A while back, when seeing another health professional for my hip ache, I was told was that I’d likely need a hip replacement when I’m older.
My hip was painful after trying to run. A few assessments were done, and I was told that I had femoroacetabular impingement. A mouthful really. Maybe I do, maybe I don’t, I never did get the scans. But, being the slightly-sensible-but-determined person that I am… I stopped trying to run, but I kept hiking, and intend to keep up my Bowen in the hope that I won’t need ever that hip replacement.
Other people aren’t so lucky. Many older people have arthritic joints, have falls, and are often forced to have a hip replacement.
One such person is a current client. He had a fall, requiring hip replacement surgery. That was about 9 months ago, and he still wasn’t walking well.
Why does someone need a hip replacement ?
The hip joint is a ball and socket, with the ball at the top of the thigh bone sitting nicely in the socket of the pelvis. The bones are covered with cartilage, providing cushioning. When the hip functions normally, the ball is able to move smoothly in the socket.
If the cartilage in the joint becomes damaged, or if the joint is not aligned properly, the cartilage can wear out more quickly than normal. This wear could cause bone to be exposed, resulting in bones rubbing against each other, making the joint painful and stiff.
Hip replacement surgery is often recommended when:
– the hip has been in pain for an extended time, making moving difficult
– painkillers or anti-inflammatories no longer reduce pain
– there is hip pain even when resting in bed
– using physical aids such as a walking stick no longer help
What happens in hip replacement surgery ?
In hip replacement surgery, the damaged cartilage and bone is removed, and replaced with a prosthetic joint.
The hip and thigh will be cut open and muscles connected to the thighbone moved to access the hip joint. The hip will be dislocated to separate the ball from the socket.
The damaged ball at the top of the thighbone is then cut off. An artificial ball, attached to a long stem, is inserted into the thighbone.
The hip socket is hollowed out, then replaced with an artificial cup-shaped socket.
A spacer (plastic, ceramic or metal) replaces the cartilage, to provide a smooth surface between the ball and socket.
Then the ball is put back into the socket, to re-create the joint, and the skin cut closed.
What’s the normal recovery process ?
Within a day of surgery, most will see a physical therapist to begin exercises. The goal is to help re-strengthen muscles around the joint. Within a couple of days, exercises will continue, including walking with the help of sticks, crutches or a walking frame. The pain would also be subsiding.
After 3-5 days, most people are usually well enough to return home. However, it’s not yet life as normal. Driving won’t yet be possible, and exercises will need to continue. Around the 2 week mark, the stitches are removed, if they’re not dissolvable.
3-6 weeks after surgery, most people can resume normal light activities A little pain or discomfort may remain, especially near the end of the day. Crutches or a stick may still be needed at times. Being able to drive may depend on whether the car is manual or auto, and which hip is involved.
During this time, there are certain movements that should be avoided. Crossing legs or twisting the hip inwards or outwards may increase risk of straining the scar or dislocating the joint.
Depending the type of work, many people can usually return to light work after about 6 weeks. However, work that requires a lot of standing or lifting would likely require longer time before returning.
After about 3 months, most people feel like themselves again. Swelling will have eased, pain will likely be gone, moving about will be easier. Most people can probably do most of their usual day to day activities.
Bowen Therapy is a very gentle form of bodywork. Small, gentle, precise moves are made on muscles, tendons, ligaments and nerves, triggering the body to begin a healing process. The treatment initiates changes in the body that may continue for up to a week.
Bowen influences the body through the connective tissue known as fascia. Fascia plays a major role in muscle coordination, postural alignment, and overall structural and functional integrity.
A Bowen treatment aims to help the body as a whole – helping bring the body back into balance, while also addressing the injury/pain site. Posture and compensatory patterns are also assessed, to ensure the problem has a higher chance of staying resolved.
Bowen Therapy for hip replacement
Bowen is a great choice to help a person’s body both prepare for medical procedures, as well as for helping the body recover.
Chances are that the body was not in the best of shape prior to needing surgery. The body was likely moving differently, holding itself not right, compensating to help manage pain or enable movement. The fascia restrictions and muscle memory won’t disappear with surgery, and the body won’t suddenly gain alignment.
Surgery causes disruption to the body, not just at the site of surgery but also the muscles and tissues in surrounding areas. The hip is being dislocated. Muscles and ligaments are being pulled and stretched to enable that hip joint to be accessed and replaced.
Even with all due care by expert surgeons, many bodies will not become perfectly aligned post-surgery. There is a chance that the leg may be a slightly different length. It’s possible that the pelvis won’t quite sit the same. Joints will bear weight differently. Other muscles will begin to adapt as the body tries to adjust to a new normal. The exercises give by a physical therapist will be great for building new strength, but for many those exercises alone could feel too slow.
A complementary therapy such as Bowen Therapy can help begin to address these compensations and posture patterns prior to surgery. Post-surgery, Bowen can also help gain alignment quicker, to enable faster recovery, and help return to normal life as soon as possible.
Bowen Therapy to help hip replacement recovery
In the case of my recent client, he’d taken a fall. The hip was “broken” and he’d had full hip replacement surgery.
The surgery was 9 months ago, and unfortunately recovery was slow. He was doing all the exercises given, and some more, but making no progress. His pelvis was uneven. His knee wasn’t sitting right, giving him pain and it wasn’t strong. His foot was also quite stiff, unable to flex as well as he’d like, so he could move easily. He was needing to use a walking frame to walk anywhere.
A relative was convinced that Bowen Therapy would help.
The first treatment was a little challenging – he insisted on getting on the table to be treated, rather than seated, despite having trouble just getting in the front door !
When I saw him next, he was without his walking frame. He was still being guided, a hand on the elbow, to be sure he remained stable on his feet.
As he arrived for a third treatment, again without the walking frame, he was waving away the helping hand, insistent that he was okay. His main complaint was that his ankle wasn’t flexing enough, giving him the risk of tripping as he walked.
Within the space of a few Bowen treatments, he had moved from being reliant on a walking frame to being able to move about independently again.
MRI of pelvis – © Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
diagram of hip replacement – By BruceBlaus (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
xray of hip replacement – © Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons