Friday Q&A: Recovering From a Hip Fracture

Fractured Hip Before Repair

Fractured Hip After Repair

Q: This info most helpful, but could you give me info on Yoga after fractured hip repair? My doctor said I did not need a total hip replacement because I have strong bones, no arthritis and no osteoporosis (do have osteopenia). He is saying no yoga for 4 mos., so bones heal completely OR I could end up having to have a total hip replacement. Appreciate any advice. Thank you 

A: We received the above inquiry about Nina’s recent post All About Hip Replacements and Yoga. Nina’s immediate response was spot on: "Will forward this to Baxter. But keep in mind we can't give specific advice to you without seeing you in person. Hope you understand that! Also, there is a lot of yoga that doesn't involve asanas that you could practice in the meantime: Savasana, pranayama, meditation, studying yoga philosophy, etc."

I should begin by clarifying that Nina’s post All About Hip Replacements and Yoga was specifically looking at the use of yoga for total hip replacements, which are usually elective procedures done mostly for those with severe arthritis of the hip joint. Our writer is in a different boat, having apparently suffered a recent hip fracture, presumably following a fall of some sort. In the face of acute trauma such as this, there are any number of possible ways an orthopedic surgeon might repair a fractured hip, depending on where the break is on the thigh bone and whether the bones are lined up or displaced. For example, my mother fell and broke her thigh bone a few years back while gardening, and because of the location of the break and the offset alignment of the two parts of the bone, a metal rod with teeth—which looked like a comb with only five teeth—was used to keep the two parts of her femur bone together as they healed. So, no total hip replacement for my mom, either! However, she still started limited physical therapy shortly after her surgery, which progressed in challenge as her pain subsided and she began to get stronger. 

As for our reader, first of all, I want to say that you should follow your doctor's instructions regarding yoga. But even if you have been warned off yoga by your doctor for now, it is likely that you, too, will be doing some sort of physical therapy in the meantime. So you could apply yoga mindfulness practices and yoga bodily awareness and focus to whatever exercises you are doing in and out of physical therapy. (But it actually might be worth the time to check in with your doctor and physical therapist regarding their understanding of yoga asana and its adaptability. After you educate them with an explanation of the wide variety of ways that yoga can be modified to meet the person where they are at, that they might revise their caution regarding yoga asana in the first four months.)

Next, because a common result of acute fracture of the hip is pain, you can also use yoga for pain management. In fact, one of the primary goals of physical therapy and rehabilitation after surgery is to reduce pain. So, leaving yoga asana out for now, I recommend that anyone recovering from a hip fracture use the other tools in our Yoga for Healthy Aging kit, especially practice pranayama and meditation, to assist in pain management. We’ve written extensively about this, so check out this post Yoga for Pain Management: The Big Picture, which provides an overview of the information we have on pain management: 

It is also common for those suffering hip fractures to experience fear regarding future falls, increased levels of stress, and/or increased rates of depression and anxiety. Again, yoga tools can be a very good adjunct to a more broad-based approach to these issues that your doctor may already have recommended. Here are some posts with helpful information.

Yoga for Anxiety: Yoga for Anxiety: The Big Picture

Yoga for Depression: Practicing Yoga for Depression: An Overview

Yoga for Stress Management: Stress Management for When You're Stressed

Practicing Yoga Mindfully (which could you could to doing physical therapy if you are not practicing asana): Coming to Your Senses in Yoga Poses 

So, even if you are recommended to hold off on doing yoga asana for a period of time following a hip fracture repair, you are now armed with a whole lot of information and tools that can help you on your road to recovery! 

NOTE: While it sounds like our reader may not be in the acute hospitalized period just following fracture repair, it is worth mentioning for others who may face this situation in the future that there is up to a 20% chance of complications following fracture repair surgery in adults over 65. This can include altered mental status, cardiac and vascular issues (such as irregular heart rhythms, heart failure, heart attacks, blood clots in the leg veins or to the lungs), as well as lung and gastrointestinal issues. The chances of these problems occurring is highest right after surgery while a person is recovering in the hospital. If you are already a yoga practitioner, your increased levels of interoception (the awareness of your internal body moment by moment) could clue you into potentially problematic changes that you should bring to the attention of your health care team as soon as possible. 

—Baxter

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