Bone Biopsy (Open) — Complete Exercise Program

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.

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.

Ankle Pumps

Improves circulation and helps reduce swelling.

What it helps: Keeps blood moving to reduce swelling and the risk of clots while you're less active — small, frequent, and important early on.

1. Flex your foot up, pointing your toes toward the ceiling.
2. Point your toes down, away from your body.

Tips:

• Move slowly and with control.

Commonly done as 20 repetitions, several times a day.

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.

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.

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.

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.

Progressive Walking Program

Keep building your walking distance and pace.

What it helps: Keep building your walking distance and pace — steady gains in endurance and confidence on your feet.

1. Walk on level ground at a comfortable pace, landing on the heel and rolling through the foot.
2. Add a few minutes to the walk before you add speed or hills.
3. Go a little further each week rather than a lot further in one day.

Tips:

• Turning back while you still feel good is how the distance builds.
• Supportive shoes make more difference than the route does.
• The three figures here are the same walk with a longer stride, not a faster one - an even stride matters more than pace.

Commonly done daily.

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.

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.

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.