Why am I still walking with a limp after Hip Replacement?

You underwent a Total Hip Replacement (THR) to get rid of that nagging hip pain, and to be able to walk normally again. However, it's been 6 or more months since your surgery and you are still limping. Your friends are saying, I thought you got your hip fixed, why are you still limping?

Well when you ‘got your hip fixed’, your surgeon most likely did a great job of replacing the arthritic part of the joint.  You may have received some post operative rehab or physio to get some basic movement and strength back to the hip, but your limp remains. Without some specific muscle and gait retraining, your walking gait or limp won't change.

Here is some information about recovery from hip replacement. Firstly, prior to your surgery, the pain and arthritis lead to two common muscle issues. Pain in the hip creates inhibition of the gluteus medius/minimus muscles, as when these muscles contract, they put pressure on the arthritic joint, which in turn leads to more pain in the joint. You body want to avoid pain, so it changes the way you walk, and the muscles you use in an attempt to reduce the hip pain. This leads to a type of limp called a Trendelenburg gait, where you lean your trunk over to one side as you walk. This helps by shifting your centre of gravity over the arthritic hip, so those gluteal muscles don't have to work as hard. The results are continuing weakening to the gluteal muscles, and over time, the Trendelenburg gait becomes your ‘normal or preferred’ walking pattern, every after hip replacement.

The second common issue is reduced hip extension movement, that is your ability to move your leg backwards. As your hip becomes more arthritic, the changes within the joint start to restrict your ability to move the hip. Over time your muscles shorten to work around this reduced movement. Now that your surgeon has replaced the hip, the joint now has full movement, but your muscles are still tight. This leads to a shortened stride, that is often compensated by rotating your pelvis as you walk.

To overcome these two common limps following hip replacement, your need to ensure 3 things being:

1. You have full movement in your hip, that is not restricted by tight muscles
2. You have adequate muscle strength to support a normal walking gait
3. You undertake some specific gait retraining exercises to teach you body how to walk normally again.

For the past 20 years, the staff at HFRC have been researching and rehabilitation people following total hip replacement, with a specific focus on returning you to normal function, including a normal walking gait. The Exercise physiologists at HFRC will apply their expertise to ensure that you have stretched out those tight muscles, assess and provide some specific strengthening exercises to any weak muscles, and most importantly, retrain your walking gait through a series of exercises and quality education. Our goal is to get you walking normally again, because it's one of the main reasons you had hip replacement in the first place. If you are still limping, and want the solution, please contact us and we will personally discuss your situation to ensure we can help your prior to starting a program. Contact us at www.hfrc.com.au

By Dr Brendan Joss, ESSAF, AEP

Managing Director, HFRC

HFRC is a state of the art clinical practice based on 20 years of continual involvement in cutting edge research delivered with the utmost care in a supportive, fun environment. Contact HFRC for Less Pain & Improved Function, FASTER. HFRC offers the following services:

Exercise Physiology

Pre- and Post-surgery orthopaedic rehabilitation

Exercise rehabilitation for musculoskeletal pain or injury

Arthritis Management | Weight Management

Return to sport readiness assessments and rehabilitation

Physiotherapy

Musculoskeletal, sports and general Physiotherapy

Back, Neck and chronic pain management

Vertigo and Dizziness

Tendinopathy management and Shockwave therapy

Remedial Massage

General, sports and lymphoedema