Distal Humerus ORIF — Complete Exercise Program

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck your elbow in at your side, bent to 90 degrees, and hold a hammer by the end of its handle.
2. Slowly rotate your forearm to turn the palm up, then down, through a comfortable range.
3. The hammer head swings from one side to the other as you turn — that arc is the whole movement.
4. Keep the elbow pinned to your side throughout.

Tips:

• Holding the hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.
• No hammer? A light hand weight works the same way.

Commonly done as 2–3 sets of 10–12 each way, most days.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Arm Nerve Glides

Gentle movements that help a neck nerve slide freely down the arm.

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tips:

• Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.
• Small, smooth, repeated movements — not a hard stretch.
• Stop and check with your care team if symptoms steadily worsen.

Commonly done as 2–3 times sets of 10–15 slow glides, daily.

Wrist Isometrics

Gentle no-movement holds that calm tendon pain while keeping the muscles active.

What it helps: Loads the forearm tendons gently without movement — a comfortable way to keep them strong and often to ease tendon pain before they're ready for moving resistance.

1. Rest the forearm on a table, hand off the edge. For extensors: make a light fist, push the back of the hand up against your other hand — no movement — and hold.
2. For flexors: push the palm down against your other hand and hold.
3. Use comfortable pressure; the wrist stays still.

Tips:

• No movement happens — you're holding against resistance.
• Start light; isometrics often ease tendon pain, so find a comfortable level.

Commonly done as 1 sets of Hold 20–45 sec ×3–5, daily.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• If your arm is in a sling, leave it there. This works just the same.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Gentle Neck Isometrics

A steady, held press against your own hand — strengthens the neck with no movement.

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tips:

• Light pressure — about 20–30% effort. This is not a strength test.
• No actual neck movement: the head stays still while the muscles work.
• Keep the gentle chin-tuck throughout.

Commonly done as 5 each direction sets of Hold 5–10 seconds, daily.

Core Activation

Gentle core engagement to support posture and balance while you recover.

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

1. Lie or sit comfortably.
2. Gently draw your belly button toward your spine.
3. Hold a few seconds while breathing normally, then relax.

Tips:

• Avoid holding your breath.

Commonly done as 2-3 sets of 10, daily.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck your elbow in at your side, bent to 90 degrees, and hold a hammer by the end of its handle.
2. Slowly rotate your forearm to turn the palm up, then down, through a comfortable range.
3. The hammer head swings from one side to the other as you turn — that arc is the whole movement.
4. Keep the elbow pinned to your side throughout.

Tips:

• Holding the hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.
• No hammer? A light hand weight works the same way.

Commonly done as 2–3 sets of 10–12 each way, most days.

Forearm Stretch (Flexors & Extensors)

Stretches the muscles of the forearm that attach at the elbow.

What it helps: Loosens the forearm muscles that attach at the elbow — easing the tension that pulls on irritated tendons and limits comfortable wrist and grip use.

1. Straighten the arm in front of you, palm down. With the other hand, gently bend the wrist down until you feel a stretch along the top of the forearm (extensors).
2. Then turn the palm up and gently bend the wrist down to stretch the underside (flexors).
3. Hold each gently; keep the elbow straight.

Tips:

• A gentle, steady pull — never sharp.
• Keeping the elbow straight makes the stretch reach the muscles that attach there.

Commonly done as 3 sets of Hold 20–30 sec each, daily.

Wrist Curls

Strengthens the forearm muscles in both directions.

What it helps: Builds balanced forearm strength in both directions — the everyday strength behind a comfortable, capable wrist and grip.

1. Rest your forearm on a table with your hand just past the edge, holding a light weight.
2. Palm up: curl your wrist upward, then lower it slowly.
3. Turn your forearm over so the palm faces down, then lift the back of your hand upward and lower it slowly.
4. Move smoothly through a comfortable range.

Tips:

• Light weight, controlled motion.
• Your forearm stays resting on the table — only the wrist moves.
• Build the forearm in both directions for balance.

Commonly done as 2–3 sets of 12–15 each, most days.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Arm Nerve Glides

Gentle movements that help a neck nerve slide freely down the arm.

What it helps: Helps an irritated neck nerve glide freely down the arm, which can ease arm pain, tingling, or numbness. Gentle, repeated motion — never forced.

1. Sit or stand tall. Start with the affected arm out to the side, elbow bent, palm up.
2. Slowly straighten the elbow and ease the arm out while gently tilting your head AWAY — then return as you tilt the head back toward that side.
3. Move smoothly in and out of the range, like flossing — never holding at the end or pushing into symptoms.

Tips:

• Gentle is the rule — ease back the moment it provokes sharp or shooting arm symptoms.
• Small, smooth, repeated movements — not a hard stretch.
• Stop and check with your care team if symptoms steadily worsen.

Commonly done as 2–3 times sets of 10–15 slow glides, daily.

Pendulum Swings

Gentle, relaxed swinging that eases the shoulder into motion without the muscles having to work.

What it helps: Coaxes the shoulder through gentle motion with the muscles relaxed — keeping the joint moving and easing stiffness when active movement is still uncomfortable.

1. Lean forward and support your good arm on a table or chair, letting the sore arm hang down relaxed.
2. Let the arm swing gently — small circles, then forward-and-back and side-to-side — using a gentle sway of your body, not the shoulder muscles.
3. Keep it loose and pain-free, like a relaxed pendulum.

Tips:

• The movement comes from rocking your body, not from working the shoulder.
• Keep the swings small and comfortable.

Commonly done as 2–3 sets of 1–2 min, a few times a day.

Scapular Retraction

Gentle shoulder-blade squeezes — safe immediately, because the shoulder joint itself does not move.

What it helps: Keeps the muscles that position the shoulder blade working while the shoulder joint itself is resting. Those muscles set the platform the whole shoulder moves on, and they weaken quickly in a sling, which makes the later recovery harder than it needs to be.

1. Sit or stand tall with your arms resting at your sides.
2. Draw both shoulder blades gently back and down, as though squeezing them toward each other.
3. Keep the movement small and slow. Your arms should not move at all.
4. Hold briefly, then relax completely.

Tips:

• Small is correct. This is a squeeze between the shoulder blades, not a shrug and not an arm movement.
• Because the shoulder joint stays still, this is usually allowed from the first days — check with your care team if unsure.
• If your arm is in a sling, leave it there. This works just the same.
• Easy to do sitting at a desk or watching television, several short sets through the day.

Commonly done as 2–3 sets of hold 5s, 10 times, daily.

Stationary Bike

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

1. Set the seat so pedaling is comfortable.
2. Pedal at an easy pace.
3. Increase your time gradually.

Commonly done as directed.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck your elbow in at your side, bent to 90 degrees, and hold a hammer by the end of its handle.
2. Slowly rotate your forearm to turn the palm up, then down, through a comfortable range.
3. The hammer head swings from one side to the other as you turn — that arc is the whole movement.
4. Keep the elbow pinned to your side throughout.

Tips:

• Holding the hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.
• No hammer? A light hand weight works the same way.

Commonly done as 2–3 sets of 10–12 each way, most days.

Wrist Curls

Strengthens the forearm muscles in both directions.

What it helps: Builds balanced forearm strength in both directions — the everyday strength behind a comfortable, capable wrist and grip.

1. Rest your forearm on a table with your hand just past the edge, holding a light weight.
2. Palm up: curl your wrist upward, then lower it slowly.
3. Turn your forearm over so the palm faces down, then lift the back of your hand upward and lower it slowly.
4. Move smoothly through a comfortable range.

Tips:

• Light weight, controlled motion.
• Your forearm stays resting on the table — only the wrist moves.
• Build the forearm in both directions for balance.

Commonly done as 2–3 sets of 12–15 each, most days.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Eccentric Wrist Extension

Slow lowering of the wrist that rebuilds the tendons on the outside of the elbow (tennis elbow).

What it helps: Rebuilds the wrist-extensor tendons on the outside of the elbow through slow, controlled loading — the proven way to make tennis-elbow tendons stronger and more resilient.

1. Rest the forearm on a table, palm down, hand off the edge, holding a light weight.
2. Use your other hand to help lift the wrist up.
3. Let go with the helping hand and lower the weight down slowly over 3–4 seconds. Help it back up and repeat.

Tips:

• The work is in the slow lowering, not the lift.
• Start with a very light weight (even a soup can); add load only as it stays comfortable.
• Some mild ache during/after is normal with tendon work.

Commonly done as 3 sets of 10–15, daily (or every other day).

Shoulder Isometrics

Gentle no-movement holds that switch on the shoulder muscles without straining the joint.

What it helps: Activates and strengthens the shoulder muscles with gentle static holds — a comfortable way to build strength early, before the joint is ready for moving resistance.

1. Stand beside a door frame or wall with that arm at your side.
2. Bend your elbow and press the back of your hand gently into the frame. Hold steadily — nothing moves.
3. Then let the arm hang straight down and press the outside of your arm into the frame the same way.
4. Use light, comfortable pressure, hold, then relax.

Tips:

• No movement happens — you're gently pressing against something solid.
• Start at about a quarter effort; never push into pain.
• Pressing the front of your fist into the frame works the front of the shoulder in the same way.

Commonly done as 2 sets of Hold 5–10 sec ×5, most days.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down with your arms hanging and your thumbs pointing up.
2. Y: raise both arms overhead into a wide Y, squeezing the shoulder blades together. Lower.
3. T: raise both arms straight out to the sides into a T. Lower.
4. W: bend your elbows and pull them down and back into a W, squeezing the blades. Lower.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.
• Thumbs stay pointing up throughout.
• If lying face-down is not comfortable, the same three shapes work bent forward at a table.

Commonly done as 2 sets of 8–10 each, a few times a week.

Core Strengthening

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

1. Lie on your back with your knees bent, feet flat and arms resting at your sides.
2. Gently tighten your stomach muscles, as though bracing.
3. Lift your hips until your body makes a straight line from shoulders to knees.
4. Hold for a few seconds, then lower slowly.

Tips:

• Push through your heels and let your shoulders stay resting on the floor.
• Breathe normally through the hold rather than holding your breath.
• The bridge shown here is one of several ways to work the core - your therapist may give you others.

Commonly done a few times a week.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Progressive Strengthening

Gradually increases strength as you recover.

What it helps: Gradually raises the challenge as you get stronger, so your body keeps adapting and improving rather than plateauing.

1. Begin with no added weight and get the movement smooth and comfortable first.
2. When a set starts to feel easy, add a light load - the ankle cuff shown here, a dumbbell or a band.
3. Sit tall, straighten the knee against the weight, hold briefly, then lower slowly.
4. Step the load up in small amounts rather than in jumps.

Tips:

• Progress one thing at a time - more weight or more repetitions, not both in the same week.
• If your form slips before the set ends, the load is too heavy.
• The ankle-weight knee extension is the example drawn. The same rule of small steps applies to whichever exercises your program includes.

Commonly done as directed.

Scapular Y-T-W

Strengthens the muscles between and around the shoulder blades.

What it helps: Builds the mid-back and shoulder-blade muscles that anchor and position the shoulder — the foundation that lets it move and lift without pinching.

1. Lie face-down with your arms hanging and your thumbs pointing up.
2. Y: raise both arms overhead into a wide Y, squeezing the shoulder blades together. Lower.
3. T: raise both arms straight out to the sides into a T. Lower.
4. W: bend your elbows and pull them down and back into a W, squeezing the blades. Lower.

Tips:

• Lead with squeezing the shoulder blades, not shrugging.
• Light or no weight; quality over quantity.
• Thumbs stay pointing up throughout.
• If lying face-down is not comfortable, the same three shapes work bent forward at a table.

Commonly done as 2 sets of 8–10 each, a few times a week.

Biceps Curls (Upper Body)

Builds the arm strength you'll use for a walker or crutches after surgery.

What it helps: Builds the arm strength you rely on for lifting and carrying — and for managing crutches or a walker.

1. Sit tall or stand with your elbow close to your side.
2. Bend your elbow, bringing your hand toward your shoulder.
3. Lower slowly with control.

Tips:

• A light weight or a can of soup works well. Keep your wrist straight.

Commonly done as 2-3 sets of 5-10, daily.

Rowing Machine

Low-impact, full-body conditioning.

What it helps: Full-body, low-impact conditioning that builds strength and stamina without pounding the joints.

1. Sit tall with your feet strapped in, knees bent, and hold the handle with both hands, arms straight.
2. Push through your legs first. Once they are nearly straight, lean back slightly and draw the handle in to your lower ribs.
3. Come back the other way in reverse: arms out straight, then lean forward from the hips, then let the knees bend.
4. Settle into a smooth, continuous rhythm rather than rushing the stroke.

Tips:

• The legs do most of the work — the arms only finish the stroke. Pulling with the arms first is the usual mistake.
• Keep your back straight and the movement coming from your hips rather than rounding your spine.
• It is low-impact, so it is often comfortable early on; let effort build gradually as your stamina returns.

Commonly done as able.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Sit tall in a chair without arms, both feet flat on the floor and your back supported.
2. Hold a light weight in each hand, arms relaxed at your sides, palms turned in toward your thighs.
3. Raise both arms out to the sides until they are level with your shoulders.
4. Lower them slowly back to your sides.

Tips:

• Stay seated and supported while you're non-weight-bearing.
• Light weights are plenty — a resistance band, or no weight at all, works just as well.
• The lift stops at shoulder height.

Commonly done a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

1. Wait until any wound is fully healed and you have been cleared to swim.
2. Start with a few easy lengths, resting between them.
3. Build the distance gradually across sessions rather than within one.

Tips:

• The picture shows front crawl. Which stroke suits you depends on which joint was operated on, and your care team can say which to begin with.
• The water carries most of your weight, so a session can feel easier than it was - judge it by how you feel the next day.
• Walking in chest-deep water is a gentler place to start than swimming lengths.

Commonly done as able.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

1. Set the saddle so your knee stays slightly bent at the bottom of the pedal stroke.
2. Begin with light resistance on flat ground, pedalling smooth, full circles.
3. Build the time you ride before you build the resistance or the hills.

Tips:

• Many people start on a stationary bike and move outdoors, as drawn here, once balance and confidence are back. The pedalling is the same either way.
• A saddle set too low is the usual reason a hip or knee feels cramped while riding.
• Your surgeon can say when getting onto a road bike is reasonable for you.

Commonly done as able.

Strength Training

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

1. Work the major muscle groups two or three times a week, leaving a day between sessions.
2. Use a weight you can lift with good form for the whole set - the last repetition should feel hard, not impossible.
3. Lower slowly. The controlled way down is where much of the benefit sits.
4. Add a little weight only once the current one feels comfortable.

Tips:

• The dumbbell squat shown is one example. Which exercises suit you depends on the joint you are recovering from, and your program will say.
• Breathe out on the effort rather than holding your breath.
• Muscle soreness a day or two later is expected. Pain in the joint itself while you lift is a sign to lighten the weight.

Commonly done a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Sit tall in a chair without arms, both feet flat on the floor and your back supported.
2. Hold a light weight in each hand, arms relaxed at your sides, palms turned in toward your thighs.
3. Raise both arms out to the sides until they are level with your shoulders.
4. Lower them slowly back to your sides.

Tips:

• Stay seated and supported while you're non-weight-bearing.
• Light weights are plenty — a resistance band, or no weight at all, works just as well.
• The lift stops at shoulder height.

Commonly done a few times a week.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

1. Sit tall on a chair and slide one leg forward, heel on the floor and toes up.
2. Hinge forward from the hips and reach gently toward that foot until you feel a stretch behind the thigh.
3. Hold for around 30 seconds, breathing normally, then ease back.
4. Repeat on the other side.

Tips:

• A stretch should feel like a long pull, never a pinch - and never bounce into it.
• Muscles stretch more easily when they are warm, so after a walk is a good time.
• The seated hamstring stretch drawn here is one example; your program may include stretches for other areas too.

Commonly done most days.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

1. Wait until any wound is fully healed and you have been cleared to swim.
2. Start with a few easy lengths, resting between them.
3. Build the distance gradually across sessions rather than within one.

Tips:

• The picture shows front crawl. Which stroke suits you depends on which joint was operated on, and your care team can say which to begin with.
• The water carries most of your weight, so a session can feel easier than it was - judge it by how you feel the next day.
• Walking in chest-deep water is a gentler place to start than swimming lengths.

Commonly done as able.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

1. Set the saddle so your knee stays slightly bent at the bottom of the pedal stroke.
2. Begin with light resistance on flat ground, pedalling smooth, full circles.
3. Build the time you ride before you build the resistance or the hills.

Tips:

• Many people start on a stationary bike and move outdoors, as drawn here, once balance and confidence are back. The pedalling is the same either way.
• A saddle set too low is the usual reason a hip or knee feels cramped while riding.
• Your surgeon can say when getting onto a road bike is reasonable for you.

Commonly done as able.

Balance Exercises

General balance work to steady your gait.

What it helps: Steadies your gait and sharpens your balance, helping you move with confidence.

1. Practice standing balance near support.
2. Progress as you feel steady.

Commonly done daily.

Low-Impact Recreational Activities

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

1. Choose activities that keep you moving without jarring the joint - walking, cycling and golf are three common ones.
2. Start with a short session and add time before you add intensity.
3. Spread them across the week rather than doing everything in one day.
4. Keep the effort at a level where you could still hold a conversation.

Tips:

• The picture shows three examples, not a list to work through - the best activity is the one you will keep doing.
• A little stiffness the next day is usual; a flare that lingers means the session was too long, not that the activity was wrong.
• Your surgeon or therapist can say when each activity is a reasonable one to add.

Commonly done as you like.