Hip replacement surgery gives you a new joint.The exercises you do afterward give you a new life.Without consistent rehab, even the best surgical outcome can leave you stiff, weak, and afraid to move. With the right exercises, most patients are back to walking, gardening, and travelling within 3-4 months.
This guide covers the exercises physiotherapists use most often in hip replacement recovery. They're organized by phase so you know exactly what to do and when. But first — the precautions that keep your new hip safe.
Hip Precautions: The Rules That Protect Your New Joint
Your surgeon will give you specific precautions based on your surgical approach. The most common approach (posterior) requires these precautions for thefirst 6-12 weeks:
- Don't bend your hip past 90 degrees— no deep squats, no bending to tie shoes the regular way
- Don't cross your legs— keep your knees apart when sitting and sleeping
- Don't twist your body toward the surgical side— turn your whole body, not just your torso
If your surgeon used ananterior approach, your precautions may be less restrictive. Always follow your surgeon's specific instructions — they know what happened inside the joint.
Note on newer techniques:Some surgeons using the anterior or direct superior approach may not impose traditional precautions. Ask your surgeon what applies to you. The exercises below are safe for all approaches unless noted otherwise.
Week 1-2: Protecting and Activating
You'll likely leave the hospital within 1-3 days. Your goals for the first two weeks:reduce swelling, prevent blood clots, activate your muscles, and walk safely with your walker.
Ankle Pumps
Lying on your back, push your feet down and pull them up in a pumping motion. This simple exercise is your best defence against blood clots in the early days.
- Repetitions:20-30
- Frequency:Every hour while awake
Glute Sets
Lying on your back, squeeze your buttock muscles together as hard as you can. Hold for 5 seconds, then relax. Your glutes are the powerhouse of your hip — they need to wake up after surgery.
- Hold:5 seconds
- Repetitions:10-15
- Sets:3-4 times per day
Quad Sets
Lying on your back with your leg straight, tighten the thigh muscle by pressing the back of your knee into the bed. Hold 5 seconds. This works together with glute sets to stabilize your hip and knee.
- Hold:5 seconds
- Repetitions:10-15
- Sets:3-4 times per day
Heel Slides
Lying on your back, slowly slide your heel toward your buttocks, bending at the hip and knee. Stopbefore 90 degreesof hip flexion (keep your thigh below the horizontal line). Hold briefly, then slide back.
- Repetitions:10
- Sets:3
- Caution:Stay within your hip precaution angle
Supported Standing Hip Abduction
Standing with your walker, slowly slide your surgical leg out to the side about 15-20 cm, keeping your toe pointing forward. Bring it back. This activates the muscles on the outside of your hip that are essential for stable walking.
- Repetitions:10
- Sets:2-3
Week 3-6: Building Strength and Confidence
Swelling is decreasing, your incision is healing, and you're getting around the house more easily. Now it's time tobuild real strength, improve your walking pattern, and start doing more of your daily activities.
Standing Hip Flexion
Stand behind a sturdy chair, holding the back. Slowly raise your surgical knee toward your chest — butstay within the 90-degree limitif you're still in your precaution period. Hold 3 seconds, lower slowly.
- Repetitions:10
- Sets:3
Standing Hip Extension
Same starting position. Slowly move your surgical leg straight behind you, keeping your knee straight and your body upright. Don't arch your lower back. This strengthens your glutes — the most important muscle group for hip replacement patients.
- Repetitions:10
- Sets:3
- Progression:Add resistance band around ankles at week 5-6
Standing Hip Abduction (Side Raises)
Stand behind your chair. Lift your surgical leg out to the side, keeping your body straight. Don't lean away from the leg — the movement should come entirely from your hip. Lower slowly.
- Repetitions:10
- Sets:3
This exercise is critical. Weakness in the hip abductors (the muscles on the outside of your hip) causes the Trendelenburg gait — that noticeable limp where the opposite hip drops when you walk. Abduction exercises fix it.
Bridge
Lie on your back with both knees bent, feet flat on the floor, hip-width apart. Squeeze your glutes and lift your hips off the bed until your body forms a straight line from shoulders to knees. Hold 5 seconds, lower slowly.
- Repetitions:10
- Sets:3
- Progression:Single-leg bridge (after precaution period ends)
Step-Ups
Using a low step (10 cm to start), step up leading with your surgical leg. Straighten fully at the top. Step down leading with your non-surgical leg. Use the railing for support.
- Repetitions:10
- Sets:2
- Progression:Increase step height as strength improves
Week 7-12: Return to Normal Life
Your precautions may be lifting around this time (check with your surgeon). You should be walking without a cane and doing most household activities. Goals:full strength, normal walking pattern, and return to activities you enjoy.
Walking Program
- Weeks 7-8:20-30 minutes on flat surfaces
- Weeks 9-10:30 minutes, include gentle hills
- Weeks 11-12:30-45 minutes, varied terrain
Pay attention to your walking pattern. If you're still limping, it's usually glute weakness — focus on bridges and standing hip abduction.
Stationary Bike
Start with the seat high to limit hip flexion. As your range of motion improves and precautions lift, gradually lower the seat. Pedal forward and backward for 15-20 minutes.
- Frequency:Daily or every other day
- Duration:15-30 minutes
Side-Lying Hip Abduction
Lie on your non-surgical side with your legs straight. Slowly lift your surgical leg toward the ceiling, keeping your toe pointing forward (not up). Hold 3 seconds at the top. Lower slowly. This is a more challenging version of standing hip abduction.
- Repetitions:10-15
- Sets:3
Functional Training
At this stage, your exercises should mirror the activities you want to return to:
- Getting in and out of a car:Practice the pivot-and-lower technique
- Picking things up from the floor:Use a reacher or the golfer's lift (kick one leg back as you bend forward)
- Getting up from low seats:Practice sit-to-stand from progressively lower surfaces
- Stairs:Up and down without a railing
Recovery Milestones
- Week 1-2:Walking with a walker, basic exercises, hip precautions in effect
- Week 3-4:Transition to a cane, increased exercise intensity
- Week 6:Precautions may start lifting, driving resumes (check with surgeon)
- Week 8-10:Walking without a cane, most daily activities
- Week 12:Light recreational activities, no limp
- Month 4-6:Full return to activities — golf, swimming, cycling, travel
- Month 12:Maximum recovery — your hip should feel like your own
Common Mistakes in Hip Replacement Recovery
- Doing too much too soon.Pain and swelling are your body's brakes. Listen to them.
- Skipping glute exercises.Your glutes are the key to a normal walking pattern. Bridges and abduction are non-negotiable.
- Sitting too much.Prolonged sitting tightens the hip flexors and slows recovery. Get up and move every 30-45 minutes.
- Ignoring the non-surgical side.Both legs need to stay strong. Don't neglect the good leg.
- Stopping exercises too early.Recovery continues for 6-12 months. The exercises evolve, but they don't stop at week 6.
When to Work With a Physiotherapist
Hip replacement recovery is one of the areas where physiotherapy makes the biggest measurable difference. Studies show that supervised rehab leads to better walking ability, faster return to activities, and higher satisfaction with the surgery.
Consider in-home physiotherapy if:
- You live alone and need support with safe exercise progression
- You're still limping after week 6-8
- Your range of motion feels stuck
- You want to return to a specific activity (golf, hiking, tennis)
- You're nervous about pushing your hip and want professional reassurance
At Haven at Home, our physiotherapists specialize in post-surgical rehab and come to your home across Toronto, Scarborough, North York, Etobicoke, and Oakville. We bring all the equipment — you just need to show up in your living room.
Ready to recover right?Call416-795-0373to book your in-home hip replacement physiotherapy assessment.