Overview

Hip replacement (total hip arthroplasty) rehabilitation starts the day of surgery — you will stand and often walk within hours. The first weeks focus on protecting the new joint and restoring a normal walking pattern; the following months rebuild strength and stamina.

This guide is general education. Your surgeon's protocol — including hip precautions, weight-bearing rules and exercise doses — always takes priority.

Who This Guide Is For

This is for anyone recovering from total hip replacement, usually after advanced hip osteoarthritis. If you have not had surgery, see the hip osteoarthritis guide instead.

Hip Precautions

Your surgeon will give you specific position restrictions — usually for the first 6–12 weeks. Common ones include:

Do not cross your legs at the knees
Do not bring the knee higher than the hip (depending on the surgical approach)
Avoid twisting the hip or turning the foot sharply inward or outward
Sleep with a pillow between your knees
Use a raised seat and avoid low chairs

These protect the new joint while the surrounding tissues heal. Follow them exactly and ask if you are unsure.

Phase 1: The First Days (Day 0–2)

Goals: protect the joint, start moving, prevent complications.

Ankle pumps: 10 every hour while awake
Gluteal sets: squeeze the buttock, hold 5 seconds, repeat 10 times
Quadriceps sets: tighten the front thigh, hold 5 seconds
Stand and walk with a walker as directed
Do deep-breathing exercises

Phase 2: Early Recovery (Weeks 1–6)

Goals: improve walking pattern, restore range, begin gentle strength.

Walk several times a day with a walker, then progress to a cane
Knee lifts in a chair: lift the knee gently, staying within hip precautions — 2 sets of 10
Standing hip abduction: take the leg out to the side, keeping the pelvis level — 2 sets of 10
Heel slides: bend the knee while lying or sitting — 2 sets of 10
Continue ankle pumps and gluteal sets daily

Phase 3: Rebuilding Strength (Months 2–3)

Goals: walk without aids, climb stairs confidently, rebuild gluteal strength.

Clamshells once cleared — 2 sets of 10–12 per side
Hip hinges and glute bridges as comfort allows — 2 sets of 8–10
Sit-to-stand from a raised surface, progressing to a normal chair — 2 sets of 8
Single-leg balance near a support — 3 holds of 20–30 seconds
Stationary cycling with a raised seat once cleared

Phase 4: Stamina and Return to Activity (Months 3–6+)

Goals: return to daily life and low-impact recreation.

Progress walking distance, then pace
Continue cycling, swimming and water exercise
Add progressive resistance to leg and gluteal exercises
Return to golf, hiking and other low-impact activity with clearance; avoid high-impact and contact sports unless your surgeon approves

What Exercise Should Feel Like

Expect muscle effort and some soreness, especially in the glutes and thigh. Mild soreness that settles within a day is normal. Sharp groin pain, a hip that feels unstable, or swelling that climbs is a signal to reduce load and check in with your team.

Common Mistakes

Forgetting hip precautions once pain settles — the first weeks matter
Doing too much too fast and driving up swelling
Limping instead of walking with support until the pattern improves
Skipping the daily exercise because the hip "feels fine"

When to See Someone Urgently

Contact your care team for a red or leaking wound, fever, severe calf pain or swelling, sudden shortness of breath, or a hip that feels out of place or very painful. Contact your physiotherapist if your walking pattern is not improving or pain is climbing.

Questions to Ask Your Clinician

Which hip precautions apply to me, and for how long?
When can I drive, return to work and sleep on the operated side?
Which exercises should I prioritize, and how often?
What activity is safe at 6 weeks, 3 months and 6 months?

References

AAOS OrthoInfo. "Total Hip Replacement Exercise Guide." https://orthoinfo.aaos.org/en/recovery/total-hip-replacement-exercise-guide/
AAOS OrthoInfo. "Activities After Total Hip Replacement." https://orthoinfo.aaos.org/en/recovery/activities-after-hip-replacement/

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. If you have severe pain, visible deformity, numbness, loss of function, or symptoms that are getting worse, seek medical care promptly. Always follow your surgeon's specific protocol and hip precautions after surgery.

Hip Replacement Rehabilitation Guide