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Recovery After Hip Replacement Surgery

This week Breathe Easy welcomes guest blogger Jo Ann Staugaard-Jones. Jo Ann is an internationally acclaimed author and movement educator, as well as a full Professor of Kinesiology and dance. We became acquainted through her book The Vital Psoas Muscle, which is excellent and can be found at Her eagerly awaited next book, The Concise Book of Yoga Anatomy, is due out this fall, 2015.JSJpic

Many of my private yoga students have had hip replacement surgery and I asked Jo Ann to blog about how this surgery affects the psoas and illiopsoas muscles and the sacrum. Her comments and advice are excellent and highly useful. Whether or not you have had this surgery, staying mobile for life depends on appropriate conditioning of these areas. Enjoy Jo Ann’s blog.

Guest Blog

Hip replacements are surgical procedures performed when there is chronic pain caused by arthritis or some kind of disability/degeneration. Posterior hip replacement is the more traditional, common type performed, so let’s discuss the impact of such a surgery and areas that may be affected.

I am not an orthopedic surgeon, but a kinesiologist and author of body works books, with over 30 years of professorship in the field of Movement Sciences. With this background, I would like to make the following observations based on my preventive and rehabilitative work. I note beforehand that each case is individual and the severity of the condition and prognosis may change, and that your doctor is your best advisor.Psoas_cover_12-21

  • The anatomy of the ilio-femoral (hip) joint is straightforward: a ball (the head of the femur) sits in the socket (the acetablum of the pelvis) and is the largest ball & socket joint in the body. It is a very stable joint, with large muscles surrounding and moving it, but does take abuse over time depending on movement, alignment, injury, or disease. The cartilage that protects the joint wears away with trauma and overuse, hence arthritis: the major cause of hip replacement.
  • When this area becomes too painful and the posterior hip replacement is performed, an incision is made near the buttocks, behind the major walking muscles, to help reduce recovery time. This approach has a proven track record of success and there is low risk for complications. There are different procedures being done recently that may prove even less invasive.
  • Upon recovery, the most important rehabilitation is to not bend the hip more than 90 degrees (standing, the thigh raised in front of the pelvis in a parallel position to the floor is 90 degrees). The hip flexors on the front of the thigh contract to do this action, therefore the iliopsoas, the deepest and strongest hip flexor muscle group, is strengthened. Part of this group, the psoas major, connects to the lumbar spine and stabilizes the lower spine, past the pelvis to the inside of the femur, so this muscle becomes very important in the posturing and support of the exercise.
  • Other stabilizers that will help along with the psoas major are the quadratus lumborum, transverse abdominus (deepest abdominal), and other spinal extensor muscles. Therefore, it can be noted that the health of these muscles is paramount to the success of recovery.Anjanyasana-2
  • The other area of discussion is the sacrum, more specifically the sacro-iliac joint. This is where the sacrum bone of the spine articulates with the pelvis. It is a gliding joint, so irritation to this area can cause inflammation, usually one-sided (irritation is caused by poor posture and even over-stretching). How might a posterior hip replacement affect this? There are six deep outward rotator muscles that support the pelvis to the femur; it is suggested that inward rotation of the leg is contraindicated, as it might compromise this very sensitive sacral area. Also, crossing the thigh over the midline of the body is not recommended, as that might stretch the area too much.
  • The most important thing to remember is that surgery is actually an injury to the body: there is tissue that has been affected and needs time to heal- scar tissue develops, and care must be taken to help the area heal, not be reinjured. Follow the professional advice of your surgeons and physical therapists, and plan on consistent practice of a better diet, movement plan, and relaxation to reduce stress!
  • I suggest a gentle yoga class with an instructor that is familiar with the condition (so ask!) To condition the muscles mentioned above, do a simple lunge: strength for the hip flexors in the front leg, and stretch for the same muscles in the back leg, while stabilizing both the hip and lumbar spine.
  • For relaxation of muscles on a daily basis, do the Constructive Rest Position found on pgs. 20-22 in the Vital Psoas Muscle book


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Joanne Thompson

Joanne Thompson

Founder/Owner at Yoga for Self

Health is a precious gift and my goal is to help you live a healthier, happier life through yoga. Every private session is uniquely designed just for you. For a free telephone consultation call me at 303.818.4181. Discover whether personalized, private yoga instruction is right for you.
Joanne Thompson

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2 Responses to Recovery After Hip Replacement Surgery


    What is the “Constructive Rest Position?


      It’s described in her book over several pages but essentially is a way to release the psoas muscle by lying on your back with knees bent and feet on floor, allowing the femur to rest gently in the hip socket to release the “grip” of the hip flexors. The spine follows its natural curves.

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