Hip Replacement Exercises: Complete Recovery Guide

Hip replacement surgery gives you a new hip, but exercises give you back your life. Proper rehabilitation is essential for restoring mobility, building strength, and returning to the activities you love. This guide walks you through recovery phase by phase.

Understanding Your New Hip

Surgical Approaches

Posterior approach:

• Most common historically
• Hip precautions required (6-12 weeks)
• Avoid flexion >90°, internal rotation, adduction

Anterior approach:

• Muscle-sparing
• Often fewer precautions
• Faster early recovery typical

Follow your surgeon's specific precautions.

Recovery Timeline

• Weeks 1-2: Pain management, gentle mobility
• Weeks 2-6: Restore range of motion, begin strengthening
• Weeks 6-12: Progressive strengthening, improve endurance
• Months 3-6: Return to activities
• Month 6+: Full recovery for most

Phase 1: Early Recovery (Days 1-14)

Goals

• Prevent blood clots
• Control swelling
• Maintain gentle mobility
• Begin walking with assistive device

Ankle Pumps

Start immediately after surgery:

1. Pump ankles up and down
2. 10-20 reps every hour while awake
3. Prevents blood clots
4. Improves circulation

Quad Sets

1. Lie on back
2. Tighten thigh muscle (push knee down)
3. Hold 5 seconds
4. 10 reps, several times daily

Glute Sets

1. Squeeze buttocks together
2. Hold 5 seconds
3. 10 reps, several times daily

Heel Slides

1. Lie on back
2. Slide heel toward buttocks
3. Bend knee (within precaution limits)
4. Slide back out
5. 10 reps

Short Arc Quad

1. Roll under knee (small roll)
2. Straighten knee by lifting foot
3. Hold 5 seconds
4. 10 reps

Walking

1. Use walker or crutches as instructed
2. Weight bearing as allowed
3. Short, frequent walks
4. Proper technique: device first, surgical leg, then other leg

Phase 2: Mobility Focus (Weeks 2-6)

Goals

• Improve range of motion
• Progress weight bearing
• Build basic strength
• Wean from assistive device

Standing Exercises

Standing Hip Abduction:

1. Hold support
2. Slide leg out to side
3. Keep toe forward
4. 10-15 reps

Standing Hip Extension:

1. Hold support
2. Extend leg backward
3. Don't lean forward
4. 10-15 reps

Standing Marching:

1. Hold support
2. Lift knee (within limits)
3. Alternate legs
4. 10 each leg

Seated Exercises

Seated Knee Extension:

1. Sit in chair
2. Straighten knee
3. Hold 5 seconds
4. 10-15 reps

Seated Marching:

1. Sit tall
2. Lift knee (within precautions)
3. Lower slowly
4. 10 each leg

Lying Exercises

Side-Lying Hip Abduction:

1. Lie on non-surgical side
2. Lift surgical leg toward ceiling
3. Keep knee straight
4. 10-15 reps

Supine Hip Abduction:

1. Lie on back
2. Slide leg out to side
3. Return to center
4. 10-15 reps

Walking Progression

• Increase distance gradually
• Progress from walker to cane
• Practice stairs (up with good leg, down with surgical)
• Focus on normal gait pattern

Phase 3: Strengthening (Weeks 6-12)

Goals

• Build functional strength
• Improve balance
• Progress to normal walking
• Begin more demanding activities

Progressive Strengthening

Glute Bridge:

1. Lie on back, knees bent
2. Lift hips toward ceiling
3. Squeeze glutes at top
4. 15 reps

Mini Squats:

1. Hold support
2. Shallow squat (45° max)
3. Push through heels
4. 10-15 reps

Step-Ups:

1. Use low step (4-6 inches)
2. Step up with surgical leg
3. Step down slowly
4. 10 reps, progress step height

Clamshells:

1. Side-lying, knees bent
2. Pillow between ankles
3. Lift top knee
4. 15-20 reps each side

Balance Training

Single-Leg Stance:

1. Hold support lightly
2. Balance on surgical leg
3. 10-30 seconds
4. Progress to less support

Tandem Walking:

1. Heel to toe walking
2. Along wall for safety
3. 10-20 steps

Weight Shifts:

1. Side to side
2. Front to back
3. 10 each direction

Walking Without Device

• Practice indoors first
• Focus on equal step length
• Avoid limping
• Build endurance gradually

Phase 4: Advanced Recovery (Months 3-6)

Goals

• Return to normal activities
• Build endurance
• Sport-specific training (if applicable)
• Full function

Advanced Strengthening

Single-Leg Exercises:

• Single-leg bridge
• Single-leg stance with movements
• Single-leg mini squats

Resistance Training:

• Leg press (light to moderate)
• Hip abduction machine
• Hip extension machine
• Progress weights gradually

Functional Movements:

• Squats (increasing depth)
• Lunges (when cleared)
• Step-ups (higher steps)

Cardiovascular Training

Low Impact:

• Walking (unlimited)
• Stationary cycling
• Swimming (when incision healed)
• Elliptical

Higher Impact (if cleared):

• Golf
• Doubles tennis
• Dancing
• Hiking

Activities Typically Avoided

• Running (high impact)
• Contact sports
• High-impact aerobics
• Heavy lifting (extreme loads)

Discuss specific activities with your surgeon.

Precautions Review

Posterior Approach (If Applicable)

Avoid until cleared (usually 6-12 weeks):

• Bending hip past 90°
• Crossing legs
• Turning foot/knee inward
• Low chairs/toilets (use raised seat)

Daily Life Modifications

Getting dressed:

• Use reacher or long shoehorn
• Dress surgical leg first
• Sit to dress

Sitting:

• Use firm, high chairs
• Don't cross legs
• Keep feet flat on floor

Sleeping:

• Sleep on back or non-surgical side
• Pillow between knees when side-lying
• Avoid rolling surgical leg inward

Common Concerns

Swelling

Normal for weeks to months:

• Ice: 15-20 minutes several times daily
• Elevate leg
• Compression stockings if recommended
• Movement helps reduce swelling

Pain Management

• Take medications as prescribed
• Ice after exercises
• Don't push through sharp pain
• Notify provider of increasing pain

Limping

• Common early in recovery
• Focus on equal step length
• Don't rush walking progression
• Physical therapy helps

Sample Daily Schedule

Early Recovery (Weeks 1-4)

Morning:

• Ankle pumps: 20 reps
• Quad/glute sets: 10 each
• Heel slides: 10 reps
• Walking: 5-10 minutes

Afternoon:

• Repeat exercises
• Walking: 5-10 minutes

Evening:

• Repeat exercises
• Walking: 5-10 minutes
• Ice: 20 minutes

Later Recovery (Weeks 6+)

Morning:

• Warm-up: 5 minutes
• Strengthening: 15-20 minutes
• Walking: 15-20 minutes

Afternoon:

• Walking or stationary bike: 20-30 minutes

Evening:

• Stretching: 10 minutes
• Balance exercises: 5-10 minutes

When to Call Your Doctor

Warning Signs

• Fever over 101°F
• Increasing redness, warmth, or drainage
• Severe pain not controlled by medication
• Sudden swelling in leg
• Chest pain or shortness of breath
• Signs of infection

Concerning Symptoms

• Pain significantly worsening
• Leg length feels very different
• Clicking or popping with pain
• Instability or giving way

Long-Term Maintenance

Ongoing Exercise

• Continue hip strengthening 2-3x/week
• Maintain flexibility
• Stay active
• Protect from high impact

Protecting Your Hip

• Maintain healthy weight
• Avoid falls
• Use proper body mechanics
• Follow activity guidelines

Summary

Hip replacement recovery requires patience and consistent exercise:

1. Follow precautions - Protect your new hip
2. Progress gradually - Don't rush phases
3. Exercise daily - Key to good outcomes
4. Walk regularly - Best functional exercise
5. Build strength - Especially glutes and quads
6. Be patient - Full recovery takes 6-12 months

Successful hip replacement rehabilitation restores mobility and function, allowing return to an active, pain-free life.