WOW!
“Second to none” lol
Very interesting, I will try these exercises. It’s seven weeks since my second hip operation ,
Thank you for watching! If you want more help with improving your strength and mobility, you can find loads more exercises in my book, Thriving Beyond Fifty, here: https://hayhs.com/TBF_pp_pb_az
Well I could not work out before hand , I could hardly walk for such bad pain !!
After bilateral hips replacement can someone drive manual vehicle?
I don't go to therapy, waist of funds……
thanks,,, am being done in the autumn but looking at things now to build strenght
I wished I would have been taught these exercises after my hip replacement! Thank you, it's been over 2 years and I'm still weak. I hope it will better my strength and walking! Thank you!!
I had HIP surgery 10 weeks ago and have been going to PT for 9 weeks now. I was not shown the clam but after watching your video I tried it and on my first try I felt some relief on my glutes. I had a tightness that felt like a golf ball inside and as soon as I did 10 repetitions of the clam, I did not have that golf ball feeling or tightness. Thank You!
Had my hips replaced 24 years ago, never looked back, had great doctors and full recovery..
If you are on the Fence about surgery don't be it will give you your life back!!!
6 weeks out and these are the 3 exercises I do at home, in addition to PT 2x a week.
Would this be advisable to do these movements before surgery? And after surgery is it the side where the surgery was done that does the lifting.
I had a hip replaced in 2015 now I need my right hip replaced.
I had Legg-Calve-Perthes disease in the right hip. Is there anybody out there that had Legg-Calve-Perthes disease and a successful hip replacement?
I'm in my 13th week post posterior hip replacement…I have been keeping very active…Im 76 and love gardening…I pay the price every time and am sore and feel depressed and feel like I'm going backwards now….I'll give these exercises a go and see if it helps …thank you
I had a hip repair done two years ago early April. Still doing hip rehab exercises, but the clam is very sore to do . My pt said last year No Bridge. I also had a compression brake in my lower back four years ago.