Hip Surgery Recovery: Safe Bed Mobility and Essential Precautions

How do you move in bed after hip surgery?

After hip surgery, controlled, deliberate movements in bed are crucial to protect the healing joint, prevent dislocation, and manage pain, typically following specific hip precautions provided by your surgical team.

The Critical Importance of Safe Movement Post-Hip Surgery

Navigating your immediate post-operative period after hip surgery, whether it's a total hip arthroplasty (THA) or another procedure, demands precision in movement. The primary goal is to protect the newly repaired or replaced joint from stress that could lead to dislocation or damage, while also managing pain and promoting optimal healing. Understanding and adhering to your surgeon's specific hip precautions is paramount, as these guidelines are tailored to the surgical approach used (e.g., posterior, anterior, lateral) and the stability of the joint. Improper movements can significantly delay recovery or necessitate further intervention.

General Principles for Safe Bed Mobility

Regardless of the specific surgical approach, several universal principles underpin safe movement in bed after hip surgery:

• Adhere to Hip Precautions: This is the golden rule. Your surgical team will provide specific instructions, but common precautions include avoiding excessive hip flexion (typically beyond 90 degrees), hip adduction (crossing your legs), and certain rotational movements.
• Utilize the Log Roll Technique: This is the safest way to turn or reposition in bed. It involves moving your entire body as one unit, keeping your spine and hips aligned, rather than twisting your trunk relative to your pelvis.
• Employ Assistive Devices: Make full use of any aids provided or recommended, such as a trapeze bar, bed rails, an abduction pillow or wedge, and firm pillows to support limbs.
• Slow and Controlled Movements: All transitions should be deliberate and unhurried. Rushing can lead to loss of control, putting undue stress on the hip.
• Engage Your Core: Gently bracing your abdominal muscles helps stabilize your trunk and provides a solid base for limb movement, reducing strain on the hip joint.
• Listen to Your Body: Pain is a warning signal. If a movement causes sharp or increasing pain, stop immediately and reassess.
• Avoid Twisting: Never twist your body at the waist while your feet are stationary, or vice versa. Always move your hips and shoulders together.

Getting Into Bed Safely

Entering the bed after hip surgery requires a systematic approach to protect your new joint:

• Approach the Bed: Back up to the side of the bed, ensuring your surgical leg is slightly extended forward to maintain precautions as you lower yourself.
• Sit Down: Use your hands for support on the bed or a sturdy chair/walker. Slowly lower yourself onto the edge of the bed, keeping your surgical leg extended.
• Pivot: Once seated, pivot on your non-surgical leg. Use your arms to push off the bed and gradually swing your legs onto the bed, one at a time.
• Lift Legs: Carefully lift your surgical leg first, using your hands to support it, and then bring your non-surgical leg onto the bed. Alternatively, you can lift both legs together, keeping them straight and together, with support from your hands.
• Positioning: Once in bed, lie on your back. If prescribed, place an abduction pillow or wedge between your knees to prevent your legs from crossing and maintain proper alignment.

Moving While In Bed (Turning and Adjusting)

Maintaining proper alignment while repositioning is key:

• Lying on Your Back: This is often the most comfortable and safest initial position. Ensure your legs are not crossed and your feet are pointing straight up. A pillow under your calves can reduce pressure on your heels.
• Turning onto Your Non-Surgical Side (Log Roll):
  • Scoot to the Edge: Scoot your body towards the side of the bed opposite to the direction you intend to turn.
  • Pillow Placement: Place a firm pillow between your knees and ankles. This is critical to prevent your surgical leg from adducting (crossing midline) or internally rotating.
  • Bend Non-Surgical Knee: Bend your non-surgical knee slightly, keeping your foot flat on the bed.
  • Initiate Roll: Use a bed rail or trapeze bar if available. Push off with your non-surgical foot and use your arms to gently roll your entire body (shoulders, trunk, hips) as one unit towards your non-surgical side. Keep your head aligned with your spine.
  • Maintain Pillow: Ensure the pillow remains firmly between your knees throughout the roll. Avoid twisting your upper body away from your lower body.
• Adjusting Up or Down in Bed:
  • Bend Non-Surgical Knee: Bend your non-surgical knee and place your foot flat on the bed.
  • Push with Hands/Elbows: Use your hands or elbows to push down into the bed, simultaneously pushing with your non-surgical foot.
  • Scoot: Gently scoot your hips in small increments in the desired direction. Keep your surgical leg extended and avoid sudden movements.

Getting Out of Bed Safely

Exiting the bed mirrors the entry process, prioritizing controlled movement:

• Position for Exit: Begin by rolling onto your non-surgical side using the log roll technique, ensuring the pillow remains between your knees. Scoot your hips towards the edge of the bed where you plan to exit.
• Lower Legs: Use your arms to push yourself up from the bed. As you push up, simultaneously swing both legs over the side of the bed, allowing them to hang towards the floor. Keep your surgical leg slightly extended.
• Sit Up: Once your feet are on the floor, pause in a seated position at the edge of the bed. Ensure you feel stable and not dizzy before attempting to stand. Maintain your hip precautions, ensuring your knees do not rise higher than your hips.

Essential Post-Surgical Hip Precautions

While specific precautions vary based on surgical approach, common directives after hip surgery include:

• No Hip Flexion Beyond 90 Degrees: Avoid bending your hip more than a right angle. This means no deep squats, no bringing your knee to your chest, and using elevated seating.
• No Hip Adduction Past Midline: Do not cross your legs or ankles. Always keep your legs slightly apart, especially when lying down (often achieved with an abduction pillow).
• No Internal Rotation (for Posterior Approach): Do not let your toes turn inward.
• No External Rotation (for Anterior Approach): Do not let your toes turn outward.
• Avoid Twisting: Do not twist your trunk while your feet are stationary. Move your whole body as one unit.
• Use Abduction Pillow: If prescribed, consistently use the pillow or wedge between your legs when lying on your back or side to maintain proper alignment.

When to Seek Medical Advice

Contact your surgeon or healthcare provider immediately if you experience any of the following:

• Sudden, sharp, or severe pain in your hip.
• A "popping" or "clunking" sensation in your hip.
• Inability to move your leg.
• Leg length discrepancy that was not present immediately after surgery.
• Signs of infection: fever, chills, increased redness, swelling, warmth, or discharge from the incision site.
• Numbness, tingling, or weakness in your leg or foot.
• Any feeling that your hip has come out of place.

Conclusion

Mastering safe bed mobility after hip surgery is a foundational aspect of your recovery. By diligently following your surgeon's specific hip precautions and employing the techniques outlined, you can significantly reduce the risk of complications, manage pain effectively, and contribute positively to your healing process. Patience, consistency, and clear communication with your healthcare team are your most valuable tools throughout this critical phase of rehabilitation.