Hawkes Physiotherapy Blog

For a long time we were always told to tell the patients to not flex their hip past 90 degrees, cross their leg past the mid line or twist their leg. The reason for this was due to the increased risk of dislocation but is this really true? Well considering the emphasis and importance placed on these precautions, it may seem that they are unfounded! Now it is actually true that one of the most common complications after a total hip replacement is a dislocation, the prevalence is reported to be 19% of total hip replacements (Smith T & Sackley 2016). The problem is that if you are restricting movement for a while then you may create issues with flexibility and function. So if we didn’t restrict the patients then they can just get on with their rehab unimpeded. The other issue is the cost. For example Occupational therapists have to raise toilet seat and chairs etc. at home for the patient so that they aren’t putting their hip into these positions.   So what does the

As you know being injured means that you lose all the conditioning that you worked so hard for in the first place....FRUSTRATING! MUSCLE STRENGTH DECREASES BY 2-6% FOR THE FIRST 8 DAYS OF IMMOBILISATION (Muller,1970). So what can you do to help minimise this effect? Well, here is what the research says: What to avoid? Rest! It used to be R.I.C.E. or P.R.I.C.E. or P.R.I.C.E.M. but rest doesn't help recovery. The more recent accronym is: P.O.L.I.C.E which stands for: Protect, Optimal Loading, Ice, Compression, Elevation. It's obvious that rest will accelerate deconditioning but it also affects healing too. Malliaras et al (2013) found that tendons heal quicker when progressively loaded as opposed to rested. Anti-inflammatory drugs! The jury is out on this! Remember inflammation is the only thing that heals you so you really need it! The question is that in the first 72 hours do some things over inflame and inhibit you unnecessarily, well