Exercises after hip arthroplasty according to the Bubnovsky

Exercises of Dr. Bubnovsky with coxarthrosis( arthrosis of the hip joint)

The treatment technique developed by Dr. Bubnovsky - exercises for the hip joint - is the most effective for patients with arthrosis of the hip joint. The disease begins quite unnoticeable for a person. Articular cartilage is gradually depleted, at first it does not affect health, but gradually its depreciation properties are lost. And, as a consequence, dangerous processes begin in the hip joint - marginal bony growths.

The problem of arthrosis of the hip joint

Bubnovsky's method is the most reliable and the best way, which will not allow the disease to progress. This unique physician has developed a magical, without exaggeration, method that has restored the working capacity and the ability to move and rejoice at each step to many patients.

The developed system, which includes therapeutic gymnastics, is based on the examination of many patients.

Based on all the nuances of therapy for many people, Bubnovsky created, at first glance, a simple but very effective program.

Doctor Bubnovsky Sergey Mikhailovich

Recommendations of the professor

  1. In coxarthrosis of the hip joint, attention should be paid not only to exercise but also to proper breathing. The fact is that the right breaths-exhalations during the exercises enrich the body with oxygen.
  2. Learn to understand your feelings so that you can stop in time, if because of the loads you feel discomfort.
  3. The intensity of the first sessions and each subsequent should be distributed. The load, the number of exercises in the beginning should not be too active, so as not to provoke a new outbreak of the disease. But gradually the load every day must increase.
  4. To have a decent result - do not torture yourself. Bubnovsky's method is based on the cyclicity of exercises. Here it is meant that one movement can be repeated both 10 and 20 times. The amount depends on whether the person experiences joy and satisfaction from the exercises. Or performs them, clenching his teeth from pain. Gymnastics Bubnovsky is designed only for recovery and pleasure from classes.
  5. Make it a rule to do all the exercises regularly. If the joints are not actively exposed to positive physical effects every day, there can be no recovery at all. And it should be understood that the effect of the lessons does not come at once - there must pass the time, even a few months, but the result will please the patient.
  6. Do not be afraid of such a reaction of the body during exercise, like cramps. There are various methods of getting rid of muscle contractions. For example, a light massage. For a while it is desirable to reduce the load, but do not stop training.
  7. Perform lying all the exercises, gradually adding to the joints not only the hip, but the ankle, knee and others, following the instructions of the developed exercises.
  8. Without a good mood and faith in the victory over the disease, the effect will not be as good as the person wants. As with any initiative, it can not do without the desire to achieve results, so the arthrosis of the hip joint can be defeated with the help of curative gymnastics. To make it more fun, you need to find the right music.
Joint exercises of Bubnovsky

Doctor Bubnovsky is sure that if you follow all his instructions and wishes, do not spare the time that will be spent not only on gymnastics, but also recovery, surely a happy time will come, which is called health.

Complex of exercises

So, with coxarthrosis of the hip joint, it is necessary to take every day to perform light, but effective exercises that perform lying.

  1. On the back: legs bent. In turn, try to pull one, then the other leg to his chest, clasping his knees with his hands. The task is to be able to hold the position for 3-4 seconds. Smoothly put your feet with your hands in the starting position.
  2. On the back: legs stretched. Raise one or the other at a distance of 20-30 cm from the floor. The task is to be able to keep your feet, without bending.
  3. On the back: legs bent. Breed knees to the sides. The task: try to breed as hard as possible.
  4. On the back: the legs are bent, the arms relaxed in such a position that the hands are palms down. Then an action takes place, similar to the fact that as if with a foot a person wants to push away from himself a heavy object. The task: to extend the leg extension completely, pull the toe on itself and return to its original position.
  5. On the back: legs bent and set apart. Tilt one, then the other leg, not straightening inwards. The task: to be able to keep the pelvis motionless, try to touch the floor with the knee.
  6. On the back: the legs are bent and brought together. To raise and lower them synchronously. The task: to monitor breathing, lowering your legs - to exhale, lifting, - to inhale air.
  7. Bubnov exercises for the hip joint on the back come to an end: legs are bent. Raising his head from the floor, you also need to try to reach out to her knees.

After hip arthroplasty, the function is well restored by performing such exercises that are performed from different positions.

  1. Sitting on a chair: bend down. The task: reach out to the toes.
  2. Standing. You can hold on to the back of the chair: in turn, swing your legs forward and back. To the sides.

Bubnovsky's method works not only on the musculoskeletal structures, but also on the pelvic organs.

Even after hip arthroplasty:

  • pains are felt much less;
  • blood circulation in the affected area is markedly improved;
  • increases the elasticity of the ligament apparatus.

Each person has a huge potential, so with coxarthrosis of the hip joint, he will certainly cope.


AFC after hip arthroplasty

After a hip arthroplasty, a long rehabilitation period is required. For complete recovery should be developed as an operated limb, and healthy. That the muscles and ligaments do not atrophy and do not lose their functionality, it is necessary to start a specially developed complex of exercise exercises( both legs) a day after the surgical intervention.

Early stage of rehabilitation of

On the 1-12th day after endoprosthetics, it is recommended that such exercises performed in the supine position on the back( the first 3 days are forbidden) are recommended for the operated leg:

  1. ankle joint development - flexion and extension of the foot;
  2. Extension of the extremity in the knee with keeping it in the position of statistical stress( 5 sec);
  3. gluteus muscle tension and retention( 5 sec);
  4. Extension of the limb using a platen under the bend of the knee;
  5. pulling a straight leg to the side without lifting it from the surface of the bed;
  6. lifting a straight leg up, without lifting the pelvis.

The described exercises should be repeated from 5 times each, and the complex itself is performed at least 2 times a day.

LFK after endoprosthetics of the hip joint is also prescribed for a healthy limb. The main task is to develop all the connections: the ankle, knee, hip( flexion, extension, rotation, tension, lifts and leads).

Prohibited movements :

  • flexion in the hip joint at an angle greater than 90 ° C;
  • low slopes;
  • turns the thigh in and out.

You can start walking from the 4th day using crutches or walkers as a support.

Late rehabilitation stage

For 2-12 weeks of the recovery period, the walking time reaches 30 minutes( 3 or 4 times a day), the distance and pace gradually increase. A pole is already used for the support.

At this stage, exercises of exercise therapy after endoprosthetics of the hip joint are complicated. The increased loads for the operated limb.

In a supine position( on a flat plane):

  • flexion of the leg in the knee( without detachment of the foot from the surface of the bed);
  • tapping the leg to the side;
  • bending at the knee, straightening and lifting up, returning to the starting position.

In the position lying on the abdomen:

  • flexion of the limb in the knee before touching the foot with the buttocks;
  • bending of both legs in the knees and tearing off the floor with the help of the gluteus muscle tension;
  • lifting straight legs also by straining the buttocks.

These exercises should be repeated up to 15 times, the whole complex - 2 times a day. Parallel to develop a healthy leg on the same principle.

The final stage of rehabilitation of

At the 13-17th week of rehabilitation, it is already allowed to move without support, but if prolonged walking is accompanied by pain or discomfort, then a cane should be used.

The exercise of exercise therapy after hip arthroplasty at this stage is similar to that performed at the previous stage. The difference is only in increasing the load on the lower limbs( wearing weighting agents).Supplementary activities are half-squats with and without support. But, still bend the thigh more than 90 ° C is strictly prohibited. You can not also cross your legs and sharply unfold in the joints.

To achieve early recovery of the hip joint and return of its mobility, it is recommended to supplement exercise therapy with swimming, cycling or skiing.


What is osteoarthrosis

Osteoarthritis can affect any joints. Most often, DOA develops the knee joints, then the spine. Osteoarthritis of the hip joints is the third most common. The process can be either one-sided or two-sided.

In this case, the cartilage is destroyed in the joint, lining the surfaces of contiguous bones, the articular fluid acquires a tendency to inflammatory processes, there are marginal bony proliferation. In later stages, the joint space( the gap between the bones) disappears, and movement in the joint becomes impossible. The causes of the disease are:

  • genetic predisposition;
  • injury;
  • metabolic disorders( eg, deposits in the joints of uric acid, hydroxyapatite).

Characteristic symptom - pain in the area of ​​the projection of the joint, which increase during exercise( walking).The pain syndrome can reach such intensity, that the patient loses ability independently to move. Osteoarthritis can not be cured by conservative methods. With proper traditional treatment, only maintaining the state of remission is possible. So, the replacement of the hip joint is the only way to restore health and keep working capacity. The duration of the operation is 1-3 hours. It depends on what prosthesis is performed - full or partial. The patient is under general or spinal anesthesia. For rapid recovery and optimal treatment results, several hours after the end of the operation, special exercises should be started.

Rehabilitation stages

Initial phase( 1st postoperative day)

The first step is to set out a set of exercises necessary to improve blood circulation in the legs and prevent the formation of blood clots. Such a gymnastics is performed sitting or lying 3 times a day with both feet, regardless of whether the joint was replaced on one or both sides.

  1. Static tension of the quadriceps muscle of the thigh.
  2. Flexion of the leg in the knee.
  3. Move the stop up and down.
  4. Raising a straight leg 10 cm from the surface of the bed.
  5. Take the straight leg to the side.

First phase( 2-4 days after surgery)

The patient continues to perform the already existing set of exercises. To them are added new ones.

  1. Raising a leg bent at the knee. The starting position is at the support.
  2. Drawing a straight leg to the side in a standing position.
  3. Take the straight leg back in standing position.

The main goal of this rehabilitation period is to go to full self-service( get up, sit down, walk, visit the toilet yourself).At this time there is a risk of dislocation of the prosthesis. In order to level it, it is necessary to sleep with a pillow between the knees, not to lie down on the operated side and not to keep the knees constantly bent, even if it reduces pain.

Second phase( up to 21 days after endoprosthetics)

Patient needs to continue to increase the load. At the end of the first week, you should learn how to walk neatly up the stairs. When climbing, you first need to step on the operated leg, then healthy, while descending - on the contrary.

The risk of dislocation of the prosthesis is preserved, therefore it is necessary to follow all the recommendations of the previous stage.

Third phase( up to 2 months after surgery)

The phase of active training of the gluteal and femoral muscles. The elastic band acts as a kind of simulator, which allows all exercises to be carried out with resistance( flexion in the hip joint at the support, retraction of the leg in standing position).

The patient should walk frequently and gradually, gradually increasing the time of walking up to 2 hours a day in several stages.

In the department of physiotherapy exercises( in a hospital and an outpatient clinic) the patient is assigned exercises on a stationary bicycle, which perfectly develop muscles, and also pacing on the platform.

Fourth phase( up to 4 months after prosthetics)

This time conceals a hidden danger to patients. Having successfully passed the previous stages of rehabilitation, having learned to walk without a cane, without feeling pain and limitations of mobility, people stop doing exercises. This is a big mistake! Insufficiently strong muscles, especially in the elderly, quickly detune, which increases the risk of injury( falling due to loss of balance, for example).

Exercises to strengthen the leg muscles should be performed regularly for a long time, preferably for life. It is impossible to be trained through pain. However, it is not necessary to confuse the pain in the joint with the pain in the muscles( due to the accumulation of lactic acid) and under this pretext to give up exercise. It is necessary to perform half-squats( strictly with a straight back), pacing, drawing a straight leg with resistance or a little burden, walking along a path or practicing on an exercise bike.

You should also follow a balanced diet. The diet should contain a large number of proteins( except for the sick gout), carbohydrates( preferably long ones, ie cereals, whole-grain baking), fats( with sufficient amounts of omega-3 unsaturated fatty acids from seafood).Proper nutrition will not help gain weight to avoid stress on the joint.

The list of medications will be issued by your doctor. It usually includes vitamin complexes and supplements containing glucosamine and chondroitin in therapeutic doses.

Endoprosthetics of the hip with proper rehabilitation allows the patient to return to daily life in the shortest possible time.


Rehabilitation after hip arthroplasty: motor mode

After completion of the operation to establish an endoprosthesis in the hip joint, a course of restoring the normal functioning of the joint and also the muscles adjacent to it is required. In this case, the duration and effectiveness of the rehabilitation course depends on many factors. Rehabilitation after hip arthroplasty is carried out according to different schemes. Therefore, it is necessary to apply an individual approach to each individual patient.

Much depends on the age of the patient, on his general condition and physical development of the muscles. Accordingly, the older the patient, and also, the more he is physically weakened, the longer the rehabilitation process will take place.

Also of great importance is how much time passed between the trauma and the operation. In the event that a rather long period has passed, most likely, the muscles managed to significantly atrophy, since the damaged joint could not function fully.

A similar situation may occur with arthrosis. If the operation was carried out in a timely manner, when, despite the pain, the person could still move independently, and the muscles had to work, but to the critical point the matter has not yet reached, then the recovery process will be a little faster and more successful.

But it also happens that a person suffers pain for years, hoping that everything will pass by himself. To the doctor, he turns, when the pain becomes quite unbearable, and a person can not simply walk.

In such cases, the muscles have time to atrophy. Accordingly, the process of postoperative rehabilitation will take longer and more difficult. Considering all such factors, it is possible to draw up a general rehabilitation program that is applicable to all patients. This program is based on certain principles and goals, and an individual approach to each individual patient is also applied.

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The rehabilitation process can be broken down into several periods or phases.

Zero phase

This phase of rehabilitation begins a few hours after the operation. First, it is necessary to restore blood circulation. This is required for the normal functioning of the limb and preventing the formation of blood clots in the blood vessels.

As soon as the action of anesthesia passes, it is necessary to do the following exercises( it must be remembered that all exercises should be performed by both legs, not just the patient):

  • Movement of the foot up and down, the so-called "foot pump".Exercise should be repeated several times every 10-15 minutes, as soon as the sensitivity of the foot returns. Do the exercise during the entire rehabilitation period.
  • Rotate the ankle to the right, then to the left 5 times. It should be remembered that rotation should be performed only at the expense of this joint. The knee does not participate in this exercise.
  • Work of the anterior muscle of the thigh( the quadriceps muscle).It is necessary to strain the front of the thigh, straightening. You can pull the socks forward. At first, there will be no full leg straightening, there may be pain. But it is necessary to try, and eventually the exercise begins to work out. Keep the muscles of the front of the thigh in tension takes 5-10 seconds. Repeat the exercise for 10 approaches for both( !) Legs.
  • Bend the knee, moving the heel towards the buttocks. The heel should be pressed against the surface. The knee should not rotate to the other leg. The hip joint should not bend more than 90 degrees. Repeat exercise 10 times.
  • Squeeze the buttocks and hold in tension for 5-7 seconds. Repeat the exercise should be at least 10 times.
  • In the lying position, move the elongated leg sideways to the maximum possible distance, then return it to its original position. In postoperative days, this exercise is likely to fail, but over time it begins to work out. Repeat exercise 10 times.
  • Raise the straightened leg up a few centimeters. As in the previous case, this exercise can not be performed first. Repeat the exercise 10 times.

The first phase of

The next phase of rehabilitation after endoprosthetics begins on the 2nd day after the operation. At this time, the patient will be able to get up and move gently on crutches, leaning against the injured leg, but not at full strength. Over time, this load will increase.

The purpose of the 1st phase of rehabilitation is to restore the person's ability to move independently, including on the stairs( at first, of course, using crutches).

When traveling, it is important to follow certain rules, namely:

  • To prevent dislocation, it is necessary to bend the leg in the hip joint by no more than 90 degrees. It is forbidden to cross your legs, squat and toss your foot on your leg, when such an opportunity will appear due to the subsidence of pain.
  • In order to avoid similar actions in a dream, it is necessary to lay cushions between the legs.
  • You can sit down only on such chairs, where the knees will not rise above the level of the navel, that is, the hip joint will not bend over 90 degrees.
  • In the position lying on the back, the legs should be slightly spread apart, as in the sitting position.
  • Do not bend lower than the navel, when dressing shoes or other activities sitting, lying or standing. Always remember about 90 degrees!

Phase 1 exercises:

  1. In standing position, lift the elbow parallel to the ground. Hold the foot in this position for 5 seconds, then lower it. Several approaches are required for this exercise.
  2. In the standing position, straighten the leg and slowly retract( back in the waist can be held by hand).Hold the limb in this position for 5 seconds, then lower it. Repeat the exercise several times.
  3. Standing elongated leg to the side. Hold the limb for 5 seconds, then lower it. Repeat the exercise several times.
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The second phase of

This phase of rehabilitation after hip replacement begins about a week after surgery, includes exercises whose task is tomoving the patient on the stairs. They are carried out only with the supervision and assistance of a doctor, so here we will not touch on these exercises, since it is necessary to guide the attending physician, which is based on the patient's condition, as well as some other factors.

Video: "Endoprosthetics of the hip joint: exercises"

The third phase of the

The third phase of rehabilitation begins 4-8 weeks after the operation, depending on the physical condition and age of the patient.

In this phase it is necessary to master the movement without crutches, but for the present with the help of a cane.

For the successful implementation of the third phase, the following exercises will help:

  • The elastic band is fastened in front around the ankle, and the other end - to a secure support. In the standing position, move the leg forward, then return it to its initial position. Repeat several times for each leg. This exercise should be done 10 times a day, in the morning, in the afternoon and in the evening.
  • The exercise described above is done exactly the same way, only the elastic band is attached to the back of the ankle. In the standing position, take the leg back, then return it to its initial position. Repeat several times for each leg. This exercise should be done 10 times a day, in the morning, in the afternoon and in the evening.
  • Elastic band fastened to the side of the ankle. Take the straightened leg to the side, return the limb to its initial position. Repeat the exercise several times. Perform 10 sets per day.
  • The exercises on the exercise bike perfectly strengthen the muscles of the legs and develop the mobility of the joints. It is important to adjust the seat so that the legs are as straight as possible and hardly reach the pedals at the lowest point. First you should practice 10-15 minutes 2 times a day. Over time, the load should be increased and dealt with for 30 minutes 3-4 times a week, or more often.
  • It is important to conduct exercises for balance training. To do this, you must stand on one leg, leaning your hand against the wall, and rise up on your toe. Perform 10 repetitions per foot.
  • Walking on the treadmill in the opposite direction. The foot rolls from the fingers to the heel. When the entire foot is placed on the treadmill, the knee is fully straightened. The speed of the track should be 1-2 km / h.

Video: "Rehabilitation after hip arthroplasty: support and movement"

So, after completing the entire course of rehabilitation after hip replacement, as a result of the exercises, a person should completely return the opportunity to walk normally without the help of a cane. In this case, the hip joint restores its functions. This usually occurs 7-8 weeks after the operation. It should be remembered that in order to prevent injuries in the future, you must constantly maintain your body in good physical shape, and after completing the rehabilitation course, you must perform all the above exercises.


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