SwiftPath Physical Therapy Protocol
for the Hip
The Preoperative PT Visit
The preoperative PT visit is an opportunity for patients, family and physical therapists to become engaged in the SwiftPath approach to recovery after surgery.
Be sure to take your Patient Guide to this visit. Your therapist will need it to complete the visit.
4 goals of the Preoperative PT visit:
SwiftPath Post-op Protocol
Dr. McAllister’s approach to rehabilitation includes opiate sparing pain management and patient engagement. This approach is proven to reduce pain, stiffness, and the need for prolonged, painful physical therapy. 1,2
SwiftPath sets a new standard for communication between you and Dr. McAllister’s team. Engaged patients take control of their care, better understand their exercises, and advance to self-directed programs quickly. The result is a more pleasant and faster recovery. This timeline works for most patients. But if your experience is different, please share your goals with your physical therapist to make adjustments.
1.McAllister, CM, et al. Rapid Rehabiliation after Joint Replacement. AAOS Annual Meeting, San Diego, March, 2016
2. Austin MS, et al. Formal Physical Therapy After Joint Replacement is Not Required: A Randomized Controlled Trial. JBJS Am. 2017 Apr 19;99(8):648-655
Postoperative Exercises and Milestones
Do exercises for 5 minutes every hour for 8-10 hours per day until you get to PT.
Days 2-7: Do your best to get up and walk or do your exercises
Goals and Milestones: Icing/elevation, out of bed, chair rise, bathroom skills, stairs, household ambulation, community ambulation, in/out of a car.
Assisted leg raises
When getting up from laying position, use your non-surgical foot or a leg-grabber to raise leg to lift it in and out of bed.
Sit on high stool or table so leg is hanging, and use gravity to work toward 90° of flexion.
(Foot flexed and pointed): Do these when awake and laying down.
Weeks 1 - 2: Same exercises as above, and adding the ones below.
Goals and Milestones:
Independent walking, ascending/descending stairs (with walker, crutches, and stair rails for support, at least 90° of flexion, increase efforts at active range of motion, Continue with icing and (if appropriate) NSAIDs/acetaminophen before and after exercises.
Extension without support
Sit in a stable chair, lift leg out straight. Hold for 10 seconds then relax. Repeat 10 times.
Walk without assistive devices. Use walker or rails for support on stairs.
One of the main goals of physical therapy is to help regain your independence. The sooner that happens, the better patients do overall. This is a good time to consider fewer visits with a physical therapist with more emphasis on an independent, self-directed physical therapy program. Your therapist will help you develop a program that works best for you.
Weeks 6 - 12:
Transition to low-grade recreation (gentle hikes, golfing, extended walks, treadmill, elliptical, etc). Progress to more strenuous activities slowly and judiciously. If you struggle with pain, stiffness, range of motion or in any other way, return to the clinic and consider a PT consult.
Post-op Hip Surgery DOs and DO NOTs
DO keep feet part and even put a pillow between legs at night to prevent crossing.
DO sit in a high chair with feet apart.
DO walk up steps with the non-operated leg first.
DO walk down steps with the operated leg first.
DO NOT cross your legs for six months.
DO NOT sit with legs crossed for six months.
DO NOT bend deeply at waist. To bend over, move the operated leg back or use a reacher.
DO NOT twist your body around with the operated leg fixed on the ground.
Post-op Hip Precautions