As a personal trainer working with older adults, I often work with clients who have been diagnosed with osteoarthritis in their knees or hips. Usually, by the time I see them, they are trying to control the pain that is making everyday activities more difficult.
While it seems counterintuitive, moving more with arthritis can actually help. The Mayo Clinic offers a clear explanation of why you should add exercise to help with arthritis pain: It strengthens the muscles around your aching joints, helps maintain your bone strength, and generally improves your quality of life.
Osteoarthritis, sometimes called degenerative joint disease, is when the protective cartilage at the end of the bones that make up a joint breaks down. The loss of cartilage is what causes the joint to swell and become painful or stiff.
According to the Centers for Disease Control and Prevention (CDC), osteoarthritis is the most common reason for joint pain, and the damage it causes is one of the most prevalent reasons for hip replacements. It affects over 32.5 million U.S. adults, especially women over 50. There is no cure for osteoarthritis, but it can be managed. To do this, the CDC suggests “increasing physical activity, physical therapy with strengthening exercises, losing weight, medications, using supportive devices, and surgery when these options are no longer effective.”
The auto-immune disease rheumatoid arthritis, an injury, or damage due to a bone disease are also reasons for needing a new hip. The average age for receiving a hip replacement is over 70 years of age, and more women will seek out the surgery than men.
Compared to a knee replacement, also a common surgery for seniors, hip replacements have less post-surgical pain, and recovery time is much faster. Harvard Health Publishing reminds us that the hip joint is larger and a much simpler joint than the knee joint, which requires more soft tissue releasing and attaching during surgery to regain functionality.
For total hip replacements, there are two main types of surgeries; the posterior approach and the anterior approach. The posterior approach is more invasive and has a longer recovery time. The anterior approach is more challenging but has a quicker recovery time, according to the Jacksonville Orthopaedic Institute.
As with knees, many medical facilities recommend “prehab” before a hip replacement. Since the hip is the largest joint in the body, good torso and hip strength are beneficial before surgery. Prehab muscle strengthening will also help improve overall recovery.
Exercise #1: Bridges
This exercise helps strengthen the core muscles, the gluteals (the butt), hamstrings, and calves. These muscles help with walking, standing tall, and balance.
- Lie on your back on the floor. If you can’t get to the floor, use your bed.
- Place your feet flat on the floor or bed, about hip-width apart with your knees bent.
- Gently contract your abdominal muscles and squeeze your gluteal muscles (butt).
- As you squeeze your abs and glute muscles, press your heels into the floor or bed and lift your hips.
- Hold this position for a full second and slowly lower down to the starting position. Be careful to not over-arch your back as you push up.
- Repeat the movement for a total of 15 repetitions.
For more instruction, I recommend this American Council on Exercise resource.
Exercise #2: Squats
This exercise helps strengthen the gluteal muscles (the butt), the hips, thighs, hamstrings, calves, abdominals, and back muscles. Many fitness professionals believe this to be the most important movement to master for maintaining full mobility, especially as we get older.
- Stand with your feet about shoulder-width apart, toes pointed forward.
- Interlock your fingers, bend your arms, and bring your hands to your chest, just below your chin.
- Shift your weight to your heels. This is the most important step!
- Tighten your abdominals and push your hips back like you are going to sit.
- Keep thigh muscles tight to prevent your knees from collapsing to the center. As you squat, your bent knees should not pass in front of your toes.
- When you reach a comfortable squat, push yourself up using your thigh muscles.
- Repeat the movement for a total of 15 repetitions.
For more instruction, I recommend this Spotebi Fitness & Nutrition resource.
When 15 reps become easy, start doing two sets of each exercise. (One set is equal to performing an exercise for a set number of repetitions.) Start by doing two sets of 8 reps, and begin to increase the reps of each set by adding 1 or 2 reps each week. It’s recommended to do up to 15 reps per set for these prehab exercises.
Walking can also be a good exercise to add before hip surgery. However, if the joint is worn to the point where walking is too painful, you could try the leg exercises in my previous article, 5 Exercises To Do Now To Prepare For Your Knee Replacement.
Standing or walking exercises can also be done in a pool. The buoyancy of the water takes the pressure off the joints and allows more freedom of movement without pain.
How To Begin Using The Exercises
These exercises should be started 12–6 weeks before the planned surgery. If you have not been active because of the pain, begin slowly. To get started:
- Begin your prehab with 4–6 repetitions, or what you feel like you can do with a mild amount of exertion.
- Do those 4–6 reps every other day for 1 week.
- Add 1 or 2 reps the next week, again using a mild amount of exertion.
- Keep adding 1 or 2 reps until you are doing 15 reps.
- If you have started 3 months before surgery, at 4 weeks (before surgery), do these exercises every day instead of every other day.
Please talk to your healthcare professional before starting any new exercise program.
Related Reading: Why In-Home Physical Therapy Is A Game Changer