TO TOP

Pre & post surgery

(Including prehab
and rehab)

Many of us with hip dysplasia undergo various surgeries to help manage our symptoms, preserve our hips for as long as possible, or to eventually replace them.

There's so much to consider when preparing for surgery and then to aid in recovery. For example, did you know that if you do physio exercises before and after surgery, you might recover more quickly? 

Even knowing what to take to hospital can be confusing, so we've done the hard work for you and written a list! And we share the tips we wish we'd known about staying in hospital.

Approaches to managing hip dysplasia

To begin with, we wanted share an information leaflet about approaches to management of hip dysplasia in adults (PDF). The leaflet covers the broad surgical and non-surgical (conservative) approaches, and was prepared by specialist hip dysplasia physiotherapist Holly Doyle and hippy MJ.

Getting busy prior to surgery

Our movement is affected for weeks and sometimes months following many types of surgery. Knowing this, ahead of surgery we get out there and do the things we love the most. In her story, Bea talks about doing this and the challenge of knowing it’ll be a while before she can get back to doing those things again.

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WATCH
Bea's
STORY
"I was in so much pain prior to surgery that my level of physical activity significantly decreased, and I found it hard to want to do any activity. But I tried to make little changes and complete 2-3 strengthening exercises daily, which did help but be careful not to overdo them!"

Aside from a mini bucket list – there are activities you can do prior to surgery that is likely to help your post surgical recovery. This is called ‘pre-hab’.

Pre-hab

Most of us had heard of rehabilitation after an injury or surgery, whereas prehabilitation is less well known but equally as important.

Prehabilitation is known as 'a means to prepare you physically prior to surgery or treatment' (Scheede-Bergdahl, Minnella, Carli, 2019).

When we're waiting for surgery or treatment, pain can impact our ability to participate in physical activity and lead a healthy lifestyle.

However, little changes can make a huge difference to how quickly and easily hippies can recover from surgery. We've put together a few useful exercises for completing in the lead up to surgery.

Rachel workout

Rachel's story

“I did 3 months of physiotherapy before I had any hip surgery. I was assessed and given specific exercises to help correct my muscle patterning, although it didn’t change my pain, it massively improved my strength which helped with my recovery. I also found my post-op physio much easier because the exercises were familiar and I started off stronger.

“As a physiotherapist I would also recommend taking part in strength building to aid your recovery and after experiencing it myself, I can really feel the benefit. If you try physiotherapy first, but you have no change in symptoms, it hasn’t been a waste, it means you’ll be stronger and better prepared for surgery.”

“Rachel kindly gave me an exercise sheet to strengthen as much as I could beforehand. I tied a stretch band to the bedroom door handle and X20 pulls on the band before bed to strengthen my arms ready for crutches. I also used the Headspace app which had a ten minute yoga session and did what I could from the stretches.” -Liz

Disclaimer:
Please engage with your physiotherapist and use this advice alongside your health professionals’ recommendations.

Making lifestyle changes before surgery

As well as doing exercises, there are other lifestyle changes we can make which can help us cope better with surgery.

To give ourselves the best chance of a quick recovery, it's worth considering psychological well-being, nutrition, lowering alcohol consumption and stopping smoking as part of preparation for surgery.

Some of us have found our GP is a great person to discuss any potential lifestyle changes, as they can sign post to appropriate support/guidance.

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Top tip

Listen to Hip Dysplasia Specialist Physiotherapist Holly Doyle, talk about what you can do before surgery.

Types of surgery

Those of us with hip dysplasia are often offered a range of surgical and non-surgical options.  Each type of surgery and treatment option has different aims and purposes. The International Hip Dysplasia Institute gives an overview of the options.

We focus mainly on preparing for and recovering from a peri-acetabular osteotomy (PAO). Undergoing a PAO means a stay in hospital of approximately 5 days.

However, some people with hip dysplasia may need joint replacement surgery such as a total hip replacement (THR).  We spoke to Orthopaedic surgeon Mr Ajay Malviya about the differences in the types of implants used in this type of surgery. 

The weeks leading up to major hip surgery

Between us, we’ve had a lot of surgery and want to share our experiences and tips for how you can best prepare if you opt to have surgery too.

Hippy Liz has written two blogs full of top tips for preparation in the weeks before a major hip surgery like a PAO or hip replacement.

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Top tip

You may want to start planning a good few weeks before surgery as there could be a lot to organise. If you’re having a PAO, you’ll spend around 5 days in hospital and will probably need a lot of help with day-to-day activities and chores in the month following the surgery.

Preparing to go to hospital

A key question for hippies going into hospital for PAO hip surgery is What do I pack in my hospital bag? You’ll be staying for around five days so it’s worth putting thought into what you will take with you.

Check out Sally and Liz’s ‘What to pack for hospital’ blog  for a very comprehensive list of ideas!

How you’ll get to and from hospital is also something you’ll need to plan. In her blog, Aoife describes her journey from Ireland to London for surgery.

Liz also shares her experiences and gives top tips for the night before surgery, and what to wear to hospital.

Surgery and recovering in hospital

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Top tips for in the hospital

  • Hydrate all the time; make the most of drinking water to flush all the drugs through whilst the catheter is in and you don’t have to get up to go to the loo.
  • The nerve-block the anaesthetist will give you blocks out any pain but when it wears off you need the other meds to do their job so keep taking them at the start.
  • Sally's tip: Always take your pain medication on time, even if you don’t feel like you need it. Don’t try to be a pain hero. It's a lot easier to keep pain under control than to bring it back under control.
  • If the pain medication makes you feel unwell/ or nauseous, tell one of the hospital staff straight away. They may be able to try something else or give you anti-nausea treatments. There is normally a person in charge of your pain management/medication - ask to see them if this needs revising.
  • After the op you will have a stand which will raise your leg and move it for you. This will not be painful, it will feel positive. If the stand is left uncovered it can rub the leg, so ask them to put something soft and lightweight like a pillowcase under you the two main contact points under your knee and heel.
  • Ensure the nurses check for any sore patches or anything rubbing your skin to make sure it doesn’t blister and apply barrier cream when needed. Ask them to check any tape stuck to your body, to ensure that it's not sore or blistering, as you may not notice initially.
  • Ask for laxatives straight away and be proactive in making sure you are avoiding going too long into constipation. This is inevitable but deal with it soon as you can move and by any means necessary - do not be afraid of suppositories later on if needed!
  • Use the hospital bed to get your head down and legs up to help with any swelling but also alternate this so you are used to being sat up right before the physio comes in and so your head is used to being upright before you try to stand up.
  • Ask for ice packs to reduce swelling/ inflammation as soon as possible.
  • Breathe - don’t hold your breath. Try controlling your breathing to help you relax. Just remember that if your mind is racing, try to control it, just breath into it and relax your body. You can do it. Your mind can get in the way and make things seem worse, so mental fitness and preparation is equally important as physical.
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Let's talk pee and poop

Lots of people who have surgery can suffer with constipation afterwards. This is the impact of not be able to move about and the effects of the medication needed to manage postoperative pain.

Take notice of your bowels and let the nurses know if you haven’t gone for a few days. It’s much easier to deal with if you don’t let the problem go on for too long.

Listen to pelvic health specialist physiotherapist Jilly Bond talk about things you can do to manage this.

Leaving hospital and getting home

Getting home after surgery is often a great moment. Again, there are a few things we wish we’d known beforehand to help with home preparations.

In her blog, Liz shares her top tips for getting ready to leave hospital after a major hip surgery, and for the trip home. 

Rehabilitation

Not everyone with hip dysplasia will need surgery, but it's offered as part of hip dysplasia management in many cases.

Some form of rehabilitation (rehab) is required after each type of surgery, but the longest period of rehab is after a PAO.

Following hip preservation surgery like a PAO you won’t be able to put full weight through your leg for some time and there will be a post surgical journey of healing and strengthening that follows.

Read about the rehabilitation process after a PAO (PDF).

rehab
Resistance band

Returning to Sport

Following surgery, listen to what specialist hip dysplasia Holly Doyle has to say about returning to sport and for those of you who like to run, how to get back to running.

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Top tip:

Find a way to build / maintain hip strength which doesn’t cause pain.

“Movement and exercise is important even if you don't want to do it. The gain in mobility, strength and independence will be worth it”

— Alison
“Less is sometimes more, but being consistent is everything”

— Lena