From Amy Gets the Answers on the St. Louis Post-Dispatch, November 14 and 21, 2005

Q: I have had a double hip replacement. I walk, but I want to know what other types of exercises I can do. I''d like to firm up and lose weight. - H.M., south St. Louis County.

A: Hip replacements don''t mean an end to exercise. You can do almost anything as long as it''s not high-impact or high-flexion, meaning it uses an extremely flexed hip position, says Dr. Robert Barrack, chief of staff of orthopedics at Barnes-Jewish Hospital.

"That means no running or jumping, but walking is a good option. So is bicycling, swimming, the elliptical, even playing golf," he says.

For cycling, he recommends you raise your seat just a bit to ease the pressure on your hips.

As for toning, Barrack says you''ll want to avoid squats and lunges, but most other lower-body lifting is OK so long as your hip isn''t in an "extreme position." All upper-body moves are acceptable, and you can do sit-ups and crunches for your abdomen.

But for overall cardio fitness and toning, your best bet is probably swimming or water exercise. "It''s low-impact and offers good conditioning ... that''s probably optimal for hip replacements," he says.

Q: I''m a 56-year-old man in relatively good shape. In the last few years, when I run or play soccer, my lower back hurts afterward. In a couple of days it goes away, especially when I stretch my lower back. How can I get those back muscles stronger? - F.R, St. Louis

A: Your lower-back muscles may not be the ones you should be concentrating on. Rather, strong abdominals help support that core area and can keep your back from ailing, says Dr. Robert Barrack, chief of staff of orthopedics at Barnes-Jewish Hospital. To that end, Barrack suggests doing abdominal strengthening moves such as sit-ups and crunches.

You may also want to try the plank position. Get in the push-up position and lower yourself onto your forearms. Hold this pose as long as you can, working up to a couple of minutes. This move strengthens your transverse abdominus, the muscle that wraps around your abs.

Barrack also suggests doing a lot of stretching before you play. "Stretch your quads and your hamstrings, too," he says. "It''s important that when you get older you stretch more."

He sometimes tells patients to take anti-inflammatory medication before strenuous activity. And he suggests using heat on the back before exercise to loosen up and ice afterward to prevent inflammation.