Strengthening and progression exercises

3-4 times per week (every other day)
Start with 1 set of 10-15 repetitions
Progress gradually to 3 sets of 10-15 repetitions, take a 1-2 minute break between sets
Think slow and controlled movements, no need to hold the position
Move on to an exercise labeled “progression” when you can easily complete 3 sets of 10-15 repetitions
Repeat exercises on your other leg

Tips:

It is normal for muscles to feel sore or even shaky when starting a new exercise
Joint pain is not normal. Pain, unlike soreness, is an indicator that you may be overdoing it with your exercises. Rest for 1-2 days and then start exercising again slowly
Gradually increase your activity level
Walking DOES NOT take the place of your exercises
Continue with these strengthening exercises for at least the first year after your surgery

7. Bridge progression

Lying on back, knees bent
Squeeze buttocks
Lift buttocks off bed

Progression level 1

Lift buttocks off the bed with both feet on bed
Once you are up, lift non-operated slightly off the bed
Keep non-operated leg up as you lower buttocks back to the bed

Progression level 2

Raise and lower buttocks with operated leg only on bed
Try straightening your non-operated leg while keeping it off the bed slightly

8. Clam shell

Lie on your non-operated side with your hips and knees slightly bent
Keep your feet together
Open your knees as much as you can without letting your top hip roll backwards

Note: If you are having difficulty opening your knees or preventing your hip from rolling then push your feet against a wall or headboard as you lift your top knee

Progression: Tie a TheraBand® around your lower thighs, just above your knees. You may want to start off with a light resistance TheraBand®

9. Hip flexor strengthening

In sitting, lift your operated leg up so that your foot is off the floor
Try to avoid leaning back
Do not let your knee turn out to the side

Progression: push down with your hands to apply resistances

10. Standing hip abduction progression

Hold onto a counter for balance
Lift your operated leg out to the side while standing tall
Keep your hips level and upper body straight
Do not hike your hip. Try to keep your foot slightly off the floor
Keep your toes pointing forward
Alternate legs

Progression: Tie a TheraBand® around your lower thighs

11. Squat progression

Stand in front of a chair/sink and keep equal weight through both feet
Keep your toes pointing forwards
Bend your knees and stick your buttocks out
Lower your buttocks down slowly and with control, using hand support if needed
If using a chair, lower all the way down into sitting
Do not allow your knees to go ahead of your toes

Progression level 1: Tie a TheraBand® just above your knees. Press thighs apart against tension of TheraBand® while doing the chair squat exercise

Progression level 2: Alternate single leg squat between operated and non-operated leg, using hand support if needed

12. Crab walk

Bring your feet together and tie a TheraBand® just above your knees
Stand with feet shoulder distance apart
Stick your buttocks out as if you are about to sit in a chair
Do not allow your knees to go ahead of your toes
Maintain this squat position and take a few steps in one direction, then side step back in the other direction
When stepping feet back together, don’t bring feet closer than hip distance apart
Repeat in opposite direction until you are back to your starting position

Crab walk

13. Standing abduction against wall

Stand on operated leg
Bend non-operated leg and push your knee against the wall and return to standing on both legs
Your hip should not be touching the counter
Make sure to keep your hips level and thighs in line

Progression: Try to take your hand off the counter so that your lower leg is the only part of your body touching the wall.

14. Marching in standing

Hold onto a counter for support if needed
Bend your operated hip and lift your knee up towards your chest
Keep your back straight and ensure that you are not rocking from side to side
Alternate legs

Helpful Tip: perform this exercise in front of a mirror.

Progression:

level 1: Once you are able to stand without holding on, progress to marching at a slower pace
level 2: Standing on an uneven surface such as a flat pillow, wobble board or Bosu® ball

Stretches

Warm up for 5-10 minutes before stretching (e.g walking, warm shower)
Hold stretches 45 seconds (or 5 slow deep breaths), repeat 3 times
Can be done everyday or several times a day if your muscles are tight
Repeat with the other leg

Exercise instructions

15. Hip bending stretch

Bend your knee and bring your operated leg toward your chest
When you cannot go any further on your own, use your hands/towel to pull your thigh towards your chest until you feel a gentle stretch

16. Hip flexor stretch

Lie with operated leg hanging over the end of the bed
Bend the non-operated leg toward your chest using your hands or a towel
You should feel the stretch at the front of your thigh/groin

Note: to increase the stretch, let more of your thigh hang off the bed and bend your knee.

17. Seated hamstring stretch

Sit on the edge of a chair
Keep non-operated foot flat on floor. Straighten your operated leg with heel on floor and toes pointing up to the ceiling
Ensure that you are sitting up straight with an arch in your low back
Slowly lean forward at hips while maintaining a straight back with chest up

18. Adductor stretch

Stand with your feet wider than hip distance apart
Lunge away from the side that you are stretching
You should feel the stretch in your groin or the inside of your thigh

19. Side stretch

In sitting or standing
Raise the arm on your operated side above your head
Lean away from your operated side
Take 4 deep breaths to increase the stretch

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