REHABILITATION GUIDE
Rehabilitation after hip replacement.
Total hip replacement. What to expect, stage by stage, with a printable copy to download.
This guide explains what to expect in the weeks after a total hip replacement. Everyone recovers at their own pace, and your physiotherapist will tailor the exercises to you.
At a glance
| Weight bearing | Full weight bearing from the day of surgery, using crutches or sticks for balance and comfort |
| Walking aids | Usually reduced over 2–6 weeks, as your walking becomes steady |
| Leg wedge or pillow | Not routinely used after surgery |
| Movement precautions | Your team will tell you if any specific precautions apply to you |
| Driving | Usually around 6 weeks, once you can perform an emergency stop safely |
| Work | Desk-based work often 4–6 weeks; physical work often 8–12 weeks |
| Normal daily activities | Most by around 3 months; improvement continues for up to a year |
Your recovery, stage by stage
In hospital Day 0–3
- You will usually get up and walk with the physiotherapists on the day of surgery or the next morning.
- You can put full weight through the leg unless you are told otherwise.
- Before going home you should be able to walk safely with your walking aids, manage stairs if needed, and get in and out of bed and a chair.
Early recovery Weeks 0–2
- Do your exercises 3–4 times a day, little and often.
- Walk short distances regularly through the day rather than one long walk.
- Use a firm chair with arms, and avoid very low seats while the hip is sore.
- Take pain relief regularly, especially before exercising.
Building strength Weeks 2–6
- Outpatient physiotherapy usually starts in this period.
- Gradually increase walking distance and reduce your walking aids as your balance and confidence allow.
- Progress to standing strengthening exercises, step-ups and an exercise bike when advised.
- Your wound will be reviewed and clips or stitches removed at around 10–14 days if needed.
Returning to activities Weeks 6–12
- Most people are walking without aids by this stage.
- Return to driving, work and low-impact exercise such as swimming, cycling and walking, as advised.
Longer term 3–12 months
- Strength and stamina continue to improve for up to a year.
- Low-impact activities are encouraged. Discuss higher-impact sports at your follow-up.
Early exercises
- Ankle pumps
- Point your feet up and down briskly, 10–20 times every hour while awake.
- Buttock squeezes
- Squeeze your buttock muscles together, hold 5 seconds, relax. Repeat 10 times.
- Static quads
- With the leg straight, tighten the thigh muscle to push the back of the knee down. Hold 5 seconds. Repeat 10 times.
- Heel slides
- Lying on your back, slide the heel of the operated leg towards your bottom, then straighten. Repeat 10 times.
- Leg slides out to the side
- Lying on your back with toes pointing up, slide the operated leg out to the side and back. Repeat 10 times.
- Standing exercises
- Holding a firm support: march on the spot, take the leg out to the side, and take the leg backwards, keeping your body upright. 10 of each.
Looking after yourself
- Wound care
- Keep the dressing clean and dry. Stitches or clips are usually removed at around 10–14 days. Do not soak the wound in a bath, pool or hot tub until it has fully healed.
- Swelling
- Rest with the leg raised, and use an ice pack wrapped in a towel for 15–20 minutes several times a day. Swelling can last for weeks or months and is common.
- Pain relief
- Take your pain relief regularly in the early weeks, as prescribed, particularly before exercising. Reduce it gradually as the pain settles.
- Blood clot prevention
- Follow the hospital’s advice on blood-thinning medicine and stockings. Keep moving, do your ankle exercises, and drink plenty of fluids.
When to seek urgent help
Call 999 or go to A&E if you have chest pain, sudden breathlessness or cough up blood.
Contact the hospital where you had your operation straight away (or NHS 111 out of hours) if you have:
- Pain, swelling or tenderness in the calf
- The wound becomes red, hot or increasingly painful, or leaks fluid after the first few days
- A temperature above 38°C, shivering or feeling generally unwell
- A sudden increase in pain or swelling, or you cannot put weight on the leg as advised
- New numbness, tingling, coldness or weakness in the leg or foot
Sources
This guide is based on Mr Umar’s practice and is guided by NICE and British Orthopaedic Association (BOA) guidance:
Questions about your recovery?
| Spire Regency, Macclesfield | Denise Rowbotham · 01625 507472 |
| The Alexandra, Spire Manchester, Spire Hale and Circle Cheshire | Danielle Heron · 07528 523911 |
This is general guidance. Always follow the specific instructions from your own surgical and physiotherapy team, as your programme may differ.