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physical therapy after a hip replacement

Physical Therapy after a Hip Replacement

by Athletico30 Comments

Hip replacements are one of the most commonly performed orthopedic surgeries. Having been performed since 1960, the surgical technique and prosthesis used have been perfected to allow the patient optimal recovery of functioning with less pain. Having the surgery is only half the battle when it comes to the new joint. Physical therapy is the other important aspect in a full and successful recovery.

Following a hip replacement, physical therapy will help to restore the joint motion and strength. Initially therapy begins in the hospital the day after your surgery. The therapist will teach you how to properly move around in bed, get out of bed, get into the shower and car, go up and down a step, and walk with crutches or a walker. There may be some simple exercises you can perform in the bed to help prevent blood clots such as tightening your thighs, buttocks, and moving your ankle.

Following a hip replacement, some patients may do a short stay in a rehab facility for additional therapy before they go home. This usually depends on the age of the patient, functioning when they leave the hospital, additional care from family members at home, and what their home life environment is like (for example, lots of stairs). Some patients may go home after the hospital and have a therapist come to their home. Once the patient is comfortable and strong enough to leave the house, they can begin outpatient therapy.

Outpatient physical therapy will continue to progress the exercises that you began in home therapy. Outpatient facilities offer more options for the patient, such as exercise equipment, and allows them to rehabilitate in a real life setting alongside others that may be recovering from a similar surgery. The focus will be on increasing the range of motion in the new joint as well as strengthening the muscles surrounding the hip. Balance exercises will also be performed to help decrease the risk of falling. Ice or heat may be used in therapy. Heat may be used to warm up a tight muscle and ice may be used after the exercises to reduce swelling and soreness. Your physical therapist will keep in mind any personal goals that you may have, such as returning to golf, to ensure that you perform specific exercises to help you reach that goal.

Following a hip replacement, there are some important considerations that your physical therapist will help you to follow to decrease your risk for dislocating your new hip. If you have the traditional hip replacement from a posterior approach, meaning the incision is along the back of the hip, there are certain motions to avoid. These include not bending the hip past a 90 degree angle, not crossing your leg over the midline of your body (such as crossing your legs), and not allowing the hip to be rotated inward. Some things you can do to follow these precautions are: put a pillow between your knees, use a raised toilet seat, avoid sitting in too low a seat, avoid bending down to tie your shoe, and always make sure your knee caps are pointed forward or slightly out, never inward. Make sure to speak to your doctor or therapist to know what your precautions are since they may be different with certain surgical techniques.

Even though hip replacements are very successful surgeries, the dedication of the patient and the physical therapist will be the key to gaining your most optimal functioning so that you can start enjoying life pain free again.

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  1. Nick Kyros

    Good write up on hip replacement. I have had both my hips replaced and did my therapy at Athetico in Arlington Hts. Thanks to the PT team there, I couldn’t be better.

  2. David Wojick

    I had my hip replaced back in 2008. I saw Eileen Polewski in the Glenview Athletico office. She did a wonderful job getting me back to where I wanted. When people ask how long it took to rehab my hip, I tell tell them it depends upon what you want to accomplish and how hard you want to work. A person can be functional within a year. However, if you want to be athletic, it will take a bit more.

    I am doing everything I want to: playing golf and tennis, doing Cross-Fit, lifting weights, hiking,

    Thanks Eileen.

  3. Randy Steinmeyer

    It’s also important to get strengthen the muscles in and around the hip prior to surgery. I did a long stint at Athletico Clybourn with Monica prior to surgery and it made a huge difference post surgery. It will make rehabilitation easier and quicker.

  4. Marie Fields

    Doctor has said I will eventually have to have hip replacement surgery …. I am 77 years old and would like to know what can be done to reduce the pain without taking medication …. I’m currently taking a series of exercises at Athletico

  5. Liz Hoobchaak

    It is great to hear your comments about your positive experiences with therapy after your surgery. The hard work does pay off in the end. In response to what can be done to minimize pain without medication, strengthening your hip muscles as best as you can tolerate will help to keep your hip strong and stable. Although it may be hard if you are experiencing pain, keeping your hip moving with simple range of motion and flexibility exercises will also help. Since you are in therapy already, talk to your therapist about this and see if they can devise a simple home program that you can perform everyday to help keep your hip moble and strong.

  6. Daniel Carrillo

    Thank you all, I learned alot from you people and the web site, I had surgery on April 29 2013 and complications but with exercises menioned, I hope to recover!

  7. robin hardy

    I had very successful hip replacement on August 20, 2013. I’ve been doing all the exercises and following therapists and book. I feel fine, and now, on November 15, can I book a massage?

  8. treasie craven

    I fell down my deck stairs , it had fifteen stairs and I fell head first,damaged my left knee and hurt my back. that was in 2006 and today I am in still severe chronic pain I had knee surgery but my back damaged the l4 and l5 disc in my back, when I went for a 2nd op, the dr said my hip is also have degenerative disc disease and a cyst on the femor head. I need help and am so tired of hurting and living in pain taking all this medication. I/m only 45 and my life stopped i’m in a wheelchair and I hate it .I am looking for a skilled physcian that can help me I will drive wherever to stop this pain even if it ‘s in another state. Please Help me with my search,

  9. Sarah Clough

    Hi Treasie!

    Thank you for your post! I would be happy to help you in your search. I know some great physicians in the area and have connections with some other great physicians across the country. I am going to send you an email now to follow up with you personally.

  10. james

    I wish i knew how important physical therapy was when i got my hip done. I would of pushed my doctor to get me some therapy. I really feel that the reason my hip has not been as successful is because i didn’t have therapy since i was told i was young and would bounce back. now i have to have it re replaced since it is loose. not 100 percent it is because of not having therapy but who knows. it never really seemed to do good.

    only reason i am posting this is to say please push your doctors to give you therapy even if they feel you don’t need it.

  11. Julene

    Since starting out patient Physical therapy 10 weeks from surgery, 3 sessions ago, my hip feels worse. Tremendously painful now. I faithfully did my in home therapy, walking, and stair climbing and was getting better each day. Was walking fast with no limp for 45 minutes last week. Now after three PT exercise sessions, I can hardly walk for the pain in the low back and surgery side of pelvis; The hip extensors and related muscles to my new hip joint. The side leg lifts were fine when I did them in my yoga practice therapy but in PT they seem to have caused injury using more resistance. I’m scared now to do the exercises. Just want to be able to walk, ride bicycle and swim and practice and teach yoga. Should l push through the pain and use a cane again to walk? I don’t think so. I wonder if I should ice and rest a few days. This is what I want to do for the pain. Also so I can work on Monday. I have been icing since my surgery on May 30. Any advice?

  12. rodriquez grambeau


    It’s been awhile since your post but since my THR surgery was on Aug 27, 2014 my responses may have been a bit premature at that point.

    I am four weeks out from my surgery. About where you were in your post. I hope you used your intuition and cut back on the PT sessions or at least the intensity. Only you can evaluate how your body feels. A good PT can be a wealth of information and a great “cheer leader” but you need to call the shots! You always should have veto power over anything you are doing to your body. Additionally, you should communicate fully your feelings both physical and mental to your PT person. I am doing my own PT guided by my surgeon’s instructions. I add more if it feels doable evaluate and either stay the same or decrease an exercise based on MY bodies response. I walk 2 to 3 miles day on soft ground. Do multiple exercises for mobility, balance and slow strength gains. I ride a stationary bike daily. That’s just what works for me. Everyone is different but if you have had a THR we are similar in that regard. Also, this is no different than any athletic training you have done in the past. You only gain when you are resting! after stressing your body with an increase in activity. So, if you are hurting…listen up! Your body is talking to you. If you are feeling better and doing even a little more…listen up! Your body is telling you that you are on the road to improvement. So, REST when you need it and SLOWLY increase and improve. If your are better every day, why get greedy? Just get better every day. And, of course if you are getting worse…STOP what is making you regress! OK, the rambling is over but just remember to listen to your body! No one else can hear it talking like you can!!
    “I am bouncing back….” – Robert Cray Band

  13. Susan

    I have a couple of questions, ready soon for the other hip to be replaced, thank you.

    I may have to have the hip done while my home is under rehab. So I’m not thrilled with a PT or nurse coming in to see me. Is it acceptable for a disciplined person to do PT on their own at home (with directions provided) until they can get out of the house for PT? Same question for a nurse to check wound, required to check patient at home? Or ok for patient to monitor it themselves? Plan on anterior, front method.

    Anterior is supposed to be faster to bounce back from, true? My R hip is being done, I think this may make it harder to get into the drivers seat car? What would be an average time post surg someone w/ an anterior R THR could expect to be able to drive? Any longer than the Left hip? I’m trying to determine how long I’ll be stuck at home.

  14. Bill

    Had r hip surgery,rehabed for 3 wks, released from rehab to home & referral to outpatient rehab.After seeing Dr. and getting paperwork to contact rehab of my choice the thought hit me….I wasn’t able to walk unassisted in rehab…I couldn’t stand without falling, Vertigo dizziness standing & sitting. This thought came After…tearing my car seat trying to have wheelchair put in car….How do I get back & forth to therapy when I can’t even stand good? what are drs thinking?

  15. Elizabeth Garry

    My mother had a hip replacement three weeks ago. She is 78 years old and doing great . However today was her first outpatient therapy and now five hours later has shooting pain down the side of her leg for the very first time. Up until today she had virtually no pain. Can anyone explain if this is a common occurrence or not?

  16. ellen

    My friend just had HR surgery in a Mexico City hospital after an accident broker her hip.
    Her doctor told her to wait 6 weeks to begin p.t., altho my friend wants to start soon.
    This is very different advice; most American doctors start physical therapy almost immediately after surgery.
    Maybe my friend has a special situation, I don’t know.
    wonder if anyone knows if this is a different concept in Mexico than here re p.t. after HR. thanks.

  17. Kathie P

    I am 42 years old and had THR on the left January 7/15 and then on the right May 27/15 due to end-stage osteoarthritis. I started exercises in hospital the day after each surgery and continued them daily when I was discharged 3 days post-op. I am now going to the gym 3-4 days a week doing the bike or elliptical. On alternate days, I do the prescribed at-home strength and flexibility exercises from the physiotherapist. I have virtually no limp and feel great that I have started to return to my normal life….pain free! I had both of my surgeries done in Toronto, Canada and they have given me my life back!

  18. Janice Adcock

    My drs. asst. told me today that I so nor have to take P.T. after my THR in two weeks. He said I can just walk at home nd I will be fine. I never heard this before. Is that a true statement to tell a patient?

  19. Olivia Lennon

    I am scheduled for a hip replacement on 9/8 was told that my surgery will take 1 hour, I will stay in the hospital oven night, release the next day and NO physical therapy by the doctor. A number of other people said this is incorrect that their family members had PT for weeks, either at home or in a rehab. I’m confused.

  20. LKDH

    Good article about therapy and what NOT to do in movements. Very helpful!!

    Remarks for Thought:
    I had both hips replaced within 8 weeks. The first hip healed nicely and I did not have any significant therapy, as I was in good shape physically prior to surgery by swimming daily. I am 64.

    For the 2nd hip, the surgeon thought the second hip (now 2 months old) should have therapy (think it was a typical protocol issue rather than real therapy need by me) as I was water walking (cardio) and doing water isometrics 40 minutes 6-days a week. I went in for an “evaluation” by a physical therapist and they had me performing exercises that were outside my surgeon’s scope so that NOW when I walk, my hip makes a popping sensation. Oh, great, it is so upsetting!! I think I was injured by this over-the-top PT person.
    Why do physical therapists feel compelled to hurt you physically even if you have shown an ability to heal yourself without pain?
    Why are they taught that it is good to push the client to excel past the area of just practical healing when a track record of natural healing with strength has been demonstrated??

    I am so sad about this therapist (with 20+ years} thinking they MUST push past the dotted line of common sense rather than allowing a person (with a proven track record of healing) to heal at a similar pace as with the first hip replacement. First hip is strong, no pain, and no noise!

    My laymen advice:
    Listen to your body…use caution and do not think that a therapist is always right in their exercises and their self-appointed pace. If it really hurts it may NOT be healing or healthy for you!! You can say NO!

    Some therapists (despite their years) may be power hungry and do not realize the damage they can do by being overly zealous! They tout their years to intimidate you rather than allowing you to use common sense with pain. There is a difference between pain and discomfort.

    Sidebar of Caution:
    Not everyone can self-pace. If you are a physically weak/frail person prior to surgery, or lack motivation for self training and healing, then by all means get a “coach” yet physical therapists may fail to see that being a coach is NOT the same as a drill sergeant. PT does not have to be a Boot Camp!!

    Acquiring a good range of motion and healing therapy is not always a “feel the burn” format in every situation. That is old school. You do not have to hurt yourself to heal and recover from surgery. Good luck with your recovery!

  21. Joyce Turner

    I had surgery Oct 12 2015 (mini posterier) went home next day had first pt session oct 16 did easy muscle stretches I was doing great walking with walker but could walk with out one I had no restrictions. Second pt visit i had a different therapis, t exercises were resistance exercises, and leg lifts from flat position, and an exercise bike thing that i did for 5 minutes left feeling good by that night I cold hardly walk next day was no better after sitting then standing up I could not put any pressure on my leg what so ever than after about 1-2 minutes i could and then could walk leg was more stiff as well. next day was back to pt again I told him what i was experiencing and he said we were going to back off those exercises and jsut do thigh strengthing and not work on hip so it could rest. He also iced it and said for me ice it at home as well. He though it was just to much to soon since it still was less than 2 weeks since my operation. Is this ok or should I alert my surgeon. I am very disappointed as I was doing so well and was so pleased not the pain and back to not being able to walk and actually for the first 10 steps or so its actually worse that before surgery but just since the pt sessions started.

  22. Tim McDermott

    Had both hips replaced in ’01, never had any PT. I have been very active over the past 15 years with zero limitations and zero issues. I’m not against PT, just telling you how it was for me.

  23. don stephensen

    Just had my r hip done last week going to pt for the second time today I’m doing exercises at home and really don’t use the walker too much.I do laps outside to keep moving only 47 this sucks,I think I thrashed around too much when I was younger.when I found out I was Blow Away I’m one of the best trout fisherman in so cal and wanna get back on the water good luck everyone has

  24. Dawn Joseph

    I read all remarks and not sure if they help. I suppose every case is different. Will continue to review your articles and reviews for updates. It would be nice if there were a few different types of exercise to view. A video.

  25. Vicki Little

    I had THR on left his Jan. 3, 2017. I was released the 5th to go home feeling great and doing well with Walker. I felt good. With very little pain until first home PT session on the 11th. The girl did evaluation and pushed and pulled some. I napped afterward and woke up hurting. The pain was not as severe as before surgery but definitely more than I had been having. The PT person didn’t show up Friday as scheduled. I went to my doctor and got staples removed the 17th and he said pain probably from pulled muscle. I am changing to out patient therapy. But I would tell anyone looking into THR not to wait. I wish I had it months before I did. I put it off until after the holidays and if I had known how much less I would hurt I would never have waited.

  26. Lynda

    3 wks. After right hip replacement I am doing very well and attribute it to physical therapy.If anyone says you don’t need it, do it anyway.You won’t be sorry.

  27. Sandie

    Had hip surgery 4 months ago and am feeling good ,had pt at home then pt at a rehab center,it’s very important to have exercises and the stretching ,I am 75 years young and am now glad I had the surgery, I realize I must be careful and know that watching where I walk and what weather conditions are ,are crucial, nice and easy does it and bending is not a good idea right away I use a grabber.

  28. Joy

    My father is 81 and had a posterior hip replacement 2 weeks ago. At first they said that he was to have no PT because he was just supposed to walk around. My mom advocated for him and they gave him a weeks worth which helped him learn how to walk around d with less pain. Now the PT is over and he is really struggling, not walking much and in a lot of pain. I feel that he should have more therapy. Any thoughts?

  29. Michelle Spradlin

    Hello, I’m 45 years old. My named Michelle. I just had my rt hip replacement on February 7 2022. I stays over night. The same night of surgery I was able to stand up and walk again without excruciating pain. The osteophytes spurs, the locking catching, osteoarthritis, the surprise pinch of the nerve on inner sides of my leg from groin to knee. ALL ALL, HEAR ME ALL GONE. I could do this surgery every day verses to live with the pain I was on for 6 months. I was wheelchair or bed nonamblatory transferring from wheelchair to a potty. I tell you the surgery pain is totally a different pain. But no where close to the pain before it. I cannot CAN’T WAIT UNTIL THE 16th. My left hip gets done! To you struggling to decide to do surgery. Please, please give yourself a life back. If you haven’t had the surgery it’s just not an option to live as you are. You will only regret one thing after you have this surgery..that one regret is you couldn’t do it sooner!! I am post op 2 weeks. Still bad left hip but my rt worse lot worse. Not now. I only had pt in the hospital. No staff for home pt in my county in KY. NOT enough staff I was told to accept new patients. I do my own PT. I am shaky on my feet and uneven on right till my left is done I’m 2 in taller and the surgeon tighten my muscles real tight put my butt cheek on my back. Free butt lift lol. But folks I’m going up stairs down, drove got I an out, cook dinner etcetera. My problem is my legs get weak really quickly and shake. After my left Is complete I will start swimming and walking to gain strength and speed. I just encourage any one with any reservations about surgery to trust me. It will be best decision u ever make. Do it. To one lady who commented who hasn’t had surgery…you ask what to do to ease the pain without medication. I went 6 months in excruciating pain wanting to even die at times when I got stuck I called it. Only things helped me up till the end when nothing helped. I would keep a small pillow between my thighs hold it with your legs to sit stand walk. Especially to get up or sit down. Keep the pillow there. Another thing sleeping on my worst hip the rt helped alot at night and put the pillow between your legs to do anything. Sitting up in bed pillow under the knee. Try to keep your hips straight put your feet perfectly straight when getting up and lift up evenly baring weight on both feet same time to stand. Getting in bed and out as well as the car. You keep legs with a pillow at knees an thigh level. Do not sit in upright position on soft anything. I said on hard surfaces better than anything. I probably sound a mess in the I dozed off twice typing it lol. Not proof reading it either I’m going to bed now hope any of this helps someone.

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