T Nation

Training after Total Hip Replacement Surgery

I’m hoping you have some advice after years of training and working with others.

I’m 61 years old , 3 months out from a left total hip replacement. I’ve trained for many years with a typical type powerlifting approach to my exercise selection. Usually a linear periodization through the year. I train at home, and have a well outfitted set up.

My surgeon has advised against returning to squatting and heavy deadlifts. I’d like to be compliant with the advice. I’m actually also an Orthopaedic Surgeon,so it makes sense to me. Putting a bar on my back for squats or good mornings is probably not the best idea.
Lunges don’t agree with my knees at this point in life.
I’m looking for some advice on designing a leg day.
I have a 45 degree back extension device, a bar for deadlifts of any variety, straight leg , rack pulls etc… and a seated knee extension/ flexion machine. I try and do some walking almost every day and it’s hilly where I live.
I typically train a 4 day split, lifting every other day.
My thoughts were to train with an emphasis on what I can do. Piecing together a variety of isolation type movements seems like my best option at this time.

My goals are to stay healthy and maintain some strength.
Thank you for the time.

clee78,

Sorry to hear of your condition. But I believe you can work around your hip situation, at least for the next 3 months.

I would recommend that you stick to single-joint isolation exercises. The leg extension and leg curl should keep your thighs in reasonable shape. With those, I like the back raise, performed slowly and smoothly on your back extension device. You could also do the standing one-legged calf raise.

A while later, you might want to try the one-legged deadlift with a 15-pound dumbbell held in the same hand as the standing leg. Balance on one leg, while holding on lightly to a support with the other hand, and lean forward and lower the dumbbell down your leg to the floor. Stand smoothly and repeat for 12 reps. Do the same thing for the other leg.

Be careful with your daily walking. You don’t want to stumble or miss a step up or step down.

Let me know how it goes for the next several months . . . and after your surgery.

One of my good friends, Joe Cirulli, was about your age when he had total hip replacements. Four or five years later, his hips and thighs (and his strength training) are stronger than ever.

1 Like

You could check out Dan John’s recent stuff. He had a double hip replacement as well, and recently hit a 145 lbs power snatch. Keep moving, your spirit, and you’ll come back eventually

1 Like

Thank you

Another legendary fitness guru, Clarence Bass, has had full hip replacements done. If you look back to some older articles on his site, you can find his thoughts about training after hip replacement. He eventually gave up squats and deadlifts because of an issue with spinal stenosis. I see that he just recently bought a belt squat machine to use in place of a leg press, which was also bothering his low back. That may not be viable for you, if you are concerned about hip load in a squat like movement.

1 Like

Hey Doc, I’m no orthopedic surgeon or physical therapist but I’ve been where you are with the total hip replacement and here’s what I came up with. Starting with bodyweight squats from a parallel box, obviously paying attention to good form. Next I started adding resistance with bands. I step through the band with my right foot while sitting on the box and loop the band over my left shoulder, repeat for the other side and they are an X across your body.

When you’re ready to squat just loop the bands under your feet and you’re box squatting with resistance.From a physiological point when your joints are most compromised and the muscle leverage most inefficient the bands have the least resistance, Very joint friendly workout and also very good at building muscle and strength. I had my hip done 6 years ago at 61 and have pretty much designed 90% of my workout with bands. And yes you can train seriously with these.

I"m 6’2" and if I double Elite fitnesse 2 heaviest sets of bands I’m under more than 500 lbs. of tension at my squat lockout. You may have to make some adjustments depending on your height but once you get it figured out I think it’s a far superior way to train for us geezers that still want to keep it cranking ! Good luck with your rehab, Will

1 Like

So did Dr. Darden have total hip replacement?

I’m a big fan of bands.
Those sounds pretty solid.
Congratulations on 6 yrs post hip replacement.
I trie some body weight squats 3 mos post op and I just felt I wasn’t feeling getting any benefits.
I like squatting to a box for depth assistance as I train alone.
Do you strap the bands on sitting on the box?
When did you start these after surgery?

It’s interesting how many people I’ve come across in the last couple of years who have had total hip and sometimes knee replacements and most of the time they are younger than me. I’m wondering if more people have bad hips these days or is it just easier to get new hips? One guy I work with was a paratrooper so his hips took a beating but more than not these people didn’t do any sports or other things that might have caused hip issues?
Scott

The number of joint replacement surgeries being done has grown significantly, and that is projected to continue. I think there are several factors…

The mean age of the US is getting older; more older folks mean more arthritic joints and more potential candidates for replacement.

Overweight and obese people are at greater risk for arthritis. People are fatter than they used to be, and it happens at an earlier age. So the number of younger patients with arthritis needing joint repair is on the rise. That people are both overweight and increasingly sedentary may further increase the risk of later joint problems. Some regular movement, lots of walking, other kinds of moderate physical activity is probably good for your joint health, at least to a point.

Perhaps the rise in recreational sports among youth and adults is also a factor. Knee injuries are common in a lot of sports, and a knee injury when young will set you up for eventual arthritis and joint replacement.

The technology has gotten better, repaired joints come with fewer limitations, and are expected to last longer. Used to be that they didn’t want you to have the surgery until you were past 60, to be sure that you didn’t outlive the replacement. Now they are more willing to do the surgeries on people under 60.

1 Like

No. I have my original hips and knees.

1 Like

For band box squat users. Does this method effect the lower back/spine?
I cannot squats with weight on shoulders my more. Bad for the back. Along with dead lifts and any leg press movements… Only using splits squats.

Sorry, I guess I wasn’t clear in my post but all of the banded squats are done to a box. First off because it’s just flat out better for us and second off when you get back to where you’re able to use some decent tension you need to set the bands up from your bottom squat position. I don’t remember exactly but I think it was about 8 or 9 weeks out I started to use some small bands from a bit higher than parallel. That was another thing I liked about the box- I was able to gradually drop the depth down as my flexibility came back. It all came back pretty quickly but in spite of my usual hard-headed self I listened to my doctors advice that the hip will continue to heal for 6 months and coaxed things along pretty patiently. I’ve made great gains with the bands since then and don’t know how much strength carries over to bar poundage but I’ll never be competing so who cares ! Learn to utilize the band tension and I think you’ll be very pleased with the results. If I can be of any further assistance let me know. Best of luck with the comeback, Will

1 Like