Intertrochanteric Hip Fracture

Explanation of Diagnosis

An intertrochanteric hip fracture is a break in the upper part of the thigh bone (femur) near the hip joint, specifically between the bony prominences called the trochanters. It often happens after a fall, especially in older adults, or from a significant twisting or impact injury. Common symptoms include pain in the groin or outer hip, trouble standing or walking, and difficulty putting weight on the leg. Some people also notice swelling, bruising, or the leg may look shorter or rotated compared with the other side.

Specific Work Modifications

• Use a walker or cane exactly as instructed, and keep it with you when moving between rooms.
• Limit or avoid stairs, ladders, and high steps; if unavoidable, use a slow step-by-step approach with support.
• Set up your workstation so you can keep a neutral posture: chair at the right height, feet supported, and items within easy reach.
• Take frequent micro-breaks (for example, every 30 to 45 minutes) to change positions rather than staying in one stance too long.
• Avoid lifting, carrying, or twisting motions; ask for help with heavy tasks or use light carts.
• Wear supportive, non-slip shoes and keep walkways clear of cords, rugs, and clutter.

Specific Activity Modifications

• Avoid running, jumping, deep squats, and high-impact sports until your clinician says it’s safe.
• Do not pivot on the injured leg; turn your whole body by moving your feet instead of twisting at the hip.
• Limit time on stairs and avoid repeated stair climbing; take slower trips and hold the rail.
• Avoid bending low to pick things up; use a reacher or keep frequently used items at waist level.
• Choose low-impact activities that are approved for your weight-bearing status, such as short, supported walking.
• Stop any activity that increases hip pain sharply or causes new clicking, giving way, or worsening discomfort.

Recommended Supplements

• Vitamin D3 800–1,000 IU daily may support bone health, especially if your levels are low.
• Calcium 500–600 mg once or twice daily may help reach total daily calcium needs when diet alone is not enough.
• Protein 20–30 g per meal (or a protein supplement if you struggle to meet needs) can support healing of injured tissues.

Recommended Nutrition and Hydration

Diet Recommendations

• Aim for adequate protein at each meal (lean meats, eggs, dairy, beans, lentils, tofu) to support tissue repair.
• Include calcium-rich foods such as milk, yogurt, cheese, fortified plant milks, and leafy greens if tolerated.
• Choose a variety of colorful fruits and vegetables daily for overall micronutrients and to support healthy recovery.
• If your appetite is low, use nutrient-dense options (soups with protein, yogurt, smoothies) rather than skipping meals.

Hydration Tips

• Drink regularly through the day to keep urine pale yellow, especially if you’re less active than usual.
• If you have fluid or heart/kidney restrictions, follow your clinician’s guidance for safe daily amounts.

Home Exercise Prescription

Perform these exercises 1 to 3 times per day, unless your clinician has instructed otherwise.

1. Ankle Pumps: Sit or lie with your legs supported, and gently flex and point your toes; do 20 to 30 repetitions.
2. Glute Sets: Tighten your buttock muscles gently while keeping your hip comfortable; hold 5 to 10 seconds, repeat 10 times.
3. Seated Knee Extensions: Sit with your back supported, slowly straighten the knee as far as comfortable, then lower with control; do 10 repetitions each side if allowed.
4. Gentle Marching in Sitting: While seated, lift one knee a small, comfortable amount and place it back down; do 10 repetitions per side.
5. Assisted Weight Shifts (only if approved): Stand holding a stable support, shift weight slightly side to side without pain; do 5 to 10 gentle shifts.
6. Caution: Stop and contact your clinician if you experience sharp pain, a new inability to move the leg, dizziness, or a sudden increase in symptoms.

Helpful Books

• "Explain Pain" written by David Butler, Lorimer Moseley
• "Move Your Body, Heal Your Body" written by Ben Johnson
• "Back Mechanic" written by Stuart McGill