Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area for Hip
Welcome to Atlas Physical Therapy's patient resource about Artificial Hip Dislocation Precautions.
Hip surgeries such as total joint replacement and hemiarthroplasty require the surgeon to open the hip joint capsule. This puts the hip at risk of dislocating after surgery. Patients follow special precautions after surgery about which hip positions and movements need to be avoided to keep the hip from dislocating. While you are in the hospital, your health care team will remind you often about the need to follow these hip precautions. Once you get home, you will have to remember to follow these rules until your surgeon approves motion beyond these limits of movement.
This guide will help you understand:
why hip precautions are needed
which precautions you should use and when to use them
ideas you can use at home to protect your hip joint
Hear from some of our patients who we treated for Hip Pain
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I can't thank Alex, Angela and Heather enough! 3 years ago I was barely able to walk after a hip replacement. Now I am a competitive cyclist. They have done a great job keep me healthy and pain free... ”
“ I can't thank Alex, Angela and Heather enough! 3 years ago I was barely able to walk after a hip replacement. Now I am a competitive cyclist. They have done a great job keep me healthy and pain free since 2014 ”
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I have been going to Atlas Physical Therapy for years, alas for different body parts. Each time I have gone, for various body parts (knee, shoulder, and now hip), Atlas has been there for me. You... ”
“ I have been going to Atlas Physical Therapy for years, alas for different body parts. Each time I have gone, for various body parts (knee, shoulder, and now hip), Atlas has been there for me. You won't regret it. Hope to (not) see you there - to your health! ”
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Somehow at the ripe age of 35, I’ve had a lot of issues and I’ve worked with a lot of acupuncturists and chiropractors over the years with varied results and satisfaction rates. I’ve been seeing... ”
“ Somehow at the ripe age of 35, I’ve had a lot of issues and I’ve worked with a lot of acupuncturists and chiropractors over the years with varied results and satisfaction rates. I’ve been seeing Luke off and on since 2015 and I feel safe when I’m under Luke’s care.. I know when I leave I will always be better than when I entered. I started seeing him due to chronic neck issues and continued to see Luke when I tweaked my shoulder. Both issues are on-going, but that’s because I play hard and haven’t gone to see Luke in quite some time. He was my primary choice when I eventually had hip reconstruction. He was patient with me after that surgery yet he pushed me when I didn’t want to work any more which led to a better recovery than I could have had otherwise. Luke is friendly, thoughtful, and in most importantly in this role, he is competent. Just scheduled my first appointment in a while and felt that a review was in order to help others make a decision if they were on the fence while choosing a great PT. Thanks for all you’ve done for me. See ya next week :) ”
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Amanda was great! She helped me with my lower back pain with various types of treatments (dry needling really helped my back). I didn’t think my back could get better having a toddler climb all... ”
“ Amanda was great! She helped me with my lower back pain with various types of treatments (dry needling really helped my back). I didn’t think my back could get better having a toddler climb all over me all the time, but it turned out some exercises targeted to my hips and back were the trick. Hopefully I don’t have to go back, but if I do, I will definitely come back to Amanda. ”
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I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it... ”
“ I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it fun and just being an amazing coach. If something ails you- go see him! He has magic hands and will get you back on track in no time ”
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After experiencing shoulder and hip pain for a few months while swimming and running, I came to Atlas Congress Park looking for help. My pain was keeping me out of the pool and regularly truncating my... ”
“ After experiencing shoulder and hip pain for a few months while swimming and running, I came to Atlas Congress Park looking for help. My pain was keeping me out of the pool and regularly truncating my runs.
My experience at Atlas was excellent. The office was clean and comfortable, there was always parking in the lot, the entire team was efficient and helpful. My physical therapist, Brett, was especially great. He was evidently knowledgeable and invested in my recovery. He used several approaches and techniques to make the most of each appointment, including targeted massage, mobility training, and strength exercises. Beyond his professional aptitude and competence, Brett is also a genuinely great guy. His affable, warm nature made the recovery process enjoyable. The whole team was great, including my trainer Will.
Physically, I am noticing significant improvement in both my hip and shoulder. With the support of the team at Atlas, and the skills I've been taught, I expect this improvement to continue. I can't recommend the practice enough! ”
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Laura has been a godsend for me and has helped put me back together more than once! I came in when I was pregnant for a hip issues, then post pregnancy for a foot issue. Both situations I was treated... ”
“ Laura has been a godsend for me and has helped put me back together more than once! I came in when I was pregnant for a hip issues, then post pregnancy for a foot issue. Both situations I was treated wonderfully by the administrative staff and the physical therapist. The new location is key, parking is ample. The are communicative, timely and most importantly, work wonders on what ails you! ”
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When I first started going to PT, ahead of hip surgery, I went to another local clinic. I was one of 6 people the therapist was working with at the same time. I felt like a number - as if that clinic... ”
“ When I first started going to PT, ahead of hip surgery, I went to another local clinic. I was one of 6 people the therapist was working with at the same time. I felt like a number - as if that clinic was just trying to get as many people as possible in the door. I did not feel important nor very respected. That all changed when I found Body in Balance (which I discovered by walking in front of their building) and Lara, the therapist I worked with, was SO amazing (but I think they all likely are based on observations while I was there). From the moment I walked in to inquire about their services, I felt like I was important. They are a small office, that really focuses on patient health. A previous reviewer complained about phone coverage needing to be better -- I never found this to be an issue. Yes, if I got their voicemail I’d leave a message and would always hear back within a very short period of time. The entire team there works extremely hard to ensure patients come first and are a priority. Lara was incredible - very reassuring, assisting me with staying within my limits and then pushing me beyond those once I was ready (or once I should have been ready). Post-surgery, they did everything they could to help me navigate the facility, and constantly checked in with me at each visit. The entire team there is friendly, and full of hard work ethic and devotion to client care. You absolutely cannot go wrong with Body in Balance. Oh, and by the way - each therapist only works with one patient at a time - so you feel incredibly cared for and special. ”
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I have worked with Alex Lanton to resolve a torn rotator cuff and labral tear in my hip which eventually created back pain. Alex is wonderful, incredibly knowledgable and practical in his approach... ”
“ I have worked with Alex Lanton to resolve a torn rotator cuff and labral tear in my hip which eventually created back pain. Alex is wonderful, incredibly knowledgable and practical in his approach to healing. I’ve never moved better, am working back into a rigorous exercise routine and with Alex’s help have exceeded my expectations about the type of activity I can now enjoy injury free. I highly recommend Alex if you want to resume pain free activity! ”
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This is a great place to get therapy.I broke my hip recently.Went to Littleton hospital,then great therapy at Encompasse.Refered to Atlas.They are very good too.Convenient hrs and near my apartment. ”
“ This is a great place to get therapy.I broke my hip recently.Went to Littleton hospital,then great therapy at Encompasse.Refered to Atlas.They are very good too.Convenient hrs and near my apartment. ”
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I had hip labrum reconstruction. Andrea Guevara DFT was very knowledgeable in all the aspects of the surgery and my rehabilitation. She and her team at Atlas Central Park helped me with my bi-weekly... ”
“ I had hip labrum reconstruction. Andrea Guevara DFT was very knowledgeable in all the aspects of the surgery and my rehabilitation. She and her team at Atlas Central Park helped me with my bi-weekly PT. They provided instruction and increased my exercises to literally get me walking and skiing again. I highly recommend Andrea and Atlas PT. ”
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Andrea at Atlas Physical Therapy in Central Park was fantastic. She was able to quickly identify exactly the kind of exercises I needed for rehab from my hip replacement surgery. Continuing those... ”
“ Andrea at Atlas Physical Therapy in Central Park was fantastic. She was able to quickly identify exactly the kind of exercises I needed for rehab from my hip replacement surgery. Continuing those exercises at home greatly sped up my recovery. I would recommend her to anyone seeking Physical Therapy. ”
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I am so glad that I came to atlas physical therapy. I met with Andrea at the Central Park office. She was very knowledgeable and thorough. I was worried that my knee problem was something serious but... ”
“ I am so glad that I came to atlas physical therapy. I met with Andrea at the Central Park office. She was very knowledgeable and thorough. I was worried that my knee problem was something serious but she found that it was actually a problem with my hips and could be alleviated with a couple of sessions plus some at-home exercises. After a few exercises in the office I was able to easily walk up and down stairs which I hadn’t been able to do previously without pain. I am so thankful to be able to move around easily and pain-free again! We really do take that for granted until we can’t do it. Thank you Andrea and Atlas PT! ”
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Have had a great experience at Atlas Physical Therapy. The exercises that my therapists have given me to do at home have helped relieve the pain in my back and hips. What I really like are my... ”
“ Have had a great experience at Atlas Physical Therapy. The exercises that my therapists have given me to do at home have helped relieve the pain in my back and hips. What I really like are my therapists and how they treat me. Both Chynna and Victoria explain the reasons for the exercises. and answer any questions that I have.
Atlas Physical Therapy is both a professional and friendly environment. Hi highly recommended them. ”
Which parts of the hip joint are affected by a dislocation?
The hip joint is one of the true ball-and-socket joints of the body.
Ball and Socket
The hip socket is called the acetabulum and forms a deep cup that surrounds the ball of the upper thighbone, called the femoral head. The ball and socket is surrounded by a soft-tissue enclosure called the joint capsule.
Joint Capsule
The hip itself is surrounded by the thick muscles of the buttock on the back of the hip and the upper thigh muscles on the front.
Muscles
When the surgeon opens the hip joint capsule on the front edge, the procedure is called an anterior approach.
Opening the Hip Joint
Opening the joint from the back part of the joint is called a posterior approach.
Why are precautions needed to prevent a hip dislocation?
The joint capsule and ligaments keep the ball joint centered in the hip. When these soft tissues are cut during hip surgery, there is a greater risk for the ball to be forced out of the socket and dislocated after surgery while the soft tissues of the hip heal. The hip precautions you'll learn are used to keep your hip in safe positions. To do this, you need to avoid certain movements and positions. In this way, the ball will be less likely to push against the healing tissues and be forced out of the socket. Most surgeons prefer to have you use these precautions for at least six to twelve weeks after surgery until the healing tissues gain strength.
Dislocation of an artificial hip is uncommon but may occur within the first three months after surgery. The problem usually starts with a popping or slipping sensation. If the ball dislocates, you will be unable to put weight on the affected limb and will most likely experience discomfort in your hip. You should contact your orthopedic surgeon immediately and probably have someone take you to the emergency room. Putting the hip back in the socket will probably require medication given intravenously to relax the hip muscles and allow your surgeon to put the hip back into place.
Most patients will have an opportunity to work with Atlas Physical Therapy physical or occupational therapist before having hip joint surgery. However, patients sometimes require emergency surgery, such as after a hip fracture, and are not able to have preoperative therapy instruction.
Our therapist will go over specific precautions with you in the preoperative visit and will drill you often to make sure you practice them at all times for six to 12 weeks after surgery.
Your health care team will remind you often about these precautions. They sometimes place a sign by your hospital bed as a reminder. You'll continue to review and use these precautions until your surgeon gives the approval for you to stop using them.
General Hip Precautions
What are the precautions I should know and use to keep my hip from dislocating?
The positions and movements you'll need to avoid after surgery depend on whether your surgeon opens the joint from the front (anterior approach) or the back (posterior approach).
Anterior Approach
The main positions and movements to avoid after an anterior approach include bending the hip back, turning your hip and leg out, or spreading your leg outward.
Don't stretch your hip back. Walk with short steps. Taking a longer step when leading with your nonoperated hip stretches the surgical hip back.
Don't kneel only on one knee. Kneeling only on the surgical hip stretches the hip back. Use both knees when you must kneel down.
Don't turn your foot out. Place a pillow next to your hip and leg to keep your leg from turning or rolling out while lying on your back in bed.
Don't twist your body away from your operated hip. This means don't stand with your toes pointed out. Keep the toes of your affected leg pointed forward when you stand, sit, or walk. If you turn your body away from your surgical hip without pivoting your foot, your hip will be placed in an unsafe position. Remember to lift and turn your foot as you turn.
Don't swing your leg outward away from your body. This means scooting to the side in bed by supporting your surgical leg.
Don't put your leg in a straddling position, as though you are mounting a horse. This means preventing your leg from bending up and out when getting in or out of the bathtub. Instead, hold your leg, and lift it straight up and over the edge of the tub.
Posterior Approach
The main positions and movements to avoid after a posterior approach include crossing your legs, turning your hip and leg inward, or bending the hip more than 90 degrees.
Don't cross your legs. When sitting, do not cross your affected leg. When lying on your back, don't roll your affected leg toward the other leg as you might do when rolling over. A pillow or triangular-shaped wedge may be used to block the legs from crossing.
Don't roll your leg and foot in. Use a pillow between your legs when lying in bed to keep your leg from rolling inward.
Don't allow the knee of your operated leg to cross the midline of your body. This means don't let your knee move across your body past your navel (belly button). When lying in bed, place pillows between your legs to keep your hip in the correct position.
Don't turn your upper body toward your sore hip. When sitting, swivel your whole body rather than turning your upper body toward your hip.
Don't twist your body toward your operated hip. This means don't stand pigeon-toed. Keep the toes of your affected leg pointed forward when you stand, sit, or walk. If you turn your body in the direction of your surgical hip without pivoting your foot, your hip will be placed in an unsafe position. Remember to lift and turn your foot as you turn in the same direction as your surgical hip.
Don't bend the hip past ninety degrees. This means do not lean too far forward when sitting up in bed.
Also, raising your knee up in bed can cause the hip angle to go past ninety degrees.
To avoid bending past ninety degrees when sitting in a chair, lean back slightly.
Don't bend over past ninety degrees at the waist. Your hip may go past ninety degrees if you bend over at the waist to tie your shoes or pick up items off the floor.
Instead, use a reacher to put on your shoes and socks or to pick up items from the floor.
At-Home Considerations
What arrangements should I consider in my home to help protect my hip from dislocating?
You may require special equipment at home to keep your hip in safe positions. Following are ideas for different areas of your home.
Bathroom
Several items can be used to increase your safety in the bathroom. For instance, a toilet seat can be elevated with a raised commode seat to keep your hip from bending too far when sitting down. Getting on and off the commode may be easier with the help of handrails or grab bars securely fastened near by. For accessing your bathtub or shower, you may need one or more grab bars. For additional safety and comfort, be sure to obtain an adjustable tub or shower bench. When you first try the bench, be sure your knees are positioned slightly lower than your hips. In this way, you'll be sure to keep your hip from bending more than ninety degrees while sitting down.
Furniture
To prevent your hip from bending beyond ninety degrees, you may need to elevate your couch, chair, or recliner. A good rule of thumb is to have a seat height that is at least twenty inches above the floor. If you find that your furniture is too low, consider using a platform under your chair or couch to raise it to the desired height. Using four-by-four blocks may be helpful, but be sure that the chair or couch is safe and steady before you sit down.
Shelves and Cupboards
To avoid excessive bending and lifting, arrange your shelves and cupboards with frequently used items at waist to shoulder height. For lighter items on lower shelves, be sure to have your grabber handy to keep from bending over too far at the hip.
Summary
If you are able to see our Physical Therapist before surgery, we'll begin going over your hip precautions then. After surgery, our Physical Therapist will begin working with you right away and may see you one to three times each day in the hospital until you are safe to go home.
You are advised to continue using your hip precautions until your surgeon says you may discontinue following them.
Atlas Physical Therapy provides Physical Therapy services in Congress Park, Denver Downtown, Central Park, and Highlands Area.
Dislocation of an artificial hip is uncommon but may occur within the first three months after surgery. The problem usually starts with a popping or slipping sensation. If the ball dislocates, you will be unable to put weight on the affected limb and will most likely experience discomfort in your hip. You should contact your orthopedic surgeon immediately and probably have someone take you to the emergency room. Putting the hip back in the socket will probably require medication given intravenously to relax the hip muscles and allow your surgeon to put the hip back into place.
