If you’ve recently had what’s called a “posterior approach” hip replacement, then you were probably given the following precautions from your doctor:
1. Don’t bend over or lift your hip >90 degrees
2. Don’t turn your foot in
3. Don’t cross your legs
It’s important that you abide by these guidelines/precautions in order to prevent dislocating your newly placed joint.
Even though these instructions may seem simple, we underestimate how much we do those movements in daily life.
For example: getting out of a chair usually requires us to bend forward, which we can’t currently do. Getting in and out of a car usually requires a lot of bending at the hip which we’re now trying to avoid. Sleeping may be difficult if you used to lay on your side and allowed your legs to cross over one another.
Having these hip precautions can be more frustrating than one may anticipate, on top of that, if you just had surgery, you are likely in some pain, which makes some movements even more difficult.
Getting in and out of bed is another thing we do in daily life that requires some adjusting and greater awareness following a hip replacement. It is likely that you will need some help at first to do this without breaking your hip precautions. Not everyone who has a hip replacement goes to a rehab facility or even sees a PT following surgery. Hopefully someone has gone over this with you before, but after surgery and all of the instructions that come with it, it’s normal to forget some things and then feel overwhelmed upon return home.
In this article, I will break down the steps of helping someone, or having someone help you get out of bed after your hip replacement. There are two methods that I typically use with clients, depending on which side of the bed they get out on and which leg had surgery (which will be referred to as the “affected leg” from here on out).
**Please Note: All videos in this post are muted. If you would like to hear the audio, please check out this video:**
Method 1: Up on Elbows
This is the method I prefer to use if my client is able to get up on their elbows (see pictures below). It does require more upper body strength than the other option I will discuss, but I believe that it decreases the risk of breaking hip precautions.
This is the method that should be used if the affected leg is the one closest to the edge of the bed. That is, in the other method (rolling), you don’t want to roll onto your affected leg, because that could be painful.
**Both methods are assuming the client is starting on the back.**
1. Client: Bring both elbows under your shoulders
The easiest way to do this is to shift your weight to your right side, then slide your left elbow up, then shift to your left side, then slide your right elbow up.
2. Client: Press up to your hands
Use that same weight shifting technique to move from your elbows to your hands, making sure your torso stays reclined somewhat, so you don’t lean over your hips.
3. Caregiver: Grab their affected leg (One hand under the thigh, the other hand under the calf)
**Caregiver Note: Make sure you are in a split stance, so you feel balanced and sturdy. Have some bend in your knees, so that you are lifting your loved one’s leg with the power from your legs, and not lifting their leg with your back. **
These next 2 Steps will happen at the same time- one is the client’s job and the other is the caregiver’s job.
4. Client: Using your hands, “walk” your torso towards the foot of the bed
4. Caregiver: Guide the leg towards the head of the bed.
**Caregiver Note: Keep your loved one’s toes pointed towards the ceiling, so that you don’t accidentally turn their foot inwards. **
Make sure to keep that reclined position in your torso to prevent leaning over your hips.
5. Client: Scoot forward by shifting you weight to the affected leg, then slide the other leg forward. Then shift your weight to your non-affected leg, and slide your affected leg forward.
**Caregiver Note: If you need to assist your loved one is scooting forward. Move the hand that’s on the calf under the thigh- this hand is just here to support the leg- don’t pull their thigh. Take the hand that was under the thigh, and cup it around the back of the hip (careful of incision). As your loved one leans to the opposite side, shift your weight towards your heels as you slide their hip forward.**
6. Caregiver: Once your loved one gets to the edge of the bed, slowly lower their foot to the floor.
**Caregiver Note: Make sure you are bending your legs as you lower the leg to the floor. Don’t bend over, as this may cause back injury. **
Method 2: Log Roll with Pillow Between the Knees
This is the method is used if my client is unable to get up on their elbows.
This is the method that should be used if the affected leg is the one closest to the center of the bed. That is, you don’t want to roll onto your affected leg, because that could be painful.
1. Client: Bend your affected knee slightly, or have your caregiver help you bend your knee.
Make sure you don’t bend at the hip 90 degrees or more.
2. Caregiver: Place a pillow between the legs
This will help prevent the legs from crossing.
3. Client: Bend the other knee.
4. Client: Turn your head towards the edge of the bed. Lift the hand on your affected side up, towards the ceiling.
5. Caregivers: Get into a split stance, so you feel balanced and stable. Your knees should be slightly bent.
6. Caregivers: Place one hand towards the back of the affected hip (try to avoid the incision) and the other hand on their shoulder blade.
These next 2 Steps will happen at the same time- one is the client’s job and the other is the caregiver’s job.
7. Client: Reach for the edge of the bed with the hand that’s in the air, as your caregiver helps your roll.
7. Caregiver: Shift your weight towards your heels as you help roll your loved one to their side.
**Caregiver Note: The point of shifting your weight is making sure you’re using your legs, rather than your back to help achieve a side-lying position. This will help decrease your risk of back injury.**
8. Caregiver: Cradle your loved one’s head with your elbow, placing your hand on their upper back. Place your other forearm under their knees.
**Caregiver Note: Your arm will scoop under their neck to cradle the head, but do not pull on their neck!**
**Caregiver Note: If your loved one is taller than you, it may be difficult to move the legs and torso at the same time. If this is the case, move the legs together off of the bed first, then help get their torso up. **
These next 2 Steps will happen at the same time- one is the client’s job and the other is the caregiver’s job.
9. Client: Push down into the elbow that’s on the bed, to help move your torso up and towards your affected leg.
9. Caregiver: Bend your knees. As you stand, help bring their torso up and their knees off of the bed.
10. Client: Place your hands behind you so you can recline your torso a little.
This will help prevent leaning over your hips.
