This week’s post is all about hip surgery! In general, hip surgery isn’t quite as common as knee or shoulder surgery, but chances are you know a few people who’ve had some work done at some point.

In terms of physical therapy, there are 2 main hip surgeries that we commonly see for rehab: labral repairs and total hip replacements.

I’m going to give you some information about these 2 surgeries, and then I’ll follow it up with some tips to help you improve your recovery process.

Common Hip Surgeries

– Labral Repairs: labral tears are very common, especially in active adults. The labrum is a soft tissue ring that sits along the edge of the hip socket (the acetabulum). Damage to the labrum is typically caused by repetitive impingement over an extended period of time. We call this FAI or “femoro-acetabular impingement”. While FAI can be treated without surgery at times, often times it’s caused by changes to the bony anatomy of the hip, which often leads to surgery. If bone spurs have developed and are causing the labral damage, these will often be cleaned up and removed during surgery. Once the cause of impingement is removed, the surgeon will then repair the labrum.

– Total Hip Replacements: also known as “total hip arthroplasty”, this type of surgery is reserved for those people with end-stage arthritis (bone-on-bone), which is diagnosed via x-rays. There are 2 different approaches for this surgery, depending on where your surgeon makes the incision: posterior and anterior. In recent years, the anterior approach (where they go through the front of the hip region) has become more popular, as there are fewer precautions following surgery. However, some surgeons still recommend the posterior approach (going through the back side of the hip/buttocks) for certain people.

Tips to Speed Up Your Recovery

– Tip #1: Strengthen Your Hip and Leg Muscles. By now, I hope this tip makes sense in general… The trick to this tip is to find exercises you can perform comfortably, without aggravating your hip. It’s also important to make sure you target specific muscles that tend to get weak more quickly, such as your hip abductors and external rotators.

– Tip #2: Use a Cane or Walking Stick. Hip pain can really throw off your walking pattern, both before and after surgery. It’s important that you maintain a normal, symmetrical walking pattern at all times, in order to avoid developing a lasting limp. So make sure you figure out if a cane, walking stick or walker will be needed to help you keep yourself in good alignment. This will also help you avoid other annoying things, like developing back pain.

– Tip #3: Decide on Surgery Early. In my experience, people tend to ignore hip pain for much too long, and it slowly starts to eliminate key activities, like walking, hiking and running. Over time, this can have a significant impact on their ability to get out and do what they really enjoy doing. So my advice is simple: determine if conservative treatment will solve your hip pain. And if it doesn’t, and you do need surgery, make an informed decision with your surgeon quickly.

That last tip is pretty important… it’s very common for us to work with patients who’ve developed other problems as a result of putting up with hip pain for too long. The best example of this is people developing lower back pain, sciatica or SI joint pain.

And here’s one last tidbit of information for the day: there are quite a few other types of hip pain that can be treated without surgery (things like trochanteric bursitis, IT band syndrome and buttocks/piriformis pain). This again highlights the importance of figuring out the root cause of your hip pain as quickly as you can, which will help you choose the best course of action.

If you have any specific questions about hip pain, or you’d like more information about surgery and/or the recovery process, please feel free to reach out to me by email at Luke@GordonPhysicalTherapy.com

– Luke Gordon

Below is a video version of today’s topic of hip surgery, including some expanded ideas: