Hip Replacement Recovery: Safe Dressing, Adaptive Equipment, and Hip Precautions

How to Put on Clothes After Hip Replacement: A Guide to Safe Dressing

After hip replacement surgery, safely putting on clothes, especially lower body garments, requires strict adherence to hip precautions and often the use of adaptive equipment to prevent dislocation and promote proper healing.

Understanding Hip Precautions: The Foundation of Safe Movement

Following a total hip replacement (THR), your surgeon and physical therapist will provide specific "hip precautions" designed to protect the new joint from dislocation during the critical healing phase. These precautions are paramount when performing daily activities like dressing. While specific instructions may vary based on the surgical approach (e.g., posterior, anterior, lateral), the underlying principle is to avoid extreme movements that could compromise the joint's stability.

Common Hip Precautions (Often for Posterior Approach):

• No Hip Flexion Beyond 90 Degrees: Avoid bending your hip more than a right angle (e.g., do not bend over to tie your shoes or pick things up from the floor).
• No Internal Rotation: Do not twist your leg inward, keeping your toes pointed forward or slightly outward.
• No Adduction Past Midline: Do not cross your legs or bring your operated leg across the midline of your body.

Important Note: For an anterior approach, precautions might differ, often prohibiting hip extension and external rotation. Always follow the specific instructions provided by your surgical team and physical therapist.

Essential Adaptive Equipment for Dressing

Adaptive equipment can significantly enhance your independence and safety during the post-operative period. These tools help you dress without violating hip precautions.

• Reacher/Grabber: An invaluable tool for picking up clothes from the floor, pulling up trousers, or retrieving items without bending.
• Sock Aid: Designed to help you put on socks without bending your hips.
• Long-Handled Shoe Horn: Allows you to put on shoes without excessive hip flexion.
• Dressing Stick: A stick with a hook at one end, useful for pushing or pulling clothing, especially when maneuvering garments over the feet or shoulders.
• Elastic Shoelaces: Convert lace-up shoes into slip-ons, eliminating the need to tie laces.
• Loose-Fitting Clothing: Opt for garments with elastic waistbands, wide leg openings, and front closures for easier management.

Strategies for Dressing the Upper Body

Dressing your upper body is generally less challenging than the lower body, as it involves fewer hip movements.

• Always Sit Down: Perform all upper body dressing while seated securely in a chair with armrests. This provides stability and reduces the risk of falls.
• Affected Side First: When putting on a shirt, jacket, or bra, guide the garment over your operated arm first. This allows you to use your unaffected arm to maneuver the clothing more easily.
• Unaffected Side Last: Once the garment is on the affected arm, bring it around your back and insert your unaffected arm.
• Reverse for Removal: When taking off clothes, remove the garment from your unaffected arm first, then the affected arm.
• Choose Wisely: Opt for loose-fitting, front-buttoning, or zipper-front tops that are easy to slip on and off.

Step-by-Step Guide: Dressing the Lower Body Safely

This is the most critical part of post-hip replacement dressing, requiring careful attention to hip precautions.

1. Prepare Your Environment:

• Ensure you are seated in a stable chair with armrests.
• Gather all necessary clothing and adaptive equipment (reacher, sock aid, long-handled shoe horn) and place them within easy reach.
• Choose loose-fitting garments with elastic waistbands or wide leg openings.

2. Putting on Underwear and Pants:

• Position Garment: Use your reacher or dressing stick to pick up your underwear or pants.
• Affected Leg First: Guide the opening of the garment over your operated foot and gently pull it up your leg as far as possible (usually to the knee or mid-calf), using the reacher. Avoid excessive bending.
• Unaffected Leg Second: Now, guide your unaffected foot into the other opening and pull it up to the same height.
• Pulling Up While Seated: If possible, use the reacher or dressing stick to pull the garment up further while remaining seated, perhaps by leaning back slightly to avoid hip flexion.
• Pulling Up While Standing (If Cleared): If your therapist has cleared you for standing, slowly and carefully stand up, using a walker or other support for balance. Once standing, pull the garment up the rest of the way. Maintain a wide stance and avoid twisting.
• Fasteners: If your pants have zippers or buttons, ensure they are easily accessible or consider elastic waistbands initially.

3. Putting on Socks:

• Use a Sock Aid: This device is essential for putting on socks without bending your hip.
• Load Sock: Place your sock onto the sock aid, ensuring the opening is stretched over the aid.
• Position Aid: Lower the sock aid to the floor in front of your foot.
• Insert Foot: Gently slide your foot into the sock opening on the aid.
• Pull Up: Use the attached straps of the sock aid to pull the sock up your leg, then release the aid.

4. Putting on Shoes:

• Choose Appropriate Footwear: Opt for slip-on shoes, shoes with Velcro closures, or those fitted with elastic shoelaces. Avoid shoes with traditional laces or high heels.
• Use Long-Handled Shoe Horn: While seated, guide your foot into the shoe. Use the long-handled shoe horn to ease your heel into the shoe, preventing the need to bend.
• Avoid Bending: Never bend over to put on or tie shoes.

General Tips for Independent Dressing

• Patience and Practice: It takes time to master these new techniques. Be patient with yourself and practice regularly.
• Plan Ahead: Lay out your clothes for the next day before you go to bed.
• Choose Comfortable Clothing: Loose, stretchy, and easy-to-manage fabrics will make the process much smoother.
• Ask for Help: Do not hesitate to ask a caregiver, family member, or friend for assistance, especially in the initial weeks. Your safety is paramount.
• Consult an Occupational Therapist: An occupational therapist (OT) specializes in helping individuals regain independence in daily activities. They can provide personalized strategies and recommend specific adaptive equipment.
• Maintain Core Strength: A strong core helps with balance and controlled movements, making dressing easier and safer.

When to Consult Your Healthcare Provider

While it's normal to experience some discomfort and stiffness after hip replacement, certain signs warrant immediate medical attention:

• Sudden, Severe Pain: Especially in the hip or leg.
• Inability to Move Your Leg: Or difficulty bearing weight.
• Leg Length Discrepancy: If your operated leg suddenly appears shorter or longer.
• Popping Sensation: In the hip.
• Increased Swelling or Redness: Around the incision site.
• Fever or Chills: Signs of potential infection.
• Difficulty Breathing or Chest Pain: Seek emergency care immediately.

Conclusion: Prioritizing Safety and Recovery

Learning to dress independently after a hip replacement is a significant step towards regaining your functional independence. By diligently adhering to your hip precautions, utilizing adaptive equipment, and practicing patience, you can safely navigate this crucial aspect of daily living. Remember that your surgical team and therapists are your best resources for guidance and support throughout your recovery journey. Prioritizing safety will ensure the long-term success of your new hip joint.