A new hip? Now lose that stick

QI HAD a total hip replacement seven weeks ago and am now walking short distances and cycling on an exercise bike. I am using a walking stick when necessary but have noticed that when I walk without it, I have a limp or lean. Is there anything else I could be doing to combat this, or am I just being impatient? I am not due for physio but am expected back at work in four weeks and keen to lose the stick. A THE turnaround time and success rate of these operations has become nothing short of miraculous – but it is still a very major operation and it does take time. However, you are absolutely correct to question your timescales and to be driven to do something about your situation. You should certainly try to work with a physiotherapist on this as soon as possible to work on mobilising, strengthening and regaining normality in the whole area.

There are some basic exercises that you should do, in order to start this process. Crucially, you need to strengthen your glutes (buttock muscles), hip flexors and abductors to give yourself some control over the hip again.

1. LEG BENDS: In a standing position, bend your (bad) leg and stand on your other (good) leg. Repeat the action of pressing the leg back behind you (as though pressing the sole of your foot against something behind you), returning to the start position of knees together between each rep. Do this for 20-30 reps, and do it for both sides for 3-4 sets. To advance this, you can also do it on hands and knees on the floor and push the sole of the foot towards the ceiling.

2. KNEE RAISES: Lying on your side with knees bent, raise and rotate your top leg outwards while keeping the feet together (effectively opening your legs from the knees, with your feet and hips as the two pivot points). Repeat this for 20-30 reps, 3-4 sets on both sides.

3. STANDING KNEE RAISES: Standing against a wall, raise your knee up ahead of you (bent), and then return to the floor and repeat for 20-30 reps. Too easy? Raise your bent knee up to hip height and then straighten the leg out ahead of you, then bend it again and return back to the start position. 10-15 reps, 3-4 sets on both sides

This all takes some diligence, patience and perseverance but keep it up, it WILL be worth it.

Q I’M A 50-year-old man and used to be really sporty when I was younger – I played a lot of rugby and also used to do athletics. I’ve carried on running but now I keep getting a persistent calf-muscle tear which takes at least a month to heal if I run more than a mile. I’m looking for other ways to keep up cardiovascular fitness: I like cycling but only have time for long rides at weekends. A THESE types of injuries are often the catalyst for many people drastically reducing their exercise levels and can be the start of a downward slip in fitness.

When you are someone who has been so active, it’s hard to accept that you can’t do what you used to and it can be a struggle to switch to a new thing. However, calf injuries can be a longterm problem and, as we age, recovery only gets more difficult, so you are absolutely right to scale back on the running, but I wouldn’t rule it out completely.

First, you need to do some exercise that takes away the strain factor. Cycling is great and you don’t actually have to do long rides all of the time. Short, fast or hilly rides and spinning classes will really boost your fitness in a short time. Swimming would be fantastic for you too. You also need to really work on getting the calves strong again. Without knowing your exact injury, I would suggest some foam rolling, strengthening exercises and stretching, perhaps even yoga to help get the fibres activated. You CAN run again, you just need to change your distance ideals.

Combining cycling, swimming and a bit of running gives you a good cross-base of fitness – and maybe this adversity might actually be an opportunity to discover other forms of exercise.