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This article answers the question” “Can I sit in my recliner chair after my total hip replacement surgery?”
This is the question almost every total hip replacement patient asks me on my first visit to see them in their home to initiate their home physical therapy rehabilitation, about two days after the surgery.
Most have already discovered the recliner to be the most comfortable chair in their home, but they want to be sure what they are doing is acceptable. Some are even sleeping in their recliner chairs.
Can I sit in a recliner after hip replacement?
A recliner chair is the chair of preference after total hip replacement surgery, but be sure the reclining mechanism has a side-lever footrest action control and does not require leg power to return the footrest.
Power-lift chairs can help patients maintain range-of-motion restrictions.
The really great news is, that the answer applies regardless of the surgical approach the surgeon has chosen to replace the hip, be it posterior, lateral, or anterior.
However, one must be cautious about allowing the hip to flex more than 90 degrees, if that is a range of motion restriction a patient has been issued from their surgeon.
While sitting or reclining it is easy to observe the 90-degree flexion restriction by merely reclining the chair-back a little, but be careful the 90-degree restriction is not broken as the patient scoots back in the chair getting in, and scooting forward getting out of the recliner.
Surgeons put range-of-motion restrictions on some surgical approaches, mainly the posterior and lateral total hip replacement approach surgeries.
They do this to prevent the patient from “stretching” the joint capsule that had to be cut to get inside the hip joint to replace it.
Certain Ranges of Motion can put the surgical site of the joint capsule under stress before the patient reaches a functional end range of motion, therefore the surgeon will limit the patient’s functional range of motion.
Posterior and Lateral Hip Replacement Range Of Motion Restrictions:
Most frequently the surgeon limits the patient’s functional range of motion by instructing the patient:
- No bend of the hip into flexion greater than 90 degrees.
- No crossing the legs.
- No internal rotation.
Anterior Hip Replacement Range Of Motion Restrictions:
The huge advantage an anterior hip replacement surgery has over a posterior or lateral approach total hip replacement is……..
There are almost no range of motion restrictions with the anterior hip replacement approach surgery!
Almost all the total hip replacement patients I now see had the anterior approach.
The only range of motion restrictions these patients have are “no extreme extension with external rotation”.
The only way a patient would ever possibly get into this position would be to do a kneel-down lunge exercise and turn the toes outward in that position. I never do lunge exercises with any of my total hip replacement patients, regardless of what approach the surgeon has utilized.
So recliner chairs work great for the anterior approach to total hip replacement also.
How A Recliner Chair Helps The Patient Follow The Doctor’s Range Of Motion Restrictions:
No bending the hip into flexion greater than 90 degrees
Translated, this means that bending the hip into flexion more than 90 degrees will put unwanted stress on the joint capsule in the area where surgical stitches hold that joint capsule together.
This is where the recliner chair really helps the patient.
There is a concept in physical therapy that is referred to by therapists as “the loose-pack position” of a joint.
Loose-pack position simply means the position where the specific joint is placed in a position whereas all portions of the joint capsule are in their relaxed state and all portions of the joint capsule are under no stress.
For the hip joint, that is about 15 degrees of flexion (hip bend) with just a slight bit of abduction (leg out to the side of the body).
A recliner chair can allow a total hip replacement patient to get into that loose-pack position by just reclining to that position.
A recliner chair also allows the patient to find a sitting position that is comfortable to converse or watch television with much less than 90 degrees of flexion; something that cannot be achieved in any non-reclining chair.
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No crossing the legs
As for the “no crossing the legs” restriction, sitting in a recliner chair seems to inhibit the desire for a person to cross their legs, so it helps with this restriction as well.
No internal rotation
The final restriction is “no internal rotation” of the leg.
Standing “pigeon-toed” is internal rotation, the toes point toward each other.
Sitting in a recliner chair does the exact opposite. People sit in a recliner and let their toes drop out to the side. This position is perfect for preventing the leg from internally rotating.
The Problem With Recliner Chairs After A Total Hip Replacement
For the total hip replacement patient who has had an anterior surgical approach, there is no problem.
However, there is a problem for patients who have had the posterior or lateral approach and have that “no bending past 90 degrees” range of motion restriction.
Recliner chairs are more difficult to get out of than a standard non-reclining chair.
First, in the non-reclined position, the patient sits deeper into the recliner chair than in a non-reclining chair. This forces the patient to “scoot to the front of the chair” to get in position to get up out of the chair.
The act of scooting to the front of the chair is much more difficult if the hip is not flexed greater than 90 degrees. The patient must rely on good arm strength to lift the entire body weight out of the chair seat in order to move the buttocks to the front of the chair without bending more than 90 degrees at the hip.
Some of my patients have purchased a recliner-lift chair to solve these problems.
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Two reasons my total hip patients tell me they purchased a recliner-lift chair are:
- To help them maintain the range of motion restrictions of no bending past 90 degrees for my posterior and lateral approach hip replacement patients.
- To help them get up out of the chair because of decreased arm strength. This applies to all surgical approaches if there are arm strength issues.
How A Recliner Chair Helps Leg Swelling After Total Hip Replacement
Another thing that my total hip replacement patients have been told to do is to elevate the leg above the heart to help reduce and prevent swelling.
While this is great advice, getting into a position where the leg is higher than the heart usually requires the patient to lie flat on the bed and prop the leg up onto something, usually stacked pillows.
This is a very non-functional position to do ANYTHING, even including watching television.
Most of my patients will not tolerate this position for very long before they are up and changing to a more functional position.
It is true, sitting in the dependent position (sitting with the feet on the floor) can and does cause circulation problems which left unaddressed can lead to stasis ulceration. I instruct all my total hip patients to limit sitting in the dependent position to no more than 15 minutes before elevating the leg.
The good news is, that my patients do fine without putting the leg above their heart. Sitting in a recliner chair elevates their leg to near horizontal, even though the leg is not higher than the heart.
If I had a total hip replacement patient who also had a diagnosis of heart failure, I certainly would encourage them to place the leg above the heart. Then again, I would not expect a person with heart failure to even be a candidate for hip replacement.
My advice is for every total hip replacement patient to have a recliner chair, be it manual or lift-assist, for at least the first couple of months after surgery.
The very best scenario is for the total hip patient to have the recliner chair for a month or more before the surgery so the chair is already “broken in” before the surgery.
Take into consideration:
- Do I need a zero-wall clearance recliner chair?
- If it’s a recliner-lift chair, where can I put the chair in my home that has access to a power outlet?
- If it’s a recliner-lift chair, does it have a weight restriction?
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One option would be to do as I am doing.
Read my article How To Generate Retirement Income: Cash In On Your Knowledge.
For more information about total hip rehabilitation and expectations, read my additional articles on Total Hip Replacement.
Happy Recovery In Your Recliner
Paying It Forward
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