Hip precautions are positions and movements that your child should avoid after hip surgery. Hip precautions are needed when your child has had surgery to repair or replace the hip joint.
A physical therapist or physical therapist assistant will teach your child hip precautions and exercises to strengthen the hip. This care team member will also show your child how to walk with a walker or how to use crutches.
An occupational therapist, physical therapist, or physical therapist assistant will teach your child how to use equipment to help with everyday activities and make sure the hip is protected.
Always follow your care team’s instructions and ask questions if you are not sure.
Risk of hip dislocation after surgery
The 2 main parts that make up the hip joint are the ball (femoral head) and the socket (acetabulum). The ball at the top of the thighbone fits into a rounded socket in the pelvis.
The muscles, ligaments, cartilage, and fluid in a normal hip joint provide a stable and smooth-moving hip joint. When any part of the hip joint is not working correctly, your child is at risk for dislocating their hip.
The muscles that surround the hip joint include the buttock on the back and the upper thigh muscles on the front. These muscles and ligaments are weakened during surgery. Until the muscles heal and regain strength, there is a risk for the ball of the joint to push out of the socket, causing hip dislocation.
What you need to know about hip precautions
Your doctor may recommend temporary or long-term hip precautions based on your child’s medical needs. These are known as standard precautions.
Standard hip precautions after surgery are often recommended by your child’s doctor for 6 weeks after surgery. These restrictions are needed to prevent your child from dislocating their hip. Movement restrictions include:
1. Do not bend at the hip or lift your leg past 90 degrees
Do not lean your upper body forward while sitting or standing.
Do not lift your leg higher than parallel with the floor.
Do not sit in low chairs or on toilets that may put your hip at risk for dislocation. Instead, use higher chairs or raised toilet seats so that it is easier to stand up without leaning forward.
Use equipment to do daily activities such as putting on or removing your socks or picking up objects from the floor.
2. Do not turn your toes in at the hip
Do not turn your toes in toward the middle of your body in a “pigeon-toed” position. Make sure to keep your toes pointed straight in front of your body, even when getting in and out of bed.
3. Do not cross your knees or ankles
Do not cross your legs. Do not let your knee or ankle go toward the middle of your body. Make sure to keep your knees and ankles straight in front of your body. Use a pillow between your legs when you are in bed to keep your hip in the correct position.
( / 3 )
Do not bend at the hip or lift your leg past 90 degrees
Do not lean forward or lift your leg past 90 degrees. You may need to change the way you do some activities to keep your hip safe.
Do not turn your toes in at the hip
Do not turn your toes in toward the middle of your body. Keep your toes straight in front of your body.
Do not cross your knees or ankles
Do not cross your knees or ankles. Keep your legs straight in front of your body.
A hip abduction pillow helps keep your hip in the proper position after surgery.
How to protect the hip and prevent injury
While in bed, your child may use the hip abduction pillow for up to 6 weeks depending on your surgeon's recommendations. This pillow keeps your child’s hip in the proper position.
When doing daily activities, your child should use equipment such as a reacher, long-handled sponge, and elevated toilet seat to prevent excessive reaching, bending, and twisting.
Your care team will let you know how much weight your child can put on their leg after hip surgery. Your child should follow those weight-bearing guidelines.
Physical activity after surgery
Your care team will let you know what activities are safe and when to start them after surgery.
After hip surgery, sports and activities that are high-impact or have a high risk for falls are usually restricted. Talk to your care team before your child begins any activity.
When to call your care team
Call the care team if your child’s hip looks out of place or dislocated or if your child:
Cannot put weight onto their leg
Cannot move their leg
Is in extreme pain
Has extreme swelling
Has fever or signs of infection
Questions to ask your care team
How long will my child have to follow hip precautions guidelines?
How much weight can my child put on their leg?
Will my child have to have physical therapy or other rehab services?
What can my child do to manage pain?
Key points about hip precautions
Hip precautions are positions and movements that your child should avoid for a period of time after hip surgery.
Until muscles heal after hip surgery, your child is at risk for hip dislocation.
Your child will learn how to use crutches or a walker. Follow instructions for how much weight to put on the leg (weight-bearing).
Your care team will let you know what activities are safe and when to start them after surgery.
A walker can help patients move around and be more independent in their daily lives. It is important for patients to know how to safely walk, sit, stand, turn, and go up and down steps. Some patients may also have instructions for weight bearing.
Crutches are walking aids used to reduce weight placed on the lower body and provide support and balance. Special pediatric crutches are available that are sized to fit smaller children. A physical therapist can make sure that crutches fit properly and help patients learn to use crutches safely.
Occupational therapy helps patients improve skills for the “jobs” of living. Learn how OT helps people master everyday tasks needed at home, school, and work.
