Safe Stretching After Hip Replacement

Total hip replacement introduces a new set of considerations for stretching in yoga.

Your range of motion may be different following your surgery.
Your surgeon may have given you restrictions on your movement which will limit the kinds of poses you will be able to do. Usually restrictions are lifted after 6-12 weeks.
You may have lost strength in your core, legs muscles, and in the muscles around your hips. This can effect the stability of the hips.

Because your new hip is different from your old one you will have to learn about the new ways that it can move. This takes time. Start by moving very slowly into your poses and stay aware of how your body is responding. Start your exploration with Mountain Pose/Tadasana, a launchpad for all other standing poses and a perfect place to start for total hip replacement because it establishes principles that support our hips as we move forward in our practice.

If you have restrictions heed them to protect your new hips(s) and focus on strengthening the muscles that stabilize them. Practice standing poses, and chair pose, and review “Feet, Legs, and Pelvis Position in Open-hip Poses.” Standing poses provide the best of both worlds. With a standing pose, you first establish alignment and strength which provides stability for your hips so that when you move more deeply into a pose to find a stretch your hips are supported and safe.

Consider the different categories of stretches and how they might effect THR:

1) Dynamic Stretching – this is when you are moving and stretching at the same time.

– An example of a dynamic stretch of the hamstrings and the hip flexors would be to balance on one leg while swinging the other leg forward and back. This is a good warmup for a pose like Extended Hand to Big Toe Pose/Utthita Hasta Padangusthasana. In addition to stretching, this motion also strengthens these muscles.

– Another example of dynamic stretching for these muscles is walking. This motion also strengthens and warms up both the hamstrings and the hip flexors. Plus it is a go-to exercise for post-THR recovery.

2) Static-Active Stretching. This is when you use the muscles near the joint to bring a limb or another body part into a stretched position.

– An example of static-active stretching of the hamstrings in yoga is when you practice Extended Hand to Big Toe Pose/Utthita Hasta Padangusthasana by balancing on one leg and using hip flexor muscles to lift and straighten the other leg in front of you.

– An example of static-active stretching of the hip flexors is when you practice Locust pose/Salabhasana where you lie on your belly and use your hamstrings to lift your legs to stretch the hip flexors.

3) Static-Passive Stretching – this is when you use gravity, your limbs or some other aid to hold the stretched position.

– An example of static-passive stretching of the hamstrings is when you use a strap, your arms, or a chair to support the lifted leg in Extended Hand to Big Toe Pose/Utthita Hasta Padangusthasana.

– An example of static-passive stretching of the hip flexors is when you practice Bow Pose/ Dhanurasana

Static-Passive Stretching helps to attain a greater range of movement, but carries with it a slightly higher risk of injury. Anytime you are “pulling” on your body to make it move into a certain shape you are putting extra strain on your joints, tendons, and muscles. If you have had a total hip replacement take care with static-passive stretching especially when your hips are involved.

Follow these rules of thumb when approaching a stretch:

For the safety of THR use static-active stretching as much a possible while getting to know your new hip(s). You will enjoy the benefits of a stretch while at the same time building muscle strength to stabilize your hips.
Warm up the muscle(s) you want to stretch with dynamic stretching and with strengthening poses before you stretch. Stretching is safest when a target muscle is warmed-up and when the area you want to mobilize has first been stabilized. By establishing stability with strength you reassure the body that you have created safe circumstances for deeper movement. For this reason make strengthening the main dish while stretching is the delicious go-with.
It is hard to avoid static-passive stretches in some cases like when practicing Standing Forward Fold/Uttanasana where gravity is involved. Never “fall” into your poses. As gravity pulls you down, use your hamstring muscles, your core muscles, and/or your arm muscles with hands on blocks to control your descent. Move slowly and respect your limits.