Read on: danhwilliams.com

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Last week in the Check-up I saw: 

• A 74-year-old woman
• 5 years post hip replacement
• ‘Generally doing well..’ but some pain.

 
My Thoughts

There was a bit of back, BUT..
Mainly muscle pain..

..AND, importantly, the hip replacement was okay.
 

My Advice

Back => General strengthening
Low impact activity. Indoor exercise or static bike cycling provides the right mix of movement for a stronger, more flexible back.

MRI imaging / injection / surgery NOT necessary, because..
Sciatic nerve stretch NEGATIVE.


Muscle => Specific gluteal muscle strengthening.


Hip Joint => Reassure. Stay active.
Maintain good bodyweight. Next check 5 years (flex as required).
 

Here comes the detail...

These paragraphs or 'inserts' are right out of my clinic letter.

I've found adding these evidence-based inserts to all patient letter helps people.
We all get a lot of communication. So, a bit of repetition of key HELPFUL messages, really HELPS.

Your healthcare pro' is welcome to steal these inserts.
And add them to their word documents under the suggested [code].

 
Exercise bike cycling [EB1]

I suggest getting the exercise bike out of the shed, particularly over the winter months when you are unable to walk so much.

Put it in front of the telly or listen to the radio (‘cos it can be a bit boring).
Seat nice ‘n’ high => heel on the peddle, should be able to just lift your bum off the seat.

Build low impact exercise bike cycling if possible, from 1 minute daily in week 1, to 2 minutes daily in week 2, to 3 minutes daily in week 3 etc. until doing 20 to 30 minutes on most days.

Scaling up activity slowly is important.
This keeps the leg and back muscles strong.


Lateral straight raise [AS1]*

*NO WEIGHT NECESSARY!!

I suggest lateral straight raise exercises out to the side, building from 2-4 sets of these per day building from 3-5 repetitions each set to 10-15 repetitions.

Starting stood upright, holding on to a support..
And move the leg slowly and widely out to the side..
Repeating 3-5 times building slowly to 10-15 times over several weeks.

Once comfortable doing that I would recommend lifting the leg against gravity by lying on the opposite side and lifting the leg to the ceiling.

Again, start by repeating 3-5 times building slowly to 10-15 times over several weeks. Scaling up slowly and consistently is important.
 

Anything else?

Consider swimming with friends or family which is good for your lower back and general strength.

And keep a record of your pain. We use an Oxford pain + function score on My Clinical Outcomes...

If that's all in place we stick to routine follow-up.

Important that these are principles that you or you healthcare pro' can personalise.

Making these general + specific exercise work for you is key.
To work, they've got to stick 😀

And I say to my patients =>  ask if anything is unclear. 

So please do the same here: hit reply if you've got questions.

1000s of my patients achieve statistically high gains in pain + function by following this advice. That's compared to other UK hip + knee patients.

Please feel free to recommend this week’s newsletter to your healthcare pro:  

• Practice nurse
• Physio or
• GP. 

My colleague's copy + paste this evidence-based advice into leaflets and future patient letters to help others. Your healthcare team is welcome to do the same.

Forward this email on, subscribe for FREE at www.danhwilliams.com/#subscribe or hit the button at the bottom.

And catch up on past Newsletters at the same link.

Good luck!