After a hip replacement, most people do a short set of home exercises two to three times a day, plus several short walks. In the first weeks that’s about 20 to 30 minutes of exercise a day in total, building to walks of 20 to 30 minutes by around six weeks.
The exercises are simple: ankle pumps, muscle squeezes, knee bends in bed, then standing moves for the side and back of the hip. The muscles on the SIDE of the hip matter most.
They’re what get rid of the limp.
Your surgeon’s protocol and your physio’s program come first. If they give you a different list or different limits, use theirs.
Before you start: which surgery did you have?
The exercises are mostly the same. What changes is which positions you avoid in the early weeks.
- Posterior approach (from the back): if you’ve been given hip precautions, keep the hip bent no more than a right angle, don’t let the knee cross the middle of your body, and don’t twist the leg inward. That affects how high you lift your knee and how far you lean forward
- Anterior approach (from the front): usually fewer rules. Some surgeons ask you to avoid pushing the leg far behind you with the foot turned out, so go easy on the backward leg lift early on
- Not sure? ask at your first check or look at your discharge letter. See hip replacement precautions for the full list
Weeks 0 to 2: lying and sitting
Do these two to three times a day. About 10 of each is a typical starting point.
- Ankle pumps: point your toes down, then pull them up toward you. Do them every waking hour at first. They keep blood moving in the calf
- Thigh squeezes (quad sets): lying flat, press the back of your knee into the bed and tighten the front of the thigh. Hold for about 5 seconds
- Buttock squeezes: squeeze your buttocks together and hold for about 5 seconds
- Heel slides: lying on your back, slide the heel of the operated leg toward your bottom, then straighten. Stay within your bend limit if you have posterior precautions
- Leg out to the side (lying): keep your kneecap pointing at the ceiling and slide the leg out a short way, then back to the middle. Don’t let it cross over the midline
- Sit to stand: from a firm, high chair, push up through both legs with your hands on the armrests. This counts as exercise
Lying straight leg raises bother the front of the hip in some people. Many surgeons leave them out, especially after anterior surgery. Do them only if they’re on your program.
Weeks 2 to 6: standing exercises
Stand holding a kitchen counter or a sturdy chair with both hands. Stand tall and keep your trunk still.
- Standing knee raise: lift the knee of the operated leg a little way, then lower. After posterior surgery, keep it below hip height
- Standing leg out to the side: keep your toes pointing forward and lift the leg sideways a short distance. This is the key exercise for the limp
- Standing leg behind you: keep your back straight and take the leg back a small way. Go gently here after anterior surgery
- Mini squats: bend both knees a small amount with your weight even, then straighten
- Step-ups: on the bottom stair, holding the rail, step up with the operated leg, then down. Add these once your physio agrees
- Exercise bike: often started with no resistance once you can get on and off safely and your surgeon agrees. Set the seat high so you don’t bend the hip too far
Short walks and daily exercises beat one long, heroic session.
Walking progression
- First days: walk with a frame or crutches several times a day. Heel down first, roll through the foot, push off with the toes
- Early weeks: 5 to 10 minute walks, a few times a day, on flat ground. Put the aid down at the same time as the operated leg
- Moving to one stick: when you can walk and stand for more than about 10 minutes without much of a limp. Hold the stick in the hand opposite the new hip
- Around 6 weeks and beyond: walks of 20 to 30 minutes, two to three times a day. Many people are off all aids somewhere between two and six weeks, some later
- Stairs: up with the good leg, down with the operated leg, holding the rail. See weight bearing after surgery explained for using crutches on stairs
How much pain is OK?
- Mild to moderate discomfort is fine: an ache or pulling while you exercise, around 3 to 5 out of 10, is part of recovery
- It should settle: within an hour or two after the session, and not leave you worse the next morning
- If it doesn’t settle: cut back the number of repetitions or the walking distance for a day or two, then build up again
- Sharp or catching pain: stop that exercise and mention it to your physio
- Time your painkillers: taking them as prescribed before a session often makes exercise easier in the first weeks
Weeks 6 to 12 and beyond
Once your surgeon clears you, the program usually steps up: side-lying leg lifts, bridges, balance work on one leg, longer walks and swimming once the wound has fully healed.
The side-of-hip muscles keep getting stronger for months. Keep a few of these exercises going after the formal program ends. See hip replacement recovery week by week for driving, work and sport.
The American Academy of Orthopaedic Surgeons has an illustrated hip replacement exercise guide if you want pictures of each movement.
Go to the emergency department if
- The hip suddenly clunks, gives way or you can’t put weight on it, especially if the leg looks shorter or turned
- You have chest pain or sudden shortness of breath. Call emergency services
Call your surgeon today if
- Your calf is painful, swollen or warm. See blood clot after surgery
- The wound is red, hot, spreading or leaking, or you have a fever
- Pain is getting WORSE week on week instead of slowly better
Mention it at your next review if
- You still limp after about three months
- An exercise always causes sharp pain at the front of the hip
- You’re unsure which movements your surgeon wants you to avoid
The exercises are simple and the gains are slow, so doing them every day is what makes the difference.