Hip pain after a total knee replacement (TKR) is a common but often unexpected challenge during recovery. While the procedure addresses the knee joint, the body’s response to surgery can shift strain to the adjacent hip. Understanding that the body works as a connected chain is the first step toward managing this discomfort. This article provides strategies to relieve and manage hip pain during recovery.
Why Hip Pain Occurs After Knee Surgery
The sudden development of hip pain is often a direct result of changes in the body’s walking pattern, known as altered gait. Before surgery, the painful knee caused the body to adopt a specific protective movement pattern. This lingering pattern does not immediately disappear after replacement, causing the hip joint to take on a disproportionate amount of force during walking and standing.
The muscles surrounding the hip, particularly the abductors and flexors, must work harder to compensate for the surgical knee’s initial weakness. This compensatory effort leads to irritation, inflammation, and strain in tissues not targeted by the surgery. Hip pain may also be referred pain, occurring because the sensory nerves serving both the hip and knee originate from the same spinal region.
Occasionally, the pain signals a pre-existing issue, such as hip osteoarthritis, that was masked by the severe knee pain. Once the knee pain is resolved, the underlying hip condition becomes noticeable. Identifying the cause of the pain helps target the most effective recovery strategies.
Quick Relief Through Passive Modalities
Immediate relief for hip discomfort can be found through simple, non-movement-based strategies used at home. Over-the-counter pain relievers are effective, but patients must follow their surgeon’s specific post-operative medication schedule. NSAIDs like ibuprofen, or Acetaminophen, can be used for comprehensive pain control, but always verify this with a medical professional first.
Applying cold therapy directly to the painful hip area can decrease inflammation and numb the local tissues. Ice packs should be used for intervals of 20 to 30 minutes, separated by a 30-minute break, and should never be placed directly onto the skin. Heat therapy, such as a warm towel or heating pad, can be applied to relax stiff or strained muscles before engaging in physical activity or stretching.
Proper resting alignment is another passive way to manage strain on the hip and knee. Elevating the surgical leg helps reduce overall swelling, which contributes to discomfort. When lying down, placing a pillow between the knees helps maintain neutral hip alignment, preventing the upper leg from straining the hip joint.
Mobility Exercises and Posture Adjustments
Active management is the most effective long-term strategy for eliminating hip pain, focusing on strengthening the surrounding muscle groups and correcting posture. Gentle, daily exercises are necessary to restore muscle balance lost due to the altered gait pattern.
Strengthening Exercises
These gentle movements help re-engage hip stabilizers and restore muscle balance. A foundational exercise is the Glute Set, which involves lying on your back and squeezing the buttock muscles for a five-second hold. Straight Leg Raises involve lifting the straight leg about a foot off the bed while keeping the thigh muscles tight, strengthening the quadriceps and hip flexors. Additionally, Hip Abduction involves sliding the surgical leg out to the side while keeping the knee straight and the heel in contact with the bed, targeting the hip abductor muscles.
Posture Adjustments
Posture adjustments during daily activities are important for managing strain. When sitting, ensure the hips are not flexed past 90 degrees to relieve strain on the hip flexors. When walking, focus on gradually increasing the duration of your walks to avoid overstressing the recovering muscles. Consciously working to reduce any limping pattern helps normalize the gait and reduce compensatory effort in the hip.
Warning Signs Requiring Doctor Consultation
While some hip pain is typical during post-TKR recovery, certain symptoms suggest a more serious issue requiring immediate medical attention. Any sudden, sharp, or debilitating pain that prevents weight-bearing or walking should prompt a call to your surgeon. Pain that rapidly increases in severity instead of slowly improving is also a cause for concern.
Red flags for potential complications include pain accompanied by signs of infection, such as a fever, chills, or excessive redness or discharge around the knee incision site. Neurological symptoms, including a new onset of tingling, numbness, or pain that radiates sharply down the leg, may suggest nerve irritation or damage. These symptoms require a professional medical assessment.