Following hip surgery, a walker is a necessary tool for regaining independence and motion. Mobility is a significant component of recovery, helping to prevent complications and restore muscle function. Using a walker correctly is paramount to maintaining the integrity of the surgical repair and preventing a fall. This assistive device provides a stable base of support, allowing you to gradually increase activity while adhering to your surgeon’s specific weight-bearing instructions. Learning the correct techniques for adjusting the device and navigating daily movements ensures your recovery is safe and effective.
Adjusting the Walker for Optimal Safety
Properly setting the walker’s height is the foundational step for safe and effective use. When standing upright with your arms relaxed at your sides, the top of the walker handles should align with the crease in your wrists. This specific measurement ensures that when you grasp the handles, your elbows have a slight bend, ideally between 15 and 30 degrees. Incorrect height—either too high or too low—can lead to poor posture, causing unnecessary strain on your shoulders and back, and reducing your ability to transfer weight effectively through your arms.
Before relying on the walker for support, always confirm that all four legs are stable and resting firmly on the floor. A standard walker, rather than a four-wheeled rollator, is often recommended immediately after hip surgery because it offers a more secure platform for offloading weight. The two-wheeled walker is often preferred as it allows for a more fluid movement while still providing a secure base when pressure is applied through the hands.
Mastering the Basic Post-Surgery Gait
The process of walking with a walker, known as the gait sequence, must be performed deliberately to protect the healing hip joint. The general sequence involves three distinct movements: moving the walker, stepping with the operated leg, and then stepping with the unoperated leg. First, position the walker a short, comfortable distance—about one step length—in front of you, making sure all four tips contact the ground before proceeding. This forward placement establishes a stable base to prepare for the transfer of weight.
Next, step forward with the leg that had surgery, planting the foot within the boundaries of the walker. As you do this, you must simultaneously press down through your arms into the walker handles to accept the majority of your body weight, thereby reducing the load placed on the operated hip. The amount of weight you place on the operated foot will be dictated by your weight-bearing status, which must be strictly followed. The sequence concludes by bringing the unoperated leg forward, stepping past the operated leg to complete a near-normal stride. Maintaining this rhythm—walker, operated leg, unoperated leg—minimizes irritation to the surgical site.
Safe Techniques for Sitting, Standing, and Turning
Transitions between sitting and standing are high-risk moments where falls or excessive strain can occur, requiring specific techniques to maintain hip safety. To sit down, back up slowly until the backs of your unoperated legs are touching the chair or seating surface. Slide the operated leg slightly forward to keep the hip angle open and prevent bending past 90 degrees, which is a common hip precaution. Reach back for the chair’s armrests, or the seat itself, with both hands, using them to slowly lower your body into the seat.
When preparing to stand, scoot your body to the edge of the seat, keeping the operated leg extended slightly in front of you. The power for standing should come from pushing off the armrests, not from pulling up on the walker, which is unstable and can tip. Once upright and balanced, you can then grasp the walker with both hands. Turning should be executed by taking several small, deliberate steps, pivoting the entire body as a unit. Never attempt to twist your body or pivot on the operated leg, as this twisting motion can lead to dislocation of the hip joint.
Essential Safety Guidelines and Weight-Bearing Status
Weight-Bearing Status Definitions
Strict adherence to your surgeon’s specific weight-bearing instructions is mandatory for proper healing. These instructions dictate how much pressure you can safely place on the operated leg:
- Non-weight bearing (NWB) means the operated foot cannot touch the floor at all.
- Touch-down weight bearing (TDWB) allows the foot to lightly contact the ground only for balance, often described as not crushing an egg under the foot.
- Partial weight bearing (PWB) permits a specific fraction of your body weight, such as 20% or 50%, to be applied.
- Weight bearing as tolerated (WBAT) means you can apply weight up to the point of discomfort, using pain as your guide.
Hip Precautions and Home Safety
In addition to weight limits, you must follow specific hip precautions, which are put in place to prevent the new joint from dislocating. These precautions include:
- Never bending your hip past 90 degrees, which means avoiding leaning forward to pick up objects from the floor.
- Avoiding crossing your legs or ankles.
- Refraining from twisting your body at the waist.
Clearing your home environment of tripping hazards, such as loose rugs, cords, and clutter, is necessary to ensure a safe path of travel. Stairs should only be attempted under the direct guidance of a physical therapist.