Disclaimer: Always follow the specific post-operative instructions provided by your surgeon. This guide provides general information only. © 2026 Better Physiotherapy Bundoora.
Total hip replacement (THR) is one of the most successful operations in modern medicine — with over 95% of patients reporting excellent pain relief and improved function. But the final outcome depends significantly on the quality of rehabilitation. Physiotherapy after hip replacement restores strength, movement, confidence, and the ability to return to the activities you love.
Hip Precautions — What They Are and Why They Matter
In the first 6–12 weeks after surgery, the hip joint is at risk of dislocation while the surrounding soft tissue heals and tightens around the new implant. Hip precautions restrict certain movements that would place the new joint in a vulnerable position.
Standard posterior approach precautions (the most common approach):
- Do not flex the hip beyond 90° (avoid low chairs, picking up from the floor)
- Do not cross your legs or ankles
- Do not rotate the hip inward (pigeon-toed position)
Anterior approach surgery typically has fewer or no precautions — your surgeon will specify what applies to you.
Rehabilitation Timeline
| Timeframe | Goals & milestones |
|---|---|
| Day 0–2 (Hospital) | Stand and walk with a frame. Begin gentle bed exercises. Maintain hip precautions. |
| Week 1–2 | Walk with crutches or frame. Manage wound and swelling. Begin hip and glute exercises within precautions. |
| Week 2–6 | Progress to one crutch or walking stick. Gradually reduce walking aid use. Begin hip abductor and extension exercises. |
| Week 6–12 | Wean off walking aids if cleared. Precautions typically lifted. Progressive gluteal strengthening. Stationary cycling. |
| Month 3–5 | Full weight-bearing strengthening. Return to walking distances, stairs, swimming, and cycling. Single-leg exercises. |
| Month 6+ | Return to golf, gardening, low-impact recreation. Ongoing strength maintenance. |
Key Rehabilitation Goals
- Gluteal strength: The gluteus medius (the muscle on the outer hip) is the most important muscle for walking normally after THR. Weakness causes a Trendelenburg gait (dropping of the pelvis on the non-operated side). Progressive gluteal strengthening is the primary focus of mid-to-late rehabilitation.
- Gait retraining: Many THR patients walk with a limp pre-operatively and need to relearn a normal walking pattern post-operatively
- Balance and proprioception: The new joint has reduced proprioceptive feedback — balance training is essential for safe function
- Functional independence: Safe negotiation of stairs, getting in and out of a car, and returning to daily activities
Prehabilitation — Before Your Surgery
Starting physiotherapy 4–6 weeks before your planned hip replacement produces measurably better post-operative outcomes. Prehabilitation builds gluteal and hip strength, improves cardiovascular fitness, teaches the exercises you will need post-operatively, and reduces the total recovery time. Contact us to arrange prehabilitation before your surgery date.
Frequently Asked Questions
What should I do before hip replacement surgery to prepare?
Prehabilitation — physiotherapy before surgery — significantly improves post-operative outcomes. Exercises targeting gluteal strength, balance, and aerobic fitness before surgery produce faster post-operative recovery, shorter hospital stays, and better final function. We recommend starting prehab 4–6 weeks before your planned surgery date.
How do I get out of a chair safely after hip replacement?
Slide forward to the edge of the chair before standing. Place your operated leg slightly forward. Use your arms to push up — do not pull on armrests. Lead with your walking aid. Your physiotherapist will teach and supervise these techniques in your first post-operative session.
Can I sleep on my side after hip replacement?
For posterior approach surgery, sleeping on your back is recommended for the first 6 weeks. Sleeping on the operated side is usually restricted. Sleeping on the non-operated side may be allowed with a pillow between the legs to prevent crossing. Your surgeon will specify restrictions for your approach.
What activities are permanently restricted after hip replacement?
Most modern implants allow return to low-impact activities including walking, cycling, swimming, golf, and gardening. High-impact activities like running and contact sports are generally not recommended. Your surgeon will advise on permanent restrictions specific to your implant and surgical approach.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora